MEME KANSERİNDE NÖTROFİL-LENFOSİT ORANI VE PLATELET-LENFOSİT ORANININ KLİNİKOPATOLOJİK ÖNEMİNİN ARAŞTIRILMASI

Yıl 2022, Cilt: 55 Sayı: 3, 170 - 174, 31.12.2022

Ahmet Karayiğit , Dursun Burak Özdemir , Hayrettin Dizen , Murat Ulaş , Bülent Ünal

https://doi.org/10.20492/aeahtd.1024537

Öz

AMAÇ: Bu çalışmada meme kanseri nedeniyle ameliyat edilen kadınların nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR) değerlerinin klinikopatolojik özellikleri ile ilişkili olup olmadığını incelemeyi amaçladık.
GEREÇ VE YÖNTEM: Merkezimizde Ocak 2015 – Aralık 2020 tarihleri arasında meme kanseri nedeniyle ameliyat edilen 463 kadının verileri retrospektif olarak incelendi. Yaş, menopoz durumu, hematolojik değerler, tümörlerin histopatolojik özellikleri, hormon reseptörlerinin varlığı, cerrahi ve biyopsi teknikleri detaylı olarak değerlendirildi. Ameliyat öncesi rutin olarak yapılan hemogram testi sonuçları kullanılarak NLR ve PLR değerleri hesaplandı ve tüm parametrelerle ilişkileri analiz edildi.
BULGULAR: Olguların yaşları 23 ile 88 arasında değişmekte olup, ortalama 53.57 ± 12.66 idi. Olguların %62,42'sini postmenopozal kadınlar oluşturmaktaydı. Yaş ve PLR arasında negatif yönde bir korelasyon bulundu, ancak ne PLR ne de NLR menopoz durumu ile ilişkili değildi. Yüksek NLR değerinin yüksek N evresi, yüksek TNM evresi, yüksek metastatik lenf nodu sayısı ve ekstrakapsüler invazyon varlığı ile ilişkili olduğu bulundu (p<0.05). Ayrıca yüksek PLR değeri düşük yaş, progesteron reseptör negatifliği ve yüksek TNM evresi ile ilişkiliydi (P<0.05).
SONUÇ: Çalışmamızın sonuçları, yüksek NLR ve PLR değerlerinin kötü prognostik faktörlerle ilişkili olabileceğini göstermiştir. Bu değerlerin hasta takibinde kolaylıkla kullanılabilir olması ve hızlı sonuç vermesi nedeniyle klinisyen ve cerrahlar için faydalı olacağı düşünülmüştür.

Anahtar Kelimeler

Meme kanseri, prognoz, nötrofil-lenfosit oranı, trombosit-lenfosit oranı

INVESTIGATION OF THE CLINICOPATHOLOGICAL IMPORTANCE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO AND PLATELET-TO-LYMPHOCYTE RATIO IN BREAST CANCER

Öz

AIM: In this study, we aimed to examine whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) values of women operated for breast cancer were associated with their clinicopathological features.
MATERIAL AND METHOD: The data of 463 females who were operated for breast cancer in our center between Januray 2015 and December 2020 were analyzed retrospectively. Age, menopausal status, hematological values, histopathological features of tumors, presence of hormone receptors, surgical and biopsy techniques were evaluated in detail. NLR and PLR values were calculated using the results of routinely performed hemogram test before the operation, and their relationships with all parameters were analyzed.
RESULTS: The ages of the cases ranged from 23 to 88 years, with a mean of 53.57 ± 12.66. Postmenopausal women constituted 62.42% of the cases. A negative correlation was found between age and PLR, but neither PLR nor NLR were found to be associated with menopause status. It was found that high NLR value was associated with high N stage, high TNM stage, high number of metastatic lymph nodes and presence of extracapsular invasion (p<0.05). In addition, high PLR values were associated with low age, progesterone receptor negativity and high TNM stage (P<0.05).
CONCLUSION: The results of our study showed that high NLR and PLR values may be associated with poor prognostic factors. It was thought that it would be beneficial for clinicians and surgeons to consider these values in the follow-up of patients due to ease of use and swift results.

Anahtar Kelimeler

Breast cancer, prognosis, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio

Kaynakça

• 1) Guthrie GJ, Charles KA, Roxburgh CS, et al. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013; 88: 218-30.
• 2) Ünal Ö, Korukluoğlu B. Meme Kanseri Tanısı Almış Kadınlarda Sosyodemografik Veriler, Meme Yoğunluğu, Menopoz Varlığı ile Hematolojik ve Histopatolojik Bulguların Değerlendirilmesi. Ankara Med J. 2020; 20: 23-34.
• 3) Krenn-Pilko S, Langsenlehner U, Thurner E, et al. The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients. Br J Cancer. 2014; 110: 2524-30.
• 4) Dizen H, Karayiğit A, Özdemir DB, et al. Erkek meme kanserinde klinik ve patolojik özellikler: 16 olgunun incelenmesi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2021; 54: 321-5.
• 5) Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000; 100: 57-70.
• 6) Park HS, Kim S, Kim K, et al. Pattern of distant recurrence according to the molecular subtypes in Korean women with breast cancer. World J Surg Oncol. 2012; 10: 4.
• 7) Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106: dju124.
• 8) Özdemir BA, Koçer HB, Balci M. Mide Kanserli Hastalarda Preoperatif Serum CRP ve IL-6’nın Prognostik Değeri. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53: 188-95.
• 9) Salman E, Salman RB, Tufan A. İnflamasyonun Önemli Bir Düzenleyicisi Olarak S100 Proteinleri. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53: 41-5.
• 10) McMillan DC. The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev. 2013; 39: 534-40.
• 11) Walsh SR, Cook EJ, Goulder F, et al. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005; 91: 181-4.
• 12) Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001; 357: 539-45.
• 13) Liu C, Huang Z, Wang Q, et al. Usefulness of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in hormone-receptor-negative breast cancer. Onco Targets Ther. 2016; 9: 4653-60.
• 14) Kocaöz S, Korukluoğlu B, Parlak Ö, et al. Comparison of clinicopathological features and treatments between pre- and postmenopausal female breast cancer patients - a retrospective study. Prz Menopauzalny. 2019; 18: 68-73.
• 15) Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011; 144: 646-74.
• 16) Koh CH, Bhoo-Pathy N, Ng KL, et al. Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. Br J Cancer. 2015; 113: 150-8.
• 17) Heldin CH, Westermark B. Platelet-derived growth factor: mechanism of action and possible in vivo function. Cell Regul. 1990; 1: 555-66.
• 18) Asano Y, Kashiwagi S, Onoda N, et al. Platelet-Lymphocyte Ratio as a Useful Predictor of the Therapeutic Effect of Neoadjuvant Chemotherapy in Breast Cancer. PLoS One. 2016; 11: e0153459.
• 19) Gooden MJ, de Bock GH, Leffers N, et al. The prognostic influence of tumour-infiltrating lymphocytes in cancer: a systematic review with meta-analysis. Br J Cancer. 2011; 105: 93-103.
• 20) Shimada H, Takiguchi N, Kainuma O, et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010; 13: 170-6.
• 21) Chiang SF, Hung HY, Tang R, et al. Can neutrophil-to-lymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively? Int J Colorectal Dis. 2012; 27: 1347-57.
• 22) Stotz M, Gerger A, Eisner F, et al. Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. Br J Cancer. 2013; 109: 416-21.
• 23) Xu AM, Huang L, Zhu L, et al. Significance of peripheral neutrophil-lymphocyte ratio among gastric cancer patients and construction of a treatment-predictive model: a study based on 1131 cases. Am J Cancer Res. 2014; 4: 189-95.
• 24) Azab B, Bhatt VR, Phookan J, et al. Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol. 2012; 19: 217-24.
• 25) Cihan YB, Arslan A, Cetindag MF, et al. Lack of prognostic value of blood parameters in patients receiving adjuvant radiotherapy for breast cancer. Asian Pac J Cancer Prev. 2014; 15: 4225-31.