INFLAMMATORY HEMATOLOGICAL MARKERS IN PREDICTION OF CERVICAL INTRAEPITHELIAL NEOPLASIA RECURRENCE IN NEGATIVE SURGICAL MARGINS

Öz

Amaç: Bu çalışmada konizasyon cerrahisi sonrası servikal intraepitelyal neoplazi nüksünü öngörmede preoperatif nötrofil-lenfosit oranının prediktif değerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Bu retrospektif çalışmada, servikal intraepitelyal neoplazi patolojisine bağlı konizasyon uygulanan hastalar analiz edildi. Çalışmaya konizasyon materyalinde servikal intraepitelyal neoplazi saptanıp cerrahi sınırları negatif olan ve klinik veri tabanımızda en az 12 aylık takip süresi olan hastalar dahil edildi. Hastaların demografik, klinik, patolojik verileri ve preoperatif tam kan sayımı bulguları tıbbi dosyalardan çıkarıldı. Bulgular: Toplamda mevcut olan 105 hasta iki gruba ayrıldı: rekürrens grubu (n = 30) ve kontrol grubu (n = 85). İki grup arasında servikal intraepitelyal neoplazi patoloji dereceleri açısından istatistiksel olarak anlamlı fark yoktu. Rekürrens grubunda kontrol grubuna göre endoservikal küretaj pozitif sonuç sayısı artmıştı. Nüks grubunda rekürrenssiz sağkalım ortalaması 10.5 aydı. İki grup arasında preoperatif nötrofil-lenfosit oranı ve diğer hematolojik parametreler açısından istatistiksel olarak anlamlı fark yoktu. Lojistik regresyon analizinde rekürrens tahmininde sadece endoservikal küretaj pozitifliği belirleyici idi (p = 0.002,% 95 CI 0.084-0.365). Sonuç: Preoperatif nötrofil-lenfosit oranı ve diğer inflamatuar belirteçler cerrahi sınırları temiz konizasyon olgularında nüksü öngörmede etkin bulunmamıştır. Pozitif postkonizasyon endoservikal küretaj, eksizyonel tedaviden sonra nüks ile ilişkili tek prognostik faktör olarak bulunmuştur.

Anahtar Kelimeler

• servikal intraepiteliyal neoplazi
• konizasyon
• endoservikal küretaj
• nötrofil lenfosit oranı

INFLAMMATORY HEMATOLOGICAL MARKERS IN PREDICTION OF CERVICAL INTRAEPITHELIAL NEOPLASIA RECURRENCE IN NEGATIVE SURGICAL MARGINS

Öz

Objective: This study aimed to evaluate the predictive value of preoperative neutrophil-lymphocyte ratio in cervical intraepithelial neoplasia recurrence after conization surgery. Materials and Methods: In this retrospective study, patients who underwent conization due to cervical intraepithelial neoplasia were analyzed. Inclusion criteria were cervical intraepithelial neoplasia in the conization specimen with negative surgical margins and at least 12 months follow-up period at our clinical database. Demographic, clinical, pathological data, and preoperative complete blood count findings of the patients were extracted from medical files. Results: There were a total of 105 patients divided into two groups: the recurrence group (n = 30) and the control group (n =85). There were no statistically significant differences between the two groups in terms of cervical intraepithelial neoplasia pathology grades. There was statistically increased number of postconization endocervical positive results in the recurrence group. In the recurrence group, the mean of recurrence free survival was 10.5 months. There were no statistically significant differences in the preoperative neutrophil-lymphocyte ratio and in other hematologic parameters between the groups. In logistic regression analysis, only endocervical curettage positivity was predictive in estimating recurrence (p=0.002, %95 CI 0.084-0.365). Conclusion: Preoperative neutrophil-lymphocyte ratio and other inflammatory markers were not predictive of recurrence after conization in women with negative surgical margins. Positive postconization endocervical curettage was the only prognostic factor associated with recurrence after excisional therapy.

Anahtar Kelimeler

• cervical intraepithelial neoplasia
• conization
• endocervical curettage
• neutrophil-lymphocyte ratio
• recurrence

Kaynakça

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