Endometriyal Kanserde Delta Nötrofil İndeksinin Öngörücü Potansiyeli: Tanı için Yeni Bir Biyobelirteç

Year 2023, , 185 - 188, 30.08.2023

Caner Kose , Büşra Körpe , Vakkas Korkmaz , Yaprak Ustun

https://doi.org/10.18678/dtfd.1295697

Abstract

Amaç: Bu çalışmanın amacı, endometriyal intraepitelyal neoplazi (EIN) tanısı almış olan kadınlarda delta nötrofil indeksi'nin (DNI) endometriyal kanser (endometrial cancer, EC) gelişimi için bir öngörücü biyobelirteç olarak potansiyelini değerlendirmektir.
Gereç ve Yöntemler: Bu retrospektif çalışmaya, 2019 ve 2022 yılları arasında EIN tanısı almış ve cerrahi geçirmiş olan 139 kadın dahil edilmiştir. Demografik veriler, tıbbi öykü ve DNI da dahil olmak üzere laboratuvar parametreleri hastaların tıbbi kayıtlarından toplanmıştır. Başka kanser türüne sahip olan hastalar, steroid kullanım öyküsü olanlar, enflamatuar, hematolojik veya otoimmün hastalığı olanlar ve eksik verisi olan hastalar çalışmadan çıkarılmıştır. Hastaların patoloji raporları incelenmiş ve hastalar nihai patoloji tanılarına göre benign (n=64), EIN (n=66) ve EC (n=39) olmak üzere üç gruba ayrılmıştır.
Bulgular: EC grubunun ortalama DNI düzeyi, EIN ve benign gruplarına göre anlamlı olarak daha yüksek bulundu (sırasıyla 4,85±2,31; 2,31±0,89 ve 1,48±1,03; p<0,001). DNI için optimal kesim değeri %82,1 sensitivite ve %73,8 spesifite ile %2,75 olarak belirlendi. DNI düzeyi >%2,75 olmanın 11,56 kat (95% GA: 4,59-29,09; p<0,001) artmış EC riski ile ilişkili olduğu bulundu. Sigara içmek ve postmenopozal durum da EC için bağımsız risk faktörleri olarak belirlendi. Sigara içen hastalarda 4,13 kat (95% GA: 1,54-11,01; p=0,005) ve postmenopozal durumda ise 2,8 kat (95% CI: 1,87-9,04; p=0,034) daha fazla EC riski vardı.
Sonuç: Bu çalışmanın sonuçları DNI'nin EC riskini öngörmede kullanılabilir bir biyobelirteç olabileceğini öne sürmektedir. Sonuçlar ayrıca sigara içmenin ve menopoz sonrası durumun da EC için bağımsız risk faktörleri olduğunu doğrulamaktadır.

Keywords

Biyobelirteç, Endometriyal Kanser, Endometriyal hiperplazi

Predictive Role of Delta Neutrophil Index in Endometrial Cancer: A Promising Biomarker for Diagnosis

Abstract

Aim: This study aimed to explore the potential of delta neutrophil index (DNI) as a predictive biomarker for the development of endometrial cancer (EC) in women with endometrial intraepithelial neoplasia (EIN).
Material and Methods: This retrospective study included 139 women diagnosed with EIN who underwent surgery between 2019 and 2022. Demographic data, medical history, and laboratory parameters, including DNI, were collected from the patients' medical records. Patients with other types of cancer, a history of steroid use, inflammatory, hematologic, or autoimmune diseases, or missing data were excluded. The patients' pathology reports were reviewed, and patients were divided into three groups by the final pathological diagnosis, benign (n=64), EIN (n=66), and EC (n=39).
Results: The mean DNI level of the EC group was found to be significantly higher than the EIN and benign groups (4.85±2.31, 2.31±0.89, 1.48±1.03, p<0.001, respectively). The optimal cut-off value of DNI was determined as 2.75% with 82.1% sensitivity and 73.8% specificity. DNI levels >2.75% were found to be associated with an 11.56-fold (95% CI: 4-59-29.09, p<0.001) increased risk of EC. Smoking and postmenopausal status were also identified as independent risk factors for EC. Patients with smoking had a 4.13-fold (95% CI: 1.54-11.01, p=0.005), and postmenopausal status had a 2.8-fold (95% CI: 1.87-9.04, p=0.034) increased risk of EC.
Conclusion: The results of this study suggest that DNI may be a useful biomarker for predicting the risk of EC. The results also confirm that smoking and postmenopausal status are independent risk factors for EC.

Keywords

Biomarker, Endometrial cancer, Endometrial hyperplasia

References

• Hecht JL, Ince TA, Baak JP, Baker HE, Ogden MW, Mutter GL. Prediction of endometrial carcinoma by subjective endometrial intraepithelial neoplasia diagnosis. Mod Pathol. 2005;18(3):324-30.
• Weiderpass E, Antoine J, Bray FI, Oh JK, Arbyn M. Trends in corpus uteri cancer mortality in member states of the European Union. Eur J Cancer. 2014;50(9):1675-84.
• Baak JP, Mutter GL, Robboy S, van Diest PJ, Uyterlinde AM, Orbo A, et al. The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 World Health Organization classification system. Cancer. 2005;103(11):2304-12.
• Auclair MH, Yong PJ, Salvador S, Thurston J, Colgan TTJ, Sebastianelli A. Guideline No. 390-classification and management of endometrial hyperplasia. J Obstet Gynaecol Can. 2019;41(12):1789-800.
• Weis SM, Cheresh DA. Tumor angiogenesis: molecular pathways and therapeutic targets. Nat Med. 2011;17(11):1359-70.
• Shiao SL, Ganesan AP, Rugo HS, Coussens LM. Immune microenvironments in solid tumors: new targets for therapy. Genes Dev. 2011;25(24):2559-72.
• Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883-99.
• Kratz A, Maloum K, O'Malley C, Zini G, Rocco V, Zelmanovic D, et al. Enumeration of nucleated red blood cells with the ADVIA 2120 Hematology System: an International Multicenter Clinical Trial. Lab Hematol. 2006;12(2):63-70.
• Nahm CH, Choi JW, Lee J. Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis. Ann Clin Lab Sci. 2008;38(3):241-6.
• Bhansaly P, Mehta S, Sharma N, Gupta E, Mehta S, Gupta S. Evaluation of immature granulocyte count as the earliest biomarker for sepsis. Indian J Crit Care Med. 2022;26(2):216-23.
• Güler Ö, Bozan MB, Alkan Baylan F, Öter S. The utility of immature granulocyte count and percentage on the prediction of acute appendicitis in the suspected acute appendicitis according to the Alvarado scoring system: a retrospective cohort study. Turk J Gastroenterol. 2022;33(10):891-8.
• Shin IS, Gong SC, An S, Kim K. Delta neutrophil index as a prognostic factor for mortality in patients with Fournier's gangrene. Int J Urol. 2022;29(11):1287-93.
• Bozan MB, Yazar FM, Kale IT, Topuz S, Bozan AA, Boran OF. Immature granulocyte count and delta neutrophil index as new predictive factors for axillary metastasis of breast cancer. J Coll Physicians Surg Pak. 2022;32(2):220-5.
• Barut O, Demirkol MK, Kucukdurmaz F, Sahinkanat T, Resim S. Pre-treatment delta neutrophil index as a predictive factor in renal cell carcinoma. J Coll Physicians Surg Pak. 2021;31(2):156-61.
• Lou Y, Liao J, Shan W, Xu Z, Chen X, Guan J. Menopausal status combined with serum CA125 level significantly predicted concurrent endometrial cancer in women diagnosed with atypical endometrial hyperplasia before Surgery †. Diagnostics (Basel). 2021;12(1):6.
• Antonsen SL, Ulrich L, Høgdall C. Patients with atypical hyperplasia of the endometrium should be treated in oncological centers. Gynecol Oncol. 2012;125(1):124-8.
• Endogenous Hormones and Breast Cancer Collaborative Group; Key TJ, Appleby PN, Reeves GK, Roddam AW, Helzlsouer KJ, Alberg AJ, et al. Circulating sex hormones and breast cancer risk factors in postmenopausal women: reanalysis of 13 studies. Br J Cancer. 2011;105(5):709-22.
• Dimou N, Omiyale W, Biessy C, Viallon V, Kaaks R, O'Mara TA, et al. Cigarette smoking and endometrial cancer risk: observational and Mendelian randomization analyses. Cancer Epidemiol Biomarkers Prev. 2022;31(9):1839-48.
• Bozan MB, Yazar FM, Kale İT, Yüzbaşıoğlu MF, Boran ÖF, Azak Bozan A. Delta neutrophil index and neutrophil-to-lymphocyte ratio in the differentiation of thyroid malignancy and nodular goiter. World J Surg. 2021;45(2):507-14.