Different Expression of Erythrocyte Sedimentation Rate and C-reactive Protein in Papillary Thyroid Carcinoma and Nodular Goiter.

Background: Inflammation is the seventh hallmark of cancer. Growing evidence indicated inflammation was linked to the progression and prognosis of many malignancies. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as two inflammation markers, reported frequently in the incidence and progress of solid cancers, but little research has concerned these markers in thyroid disease. In this study, the expression of ESR and CRP both in papillary thyroid carcinoma (PTC) and nodular goiter was investigated.

Methods: 512 patients were recruited to this study, including 341 PTC and 171 nodular goiters. Serum ESR and CRP were tested before operation. The clinical pathological factors such as gender, age, body mass index (BMI), tumor size, extrathyroidal extension, capsule invasion, lymphatic metastasis, distant metastasis, and other thyroid specific markers were subanalyzed in the PTC group.

Results: In patients with PTC, the mean level of ESR was 14.24 ± 11.35 mm/h, which was lower than patients with nodular goiter (16.90 ± 12.00 mm/h, p = 0.006). Meanwhile the mean level of CRP was 1.81 ± 3.51 mg/L in PTC, which was lower than patients with nodular goiter (2.09 ± 3.34 mg/L, p = 0.008). Subanalysis in PTC showed that the ESR/CRP level has no significant difference concerning the capsule invasion, extrathyroidal extension, T grades, lymphatic metastasis, distant metastasis, Tumor Nodulus Metastases (TNM) and tumor sizes (p > 0.05). Pearson's correlation analysis showed a positive correlation between ESR and CRP (r = 0.416, p = 0.000), ESR and Tg (r = 0.140, p = 0.002), CRP and Tg (r = 0.187, p = 0.000). The results of multivariate logistic analysis showed that gender and age were the independent risk factors of ESR, meanwhile age and BMI were the independent risk factors of CRP.

Conclusions: The present study demonstrated a different expression of ESR and CRP between PTC and nodular goiter. Even though the difference in absolute figures between them was very small, it could help clinicians to distinguish the difference between nodular goiter and PTC to some extent. ESR/CRP may have potential value in distinguishing thyroid benign disease from malignant tumors. However, ESR and CRP had no effect on the progress of PTC. They may not have potential value currently in PTC staging and predicting prognosis.