Testis kanseri patolojisini ve prognozunu öngörmede tam kan sayımına dayalı immün parametrenin klinik değeri

Year 2024, , 210 - 216, 29.05.2024

Muhammed Fatih Şimşekoğlu , Ahmet Vural , Mustafa Macit , Fatih Yıldız , Göktuğ Kalender , Uğur Aferin , Mehmet Hamza Gültekin , Çetin Demirdağ

https://doi.org/10.21673/anadoluklin.1400323

Abstract

Amaç: Testis kanserinin (TK) yönetimi daha spesifik ve uygulanabilir biyobelirteçler gerektirir. Tam kan sayımı (TKS) bazlı inflamatuar belirteçlerin TK’da tümör patolojisini ve prognozunu tahmin etme yeteneğini belirlemeyi amaçladık.

Yöntemler: Çalışmaya Ocak 2011 ile Aralık 2022 tarihleri arasında hastanemizde testis germ hücreli tümör (TGHT) nedeniyle inguinal orşiektomisi uygulanan hastalar dahil edildi. Patolojik olarak doğrulanmış TK’lı hastaların demografik özellikleri, ameliyat öncesi tümör belirteçleri, ameliyat öncesi TKS, tümör özellikleri, patolojik sonuçlar, ameliyat sonrası takip ve hayatta kalma sonuçları dahil olmak üzere tıbbi kayıtları geriye dönük olarak toplandı. TKS bazlı inflamatuar belirteçler seminomatöz ve seminomatöz olmayan TGHT’ler arasında karşılaştırıldı. Genel sağkalım ve hastalıksız sağkalımın ön gören bağımsız prognostoik faktörleri belirlemek için Cox regresyon analizleri kullanılmıştır.

Bulgular: Ortalama takip süresi 48 (1-140) aydı. Bizim çalışmamızda 69 hastada seminomatöz TGHT (Grup 1), 66 hastada ise seminomatöz olmayan TGHT (Grup 2) vardı. Grup 1 ve 2’nin ortanca yaşları sırasıyla 35 (22-74) ve 31 (21-72) yıldı(p<0,05). Ortanca trombosit sayısı (TS) Grup 1’de 238 (136-377) 10³/mm³, Grup 2’de 260,5 (158-414) 10³/mm³ idi (p<0,05). Ortanca nötrofil sayısı (p=0,75), monosit sayısı (MS) (p=0,762), lenfosit sayısı (LS) (p=0,726), nötrofil-lenfosit oranı (p=0,128), trombosit-lenfosit oranı (p=0,201) ve lenfosit/monosit oranı (p=0,782) seminomatöz ve seminomatöz olmayan TGHT’ler İstatistiksel olarak anlamlı fark yoktu Seminom olmayan TGHT grubunda Sistemik İnflamatuvar indeks(SII) istatiksel olarak anlamlı derecede daha yüksekti(p<0,05). Çok değişkenli Cox regresyon analizi, yüksek TS ve MS değerleri ile düşük LS değerinin bağımsız olarak daha kötü genel sağkalım ile ilişkili olduğunu ortaya çıkardı.

Sonuç: Yüksek TS ve SII seviyeleri seminom dışı TGHT’lerle ilişkilidir. Ancak SII hayatta kalma sonuçlarıyla ilişkili değildir. Geri kalan parametrelerin aksine, yüksek TS ve MS ile düşük LS’nin, daha kötü genel sağkalım üzerinde bağımsız prognostik etkilere sahip olduğu bulundu.

Keywords

İnflamasyon mediyatörleri, patoloji, testis kanseri

The clinical value of complete blood count-based immun parameter in predicting testicular cancer pathology and prognosis

Abstract

Aim: The management of testicular cancer (TC) requires more specific and applicable biomarkers. We aimed to determine the ability of complete blood count (CBC) based inflammatory markers to predict tumor pathology and prognosis in TC.

Methods: Patients who underwent inguinal orchiectomy for testicular germ cell tumors (TGCTs) at our hospital between January 2011 and December 2022 were included in the study. The medical records of patients with pathologically confirmed TC, including demographics, preoperative tumor markers, preoperative CBC, tumor characteristics, pathological outcomes, postoperative follow-up, and survival outcomes, were retrospectively collected. CBC-based inflammatory markers were compared between seminomatous and non-seminomatous TGCTs. To determine the independent prognostic significance of survival, the data were analyzed and fitted to the multivariate Cox proportional risk regression model.

Results: The median follow-up was 48 (1-140) months. In our chord, 69 patients had seminomatous TGCTs (Group 1), and 66 had non-seminomatous TGCTs (Group 2). The median ages of Groups 1 and 2 were 35 (22-74) years and 31 (21-72) years(p<0,05). The median platelet count (PC) was 238 (136-377) 10³/mm³ in Group 1, and 260,5 (158-414) 10³/mm³ in Group 2 (p<0.05). The median neutrophil count (p=0.75), monocyte count (MC) (p=0.762), lymphocyte count (LC) (p=0.726), neutrophil-to-lymphocyte ratio (p=0.128), platelet-to-lymphocyte ratio (p=0.201), and lymphocyte-to-monocyte ratio (p=0.782) there was no statistically significant difference between seminomatous and non-seminomatous TGCTs. A higher median systemic immune-inflammation index (SII) was statistically significantly associated with non-seminomatous TGCTs. Multivariate Cox regression analysis revealed that high PC and MC values and a low LC value were independently correlated with worse overall survival.

Conclusions: High PC and SII levels are associated with non-seminomatous TGCTs. However, SII is not associated with survival outcomes. Unlike the remaining parameters, high PC and MC and low LC were found to have independent prognostic effects on worse overall survival.

Keywords

Inflammation mediators, pathology, testicular cancer

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