Opere Edilebilir Kolorektal Kanserli Hastalarda Kısa Dönem Mortalitenin Belirlenmesinde Preoperatif Nötrofil-Lenfosit Oranı ve Trombosit-Lenfosit Oranının Öngörü Değerlerinin Değerlendirilmesi

Year 2022, Volume: 24 Issue: 1, 67 - 73, 30.04.2022

Dursun Burak Özdemir Ahmet Karayiğit Hayrettin Dizen Bülent Ünal

https://doi.org/10.18678/dtfd.1063922

Abstract

Amaç: Bu çalışmanın amacı, opere edilebilir kolorektal kanserli (KRK) hastalarda ameliyat öncesi nötrofil-lenfosit oranı (NLO) ve trombosit-lenfosit oranının (PLO) kısa dönem mortalitede prediktif bir değeri olup olmadığının araştırılmasıdır.
Gereç ve Yöntemler: 2016 ve 2021 yılları arasında bir üniversite hastanesinde KRK ameliyatı yapılmış olan toplam 231 (93 kadın, 138 erkek) hasta geriye dönük olarak incelendi. Ortanca yaş 68 (aralık, 26-92) yıl ve takip süresi ortancası 25 (aralık, 0-54) ay idi. Hastalar sağ kalım durumuna göre, sağ kalanlar (n=175) ve takipler sırasında ölenler (n=56) olmak üzere gruplandırıldı.
Bulgular: NLO için eğri altında kalan alan 0,649 (%95 GA: 0,563-0,734; p=0,001), optimal kesim noktası 5,08 idi ve bu kesim noktası mortaliteyi tahmin etmek için %48,2 duyarlılık ve %81,7 özgüllük gösterdi. PLO için eğri altında kalan alan 0,635 (%95 GA: 0,546-0,723; p=0,002), optimal kesim noktası 221,5 idi ve bu kesim noktası %55,4 duyarlılık ve %72,0 özgüllük gösterdi. Çoklu regresyon analizi, nüks (OR: 60,910; 95% GA: 9,807-378,319; p=<0,001), sızıntı (OR: 10,724; 95% GA: 1,281-89,747; p=0,029), yüksek NLO (OR: 3,735; 95% GA: 1,602-8,711; p=0,002) ve yaşın artışının (OR: 1,136; 95% GA: 1,081-1,193; p<0,001) bağımsız olarak mortalite ile ilişkili olduğunu ortaya koydu.
Sonuç: Bu çalışmanın sonuçları, cerrahi rezeksiyon uygulanan KRK hastalarında preoperatif NLO ve PLO'nun kısa dönem mortaliteyi öngörmede etkili olduğunu gösteren çalışmaları desteklemektedir. Bu konuda daha fazla çalışma gerekli olmasına rağmen, bu biyobelirteçler, KRK hastalarında prognostik araçlar olarak gelecekte kullanım açısından umut vericidir.

Keywords

Kolorektal kanser, mortalite, nötrofil lenfosit oranı, trombosit lenfosit oranı

Evaluation of Preoperative Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for their Predictive Value in Determining Short-Term Mortality in Patients with Operable Colorectal Cancers

Abstract

Aim: The aim of this study was to investigate whether preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have a predictive value in short-term mortality in patients with operable colorectal cancer (CRC).
Material and Methods: A total of 231 (93 female, 138 male) patients with operated CRC between 2016 and 2021 in a university hospital were analyzed retrospectively. Median age was 68 (range, 26-92) years and patients had been under follow-up for a median of 25 (range, 0-54) months. Patients were grouped with respect to survival, those who were alive (n=175) and those who died (n=56) during the follow-up.
Results: The area under the curve for NLR was 0.649 (95% CI: 0.563-0.734, p=0.001), optimal cut-off was 5.08 and demonstrated a sensitivity of 48.2% and a specificity of 81.7% for predicting mortality. The area under the curve for PLR was 0.635 (95% CI: 0.546-0.723, p=0.002), optimal cut-off was 221.5 and demonstrated a sensitivity of 55.4% and a specificity of 72.0%. Multiple regression analysis revealed that recurrence (OR: 60.910, 95% CI: 9.807-378.319, p=<0.001), leakage (OR: 10.724, 95% CI: 1.281-89.747, p=0.029), high NLR (OR: 3.735, 95% CI: 1.602-8.711, p=0.002) and higher age (OR: 1.136, 95% CI: 1.081-1.193, p<0.001) were independently associated with mortality.
Conclusion: The results of this study support studies indicating that preoperative NLR and PLR are effective in predicting short-term mortality in CRC patients who underwent surgical resection. Although further studies are necessary, these biomarkers are promising for future use as prognostic tools in CRC patients.

Keywords

Colorectal cancer, mortality, neutrophil lymphocyte ratio, platelet lymphocyte ratio

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