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Akciğer Tüberkülozu Tanılı Hastalarda Sistemik İnflamasyon Göstergelerinin Klinik Değerlendirilmesi

Yıl 2026, Cilt: 16 Sayı: 1, 37 - 47, 15.03.2026
https://doi.org/10.16919/bozoktip.1834930
https://izlik.org/JA58YA76JR

Öz

Amaç: Bu çalışma, akciğer tüberkülozu tanısı alan bireylerde sistemik inflamasyon göstergelerinin (C-reaktif protein (CRP), Eritrosit Sedimentasyon Hızı (ESR), hematolojik oranlar ve hemogram parametreleri) düzeylerini inceleyerek, bu belirteçlerin hastalığın tanı, aktivite ve tedaviye yanıt süreçlerindeki klinik değerini değerlendirmeyi amaçlamaktadır. Ayrıca, bu biyobelirteçlerin yaş, cinsiyet ve komorbiditelerle ilişkisi analiz edilmiştir.
Gereç ve Yöntem: 2025-GOKAEK-2517 etik kurul onayıyla, 2023–2025 yılları arasında Yozgat Bozok ve Sivas Cumhuriyet Üniversiteleri’nde akciğer tüberkülozu tanılı 18–80 yaş arası bireylerin hastane kayıtları retrospektif olarak incelenmiştir. Kontrol grubunu benzer dönemde başvuran sağlıklı bireyler oluşturmuştur. Verilerden hemogram parametreleri, CRP, ESR ve sistemik immün-inflamasyon indeksi (SII) değerlendirilmiş; analizler SPSS v22.0 ile yapılmıştır.
Bulgular: Toplam 134 bireyin (67 TBC, 67 kontrol) dahil edildiği çalışmada, TBC grubunda erkek oranı %70,1, yaş ortalaması 48,76 ± 18,01 yıl idi. Komorbidite oranı %70,1 olup en sık KOAH, hipertansiyon ve koroner arter hastalığı görüldü. TBC grubunda lökosit, nötrofil, monosit, trombosit, CRP, ESR ve SII düzeyleri anlamlı derecede yüksek; hemoglobin ve lenfosit düzeyleri düşük bulundu (tümü p < 0,0001). SII değeri 2772,51 ± 4004,20 idi ancak tanısal testler ve klinik sonlanımlarla anlamlı ilişki göstermedi.
Sonuç: TBC hastalarında SII değerlerinin yüksek bulunması, bu indeksin artmış sistemik inflamasyonu yansıtan potansiyel bir biyobelirteç olabileceğini düşündürmektedir.

Etik Beyan

Yozgat Bozok Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu Karar Numarası: 2025-GOKAEK-2517_2025.10.01_649

Destekleyen Kurum

Yok

Teşekkür

Yok

Kaynakça

  • 1. World Health Organization. WHO consolidated guidelines on tuberculosis: Module 6 – tuberculosis and comorbidities. Geneva: World Health Organization; 2024.
  • 2. Goletti D, Meintjes G, Andrade BB, Zumla A, Lee SS. Insights from the 2024 WHO global tuberculosis report: more action, innovation, and investment required to achieve End-TB goals. Int J Infect Dis. 2025;150:1–5.
  • 3. Yigci D, Kayı İ, Demiroğlu YZ, Kutlu M, Kılıçaslan Z, Ergönül Ö. Tuberculosis in Türkiye: epidemiological insights and recommendations for progress. Eur J Clin Microbiol Infect Dis. 2025;44:1–10.
  • 4. Avcı E, Muharremoğlu ZD, Bozkurt ENN, Kaygusuz S. Changing epidemiology of tuberculosis and actions taken in the world and Türkiye. J Clin Pract Res. 2024;46(5):421–30.
  • 5. Kıran P, Emecen AN, Çağlayan D. Temporal trend analysis of tuberculosis in Turkey between 2005 and 2019. Mediterr J Infect Microbes Antimicrob. 2023;12:1–8.
  • 6. Leo S, Narasimhan M, Rathinam S, Banerjee A. Biomarkers in diagnosing and therapeutic monitoring of tuberculosis: a review. Ann Med. 2024;56(1):2386030.
  • 7. Gaeddert M, Glaser K, Chendi BH, Sultanli A, Koeppel L, MacLean EL, et al. Host blood protein biomarkers to screen for tuberculosis disease: a systematic review and meta-analysis. J Clin Microbiol. 2024;62(11):e0078624.
  • 8. Zimmer AJ, Lainati F, Aguilera Vasquez N, Chedid C, McGrath S, Benedetti A, et al. Biomarkers that correlate with active pulmonary tuberculosis treatment response: a systematic review and meta-analysis. J Clin Microbiol. 2022;60(2):e0185921.
  • 9. Nogueira BM, Krishnan S, Barreto-Duarte B, Araújo-Pereira M, Queiroz AT, Ellner JJ, et al. Diagnostic biomarkers for active tuberculosis: progress and challenges. EMBO Mol Med. 2022;14(12):e14088.
  • 10. Şahin F, Yıldız P. Distinctive biochemical changes in pulmonary tuberculosis and pneumonia. Arch Med Sci. 2013;9(4):656–61.
  • 11. Martins C, Gama ACDC, Valcarenghi D, Batschauer APDB. Markers of acute-phase response in the treatment of pulmonary tuberculosis. J Bras Patol Med Lab. 2014;50:428–33.
  • 12. Tiu DN, Sirajuddin Ahmed Siddiqi SMFM, Ranjan R. Hematological Changes in Pulmonary Tuberculosis: Focus on Anemia, Disease Severity, and Therapeutic Implications. Cureus. 2025;17(6):e86550.
  • 13. Fu H, Liu H, Sun W, Zhang H, Zhu H. Diagnostic value of neutrophil-to-lymphocyte ratio, fibrinogen-to-albumin ratio and red blood cell distribution width in tuberculosis with bacterial co-infection. BMC Pulm Med. 2025;25(1):134.
  • 14. Stanciu IV, Fildan AP, Thakur BR, Ilie AC, Stanga L, Oancea C, et al. Full-blood inflammatory ratios predict length of hospital stay in pulmonary tuberculosis. Medicina (Kaunas). 2025;61(7):1238.
  • 15. Zhang X, Fu H, Li J, Yan J, Huang J, Xu Z, et al. Development and validation of a predictive model using inflammatory biomarkers for active tuberculosis risk in diabetic patients. J Inflamm Res. 2025;18:4725–39.
  • 16. Lin HH, Ezzati M, Murray M. Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLoS Med. 2007;4(1):e20.
  • 17. Lee CH, Lee MC, Shu CC, Lim CS, Wang JY, Lee LN, et al. Risk factors for pulmonary tuberculosis in patients with chronic obstructive airway disease in Taiwan: a nationwide cohort study. BMC Infect Dis. 2013;13:194.
  • 18. Hossain MB, Johnston JC, Cook VJ, Sadatsafavi M, Wong H, Romanowski K, et al. Role of latent tuberculosis infection on elevated risk of cardiovascular disease: a population-based cohort study. Epidemiol Infect. 2023;151:e68.
  • 19. Chung WS, Lin CL, Hung CT, Chu YH, Sung FC, Kao CH, et al. Tuberculosis increases the subsequent risk of acute coronary syndrome. Int J Tuberc Lung Dis. 2014;18(1):79–83.
  • 20. Inghammar M, Ekbom A, Engström G, Ljungberg B, Romanus V, Löfdahl CG, et al. COPD and the risk of tuberculosis. PLoS One. 2010;5(4):e10138.
  • 21. Autentico ART, Lim BA. Characteristics and in-hospital outcomes of clinically diagnosed tuberculosis patients in a high-burden setting: A five-year retrospective analysis. Respir Med. 2025;247:108309.
  • 22. Chacko B, Chaudhry D, Peter JV, Khilnani GC, Saxena P, Sehgal IS, et al. ISCCM position statement on the approach to and management of critically ill patients with tuberculosis. Indian J Crit Care Med. 2024;28(Suppl 2):S67–S82.
  • 23. Carabalí-Isajar ML, Rodríguez-Bejarano OH, Amado T, Patarroyo MA, Izquierdo MA, Lutz JR, et al. Clinical manifestations and immune response to tuberculosis. World J Microbiol Biotechnol. 2023;39(8):206.
  • 24. Steingart KR, Henry M, Ng V, Hopewell PC, Ramsay A, Cunningham J, et al. Fluorescence versus conventional sputum smear microscopy for tuberculosis. Lancet Infect Dis. 2006;6(9):570–81.
  • 25. Zifodya JS, Kreniske JS, Schiller I, Kohli M, Dendukuri N, Schumacher SG, et al. Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis. Cochrane Database Syst Rev. 2021;2(2):CD009593.
  • 26. Sharma SK, Mohan A. Tuberculosis: from an incurable scourge to a curable disease. Indian J Med Res. 2013;137(3):455–93.
  • 27. Yaranal PJ, Umashankar T, Harish SG. Hematological profile in pulmonary tuberculosis. Int J Health Rehabil Sci. 2013;2(1):50–5.
  • 28. Kim H, Choi HG, Shin SJ. Bridging the gaps to overcome hurdles in next-generation tuberculosis vaccines. Front Immunol. 2023;14:1193058.
  • 29. Şahin F, Yazar E, Yıldız P. Prominent features of platelet indices in pulmonary tuberculosis. Multidiscip Respir Med. 2012;7(1):38.
  • 30. Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yoo CG, et al. The prevalence and evolution of anemia associated with tuberculosis. J Korean Med Sci. 2006;21(6):1028–32.
  • 31. Kang YA, Kwon SY, Yoon HI, Lee JH, Lee CT. Role of C-reactive protein and procalcitonin in differentiation of tuberculosis from bacterial pneumonia. Korean J Intern Med. 2009;24(4):337–42.
  • 32. Pang T, Wang L, Zhang J, Duan S. Association between systemic immune-inflammation index and latent tuberculosis infection. Front Med. 2025;12:1615302.
  • 33. Espinosa-Pereiro J, Alagna R, Saluzzo F, González-Moreno J, Heinrich N, Sánchez-Montalvá A, et al. Potential biomarkers for bacterial burden and treatment efficacy in tuberculosis trials. J Infect Dis. 2024;229(5):1584–95.

Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis

Yıl 2026, Cilt: 16 Sayı: 1, 37 - 47, 15.03.2026
https://doi.org/10.16919/bozoktip.1834930
https://izlik.org/JA58YA76JR

Öz

Objective: This study aimed to investigate the levels of systemic inflammation markers—including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hematological ratios, and complete blood count parameters—in individuals diagnosed with pulmonary tuberculosis (TBC). The clinical significance of these biomarkers in the diagnosis, disease activity, and treatment response was evaluated, and their associations with age, sex, and comorbidities were also analyzed.
Materials and Methods: Following ethics approval (2025-GOKAEK-2517), hospital records of patients aged 18–80 years diagnosed with pulmonary tuberculosis between 2023 and 2025 at Yozgat Bozok University and Sivas Cumhuriyet University were retrospectively reviewed. The control group consisted of healthy individuals who presented during the same period. Hemogram parameters, CRP, ESR, and the Systemic Immune-Inflammation Index (SII) were assessed, and statistical analyses were performed using SPSS v22.0.
Results: A total of 134 individuals (67 TBC and 67 controls) were included. In the TBC group, 70.1% were male, and the mean age was 48.76 ± 18.01 years. Comorbidities were present in 70.1% of patients, most commonly COPD, hypertension, and coronary artery disease. The TBC group demonstrated significantly higher leukocyte, neutrophil, monocyte, platelet, CRP, ESR, and SII levels, while hemoglobin and lymphocyte levels were significantly lower (all p < 0.0001). Although the mean SII value was elevated (2772.51 ± 4004.20), it did not show a significant association with diagnostic test results or clinical outcomes.
Conclusion: The markedly elevated SII levels in patients with pulmonary tuberculosis suggest that this index may serve as a potential biomarker reflecting increased systemic inflammation. However, its limited correlation with diagnostic and clinical endpoints indicates that it should be considered a supportive—not standalone—parameter in clinical evaluation.

Etik Beyan

Yozgat Bozok University Non-Interventional Clinical Research Ethics Committee Decision Number: 2025-GOKAEK-2517_2025.10.01_649

Destekleyen Kurum

None

Teşekkür

None

Kaynakça

  • 1. World Health Organization. WHO consolidated guidelines on tuberculosis: Module 6 – tuberculosis and comorbidities. Geneva: World Health Organization; 2024.
  • 2. Goletti D, Meintjes G, Andrade BB, Zumla A, Lee SS. Insights from the 2024 WHO global tuberculosis report: more action, innovation, and investment required to achieve End-TB goals. Int J Infect Dis. 2025;150:1–5.
  • 3. Yigci D, Kayı İ, Demiroğlu YZ, Kutlu M, Kılıçaslan Z, Ergönül Ö. Tuberculosis in Türkiye: epidemiological insights and recommendations for progress. Eur J Clin Microbiol Infect Dis. 2025;44:1–10.
  • 4. Avcı E, Muharremoğlu ZD, Bozkurt ENN, Kaygusuz S. Changing epidemiology of tuberculosis and actions taken in the world and Türkiye. J Clin Pract Res. 2024;46(5):421–30.
  • 5. Kıran P, Emecen AN, Çağlayan D. Temporal trend analysis of tuberculosis in Turkey between 2005 and 2019. Mediterr J Infect Microbes Antimicrob. 2023;12:1–8.
  • 6. Leo S, Narasimhan M, Rathinam S, Banerjee A. Biomarkers in diagnosing and therapeutic monitoring of tuberculosis: a review. Ann Med. 2024;56(1):2386030.
  • 7. Gaeddert M, Glaser K, Chendi BH, Sultanli A, Koeppel L, MacLean EL, et al. Host blood protein biomarkers to screen for tuberculosis disease: a systematic review and meta-analysis. J Clin Microbiol. 2024;62(11):e0078624.
  • 8. Zimmer AJ, Lainati F, Aguilera Vasquez N, Chedid C, McGrath S, Benedetti A, et al. Biomarkers that correlate with active pulmonary tuberculosis treatment response: a systematic review and meta-analysis. J Clin Microbiol. 2022;60(2):e0185921.
  • 9. Nogueira BM, Krishnan S, Barreto-Duarte B, Araújo-Pereira M, Queiroz AT, Ellner JJ, et al. Diagnostic biomarkers for active tuberculosis: progress and challenges. EMBO Mol Med. 2022;14(12):e14088.
  • 10. Şahin F, Yıldız P. Distinctive biochemical changes in pulmonary tuberculosis and pneumonia. Arch Med Sci. 2013;9(4):656–61.
  • 11. Martins C, Gama ACDC, Valcarenghi D, Batschauer APDB. Markers of acute-phase response in the treatment of pulmonary tuberculosis. J Bras Patol Med Lab. 2014;50:428–33.
  • 12. Tiu DN, Sirajuddin Ahmed Siddiqi SMFM, Ranjan R. Hematological Changes in Pulmonary Tuberculosis: Focus on Anemia, Disease Severity, and Therapeutic Implications. Cureus. 2025;17(6):e86550.
  • 13. Fu H, Liu H, Sun W, Zhang H, Zhu H. Diagnostic value of neutrophil-to-lymphocyte ratio, fibrinogen-to-albumin ratio and red blood cell distribution width in tuberculosis with bacterial co-infection. BMC Pulm Med. 2025;25(1):134.
  • 14. Stanciu IV, Fildan AP, Thakur BR, Ilie AC, Stanga L, Oancea C, et al. Full-blood inflammatory ratios predict length of hospital stay in pulmonary tuberculosis. Medicina (Kaunas). 2025;61(7):1238.
  • 15. Zhang X, Fu H, Li J, Yan J, Huang J, Xu Z, et al. Development and validation of a predictive model using inflammatory biomarkers for active tuberculosis risk in diabetic patients. J Inflamm Res. 2025;18:4725–39.
  • 16. Lin HH, Ezzati M, Murray M. Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLoS Med. 2007;4(1):e20.
  • 17. Lee CH, Lee MC, Shu CC, Lim CS, Wang JY, Lee LN, et al. Risk factors for pulmonary tuberculosis in patients with chronic obstructive airway disease in Taiwan: a nationwide cohort study. BMC Infect Dis. 2013;13:194.
  • 18. Hossain MB, Johnston JC, Cook VJ, Sadatsafavi M, Wong H, Romanowski K, et al. Role of latent tuberculosis infection on elevated risk of cardiovascular disease: a population-based cohort study. Epidemiol Infect. 2023;151:e68.
  • 19. Chung WS, Lin CL, Hung CT, Chu YH, Sung FC, Kao CH, et al. Tuberculosis increases the subsequent risk of acute coronary syndrome. Int J Tuberc Lung Dis. 2014;18(1):79–83.
  • 20. Inghammar M, Ekbom A, Engström G, Ljungberg B, Romanus V, Löfdahl CG, et al. COPD and the risk of tuberculosis. PLoS One. 2010;5(4):e10138.
  • 21. Autentico ART, Lim BA. Characteristics and in-hospital outcomes of clinically diagnosed tuberculosis patients in a high-burden setting: A five-year retrospective analysis. Respir Med. 2025;247:108309.
  • 22. Chacko B, Chaudhry D, Peter JV, Khilnani GC, Saxena P, Sehgal IS, et al. ISCCM position statement on the approach to and management of critically ill patients with tuberculosis. Indian J Crit Care Med. 2024;28(Suppl 2):S67–S82.
  • 23. Carabalí-Isajar ML, Rodríguez-Bejarano OH, Amado T, Patarroyo MA, Izquierdo MA, Lutz JR, et al. Clinical manifestations and immune response to tuberculosis. World J Microbiol Biotechnol. 2023;39(8):206.
  • 24. Steingart KR, Henry M, Ng V, Hopewell PC, Ramsay A, Cunningham J, et al. Fluorescence versus conventional sputum smear microscopy for tuberculosis. Lancet Infect Dis. 2006;6(9):570–81.
  • 25. Zifodya JS, Kreniske JS, Schiller I, Kohli M, Dendukuri N, Schumacher SG, et al. Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis. Cochrane Database Syst Rev. 2021;2(2):CD009593.
  • 26. Sharma SK, Mohan A. Tuberculosis: from an incurable scourge to a curable disease. Indian J Med Res. 2013;137(3):455–93.
  • 27. Yaranal PJ, Umashankar T, Harish SG. Hematological profile in pulmonary tuberculosis. Int J Health Rehabil Sci. 2013;2(1):50–5.
  • 28. Kim H, Choi HG, Shin SJ. Bridging the gaps to overcome hurdles in next-generation tuberculosis vaccines. Front Immunol. 2023;14:1193058.
  • 29. Şahin F, Yazar E, Yıldız P. Prominent features of platelet indices in pulmonary tuberculosis. Multidiscip Respir Med. 2012;7(1):38.
  • 30. Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yoo CG, et al. The prevalence and evolution of anemia associated with tuberculosis. J Korean Med Sci. 2006;21(6):1028–32.
  • 31. Kang YA, Kwon SY, Yoon HI, Lee JH, Lee CT. Role of C-reactive protein and procalcitonin in differentiation of tuberculosis from bacterial pneumonia. Korean J Intern Med. 2009;24(4):337–42.
  • 32. Pang T, Wang L, Zhang J, Duan S. Association between systemic immune-inflammation index and latent tuberculosis infection. Front Med. 2025;12:1615302.
  • 33. Espinosa-Pereiro J, Alagna R, Saluzzo F, González-Moreno J, Heinrich N, Sánchez-Montalvá A, et al. Potential biomarkers for bacterial burden and treatment efficacy in tuberculosis trials. J Infect Dis. 2024;229(5):1584–95.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Göğüs Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Ümmühan Tuğba Tümüklü 0009-0002-2998-9740

Şeyma Taştemur 0000-0002-9013-6395

Mert Üstündağ 0009-0005-3800-3762

Duygu Felek 0000-0002-7689-4552

Ömer Tamer Doğan 0000-0002-4527-7754

Zehra Seyfikli 0000-0002-6204-8224

Gönderilme Tarihi 4 Aralık 2025
Kabul Tarihi 5 Şubat 2026
Yayımlanma Tarihi 15 Mart 2026
DOI https://doi.org/10.16919/bozoktip.1834930
IZ https://izlik.org/JA58YA76JR
Yayımlandığı Sayı Yıl 2026 Cilt: 16 Sayı: 1

Kaynak Göster

APA Tümüklü, Ü. T., Taştemur, Ş., Üstündağ, M., Felek, D., Doğan, Ö. T., & Seyfikli, Z. (2026). Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis. Bozok Tıp Dergisi, 16(1), 37-47. https://doi.org/10.16919/bozoktip.1834930
AMA 1.Tümüklü ÜT, Taştemur Ş, Üstündağ M, Felek D, Doğan ÖT, Seyfikli Z. Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis. Bozok Tıp Dergisi. 2026;16(1):37-47. doi:10.16919/bozoktip.1834930
Chicago Tümüklü, Ümmühan Tuğba, Şeyma Taştemur, Mert Üstündağ, Duygu Felek, Ömer Tamer Doğan, ve Zehra Seyfikli. 2026. “Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis”. Bozok Tıp Dergisi 16 (1): 37-47. https://doi.org/10.16919/bozoktip.1834930.
EndNote Tümüklü ÜT, Taştemur Ş, Üstündağ M, Felek D, Doğan ÖT, Seyfikli Z (01 Mart 2026) Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis. Bozok Tıp Dergisi 16 1 37–47.
IEEE [1]Ü. T. Tümüklü, Ş. Taştemur, M. Üstündağ, D. Felek, Ö. T. Doğan, ve Z. Seyfikli, “Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis”, Bozok Tıp Dergisi, c. 16, sy 1, ss. 37–47, Mar. 2026, doi: 10.16919/bozoktip.1834930.
ISNAD Tümüklü, Ümmühan Tuğba - Taştemur, Şeyma - Üstündağ, Mert - Felek, Duygu - Doğan, Ömer Tamer - Seyfikli, Zehra. “Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis”. Bozok Tıp Dergisi 16/1 (01 Mart 2026): 37-47. https://doi.org/10.16919/bozoktip.1834930.
JAMA 1.Tümüklü ÜT, Taştemur Ş, Üstündağ M, Felek D, Doğan ÖT, Seyfikli Z. Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis. Bozok Tıp Dergisi. 2026;16:37–47.
MLA Tümüklü, Ümmühan Tuğba, vd. “Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis”. Bozok Tıp Dergisi, c. 16, sy 1, Mart 2026, ss. 37-47, doi:10.16919/bozoktip.1834930.
Vancouver 1.Ümmühan Tuğba Tümüklü, Şeyma Taştemur, Mert Üstündağ, Duygu Felek, Ömer Tamer Doğan, Zehra Seyfikli. Clinical Evaluation of Systemic Inflammation Markers in Patients Diagnosed with Pulmonary Tuberculosis. Bozok Tıp Dergisi. 01 Mart 2026;16(1):37-4. doi:10.16919/bozoktip.1834930
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