To Evaluate the Role of Systemic Inflammation on Conjunctival Pteryigum Etiopathogenesis

Yıl 2019, Cilt: 9 Sayı: 3, 145 - 149, 30.09.2019

Hanife Tuba Akçam

https://doi.org/10.33631/duzcesbed.590992

Öz

Aim: To assess the
complete blood count parameters and blood-based systemic inflammatory markers
in patients with conjunctival pterygium.

Materials and Methods: Thirty patients with conjunctival pterygium and 31 age and sex-matched
control subjects included in the study. All patients underwent detailed
ophthalmologic examination. Pterygium was also graded in pterygium group. Serum
samples were obtained from all subjects, and neutrophil\lymphocyte ratio,
platelet\lymphocyte ratio and systemic immune-inflammation index were
calculated. It is examined whether or not there exits an association between
groups in terms of neutrophil count\percentage, lymphocyte count\percentage,
hemoglobin, red blood cell count, white blood cell count, mean platelet volume,
red cell distribution width, platelet count, neutrophil\lymphocyte ratio,
platelet\lymphocyte ratio and systemic immune-inflammation index. The
statistical assessment was performed with the assistance of Pearson’s
Chi-square test, Independent samples t-test, Mann-Whitney U test, Pearson and
Spearman correlation analysis. P<0.05 was considered statistically
significant.

Results: The
groups were similar in terms of cell counts. Although neutrophil\lymphocyte
ratio and platelet\lymphocyte ratio are slightly higher in pterygium group, this difference is not
statistically significant (respectively P=0.141, P=0.480). Systemic
immune-inflammation index was similar between groups (P=0.897). Moreover, no
statistically significant correlation found among complete blood count
parameters, neutrophil\lymphocyte ratio, platelet\lymphocyte ratio, systemic
immune-inflammation index and grade of pterygium in the pterygium group.

Conclusion: According to our study results, no evidence supporting potential
systemic inflammatory origin of pterygium was found. Further randomized studies
with larger sample size are needed to discover if there is a relationship
between these two entities.

Anahtar Kelimeler

Blood cell count, conjunctiva, inflammation, lymphocytes, neutrophils, pterygium

Konjonktival Pterjium Etyopatogenezinde Sistemik İnflamasyonun Rolünün Değerlendirilmesi

Öz

Amaç: Konjonktival
pterjiumlu hastalarda hemogram parametreleri ve kan temelli sistemik
inflamasyon belirteçlerinin düzeylerinin incelenmesidir.

Gereç ve
Yöntemler:
Çalışmaya konjonktival pterjiumu olan 30 hasta ve yaş-cinsiyet uyumlu 31
sağlıklı gönüllü dahil edildi. Tüm olgulara detaylı oftalmolojik muayene
yapıldı. Ayrıca pterjium grubundaki olgularda pterjium derecelendirilmesi
yapıldı. Tüm olgulardan serum örnekleri toplandı ve nötrofil/lenfosit oranı,
platelet/lenfosit oranı ve sistemik immün-inflamasyon indeksi hesaplandı.
Gruplar arasında nötrofil sayı-yüzdesi, lenfosit sayı-yüzdesi, hemoglobin,
eritrosit sayısı, lökosit sayısı, ortalama trombosit hacmi, eritrosit dağılım
genişliği, trombosit sayısı, nötrofil/lenfosit oranı, platelet/lenfosit oranı,
sistemik immün-inflamasyon indeksi arasında ilişki olup olmadığı incelendi.
İstatistiksel analizde Ki-kare testi, Bağımsız örneklemler t-testi,
Mann-Whitney U testi, Pearson ve Spearman korelasyon analizleri kullanıldı.
P<0.05 düzeyi istatistiksel olarak anlamlı kabul edildi.

Bulgular: Gruplar hücre
sayıları açısından benzerdi. Nötrofil/lenfosit oranı ve platelet/lenfosit oranı
pterjium grubunda hafifçe yüksek olmakla birlikte bu fark istatistiksel açıdan
anlamlı değildi (sırasıyla P=0.141, P=0.480). Sistemik immün-inflamasyon
indeksi gruplar arasında benzerdi (P=0.897). Ayrıca, pterjium grubunda
korelasyon analizinde de hemogram parametreleri, nötrofil/lenfosit oranı,
platelet/lenfosit oranı, sistemik immün-inflamasyon indeksi ve pterjium
derecesi arasında istatistiksel olarak anlamlı ilişki olmadığı görüldü.

Sonuç: Çalışmamızın
sonuçlarına göre pterjiumun sistemik inflamatuar etiyolojisini
destekleyebilecek kanıt bulunamamıştır. Bu iki antite arasında ilişki olup
olmadığını kesin olarak ortaya koyabilmek için geniş hasta popülasyonlarında
yapılacak ileri randomize çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

İnflamasyon, kan hücresi sayımı, konjonktiva, lenfositler, nötrofiller, piterjium

Kaynakça

• 1. Liu T, Liu Y, Xie L, He X, Bai J. Progress in the pathogenesis of pterygium. Curr Eye Res. 2013; 38(12): 1191-7.
• 2. Malozhen SA, Trufanov SV, Krakhmaleva DA. Pterygium: Etiology, pathogenesis, treatment. Vestn Oftalmol. 2017; 133(5): 76-83.
• 3. Di Girolamo N. Association of human papilloma virus with pterygia and ocular-surface squamous neoplasia. Eye (Lond). 2012; 26(2): 202-11.
• 4. Coroneo MT. Pterygium as an early indicator of ultraviolet insolation: A hypothesis. Br J Ophthalmol. 1993; 77(11): 734-9.
• 5. Bradley JC, Yang W, Bradley RH, Reid TW, Schwab IR. The science of pterygia. Br J Ophthalmol. 2010; 94(7): 815-20.
• 6. Fankhauser CD, Sander S, Roth L, Gross O, Eberli D, Sulser T, et al. Systemic inflammatory markers have independent prognostic value in patients with metastatic testicular germ cell tumours undergoing first-line chemotherapy. Br J Cancer. 2018 20; 118(6): 825-30.
• 7. Yao C, Zhang Z, Yao Y, Xu X, Jiang Q, Shi D. Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty: A retrospective study. J Orthop Surg Res. 2018; 13(1): 40.
• 8. Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus. Medicine (Baltimore). 2017; 96(4): e5886.
• 9. Kanski JJ. Clinical ophthalmology. A systematic approach. 6th ed. Philadelphia, PA, Pennsylvania: Butterworth- Heinemann; 2007.
• 10. Anguria P, Kitinya J, Ntuli S, Carmichael T. The role of heredity in pterygium development. Int J Ophthalmol. 2014; 7(3): 563-73.
• 11. Golu T, Mogoantă L, Streba CT, Pirici DN, Mălăescu D, Mateescu GO, et al. Pterygium: Histological and immunohistochemical aspects. Rom J Morphol Embryol. 2011; 52(1): 153-8.
• 12. Lee JK, Song YS, Ha HS, Park JH, Kim MK, Park AJ, et al. Endothelial progenitor cells in pterygium pathogenesis. Eye (Lond). 2007; 21(9): 1186-93.
• 13. Kim KW, Park SH, Kim JC. Fibroblast biology in pterygia. Exp Eye Res. 2016; 142: 32-9.
• 14. Fougère B, Boulanger E, Nourhashémi F, Guyonnet S, Cesari M. Chronic Inflammation: Accelerator of Biological Aging. J Gerontol A Biol Sci Med Sci. 2017; 72(9): 1218-25.
• 15. Reuben DB, Cheh AI, Harris TB, Ferrucci L, Rowe JW, Tracy RP, et al. Peripheral blood markers of inflammation predict mortality and functional decline in high-functioning community-dwelling older persons. J Am Geriatr Soc. 2002; 50(4): 638-44.
• 16. Briggs C. Quality counts: Ew parameters in blood cell counting. Int J Lab Hematol. 2009; 31(3): 277-97.
• 17. Pichler M, Hutterer GC, Stoeckigt C, Chromecki TF, Stojakovic T, Golbeck S, et al. Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients. Br J Cancer. 2013; 108(4): 901-7.
• 18. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008; 102(6): 653-7.
• 19. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: A systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014; 23(7): 1204-12.
• 20. Karaca EE, Özmen MC, Ekici F, Yüksel E, Türkoğlu Z. Neutrophil-to-lymphocyte ratio may predict progression in patients with keratoconus. Cornea. 2014; 33(11): 1168-73.
• 21. Ozgonul C, Sertoglu E, Mumcuoglu T, Kucukevcilioglu M. Neutrophil-to-Lymphocyte ratio and Platelet-to-Lymphocyte ratio as novel biomarkers of primary open-angle glaucoma. J Glaucoma. 2016; 25(10): e815-e820.
• 22. Ilhan N, Daglioglu MC, Ilhan O, Coskun M,Tuzcu EA, Kahraman H et al. Assessment of Neutrophil/Lymphocyte Ratio in Patients with Age-related Macular Degeneration. Ocul Immunol Inflamm. 2014; 23(4): 1-4.
• 23. Dursun A, Ozturk S, Yucel H, Ozec AV, Dursun FG, Toker MI, et al. Association of neutrophil/lymphocyte ratio and retinal vein occlusion. Eur J Ophthalmol. 2015; 25(4): 343-6.
• 24. Atilgan Ucgul C, Kosekahya P, Tekin K, Sendul SY, Caglayan M, Goker YS, et al. The Evaluation of Neutrophil-to-Lymphocyte Ratio as a Novel Marker in Patients with Pterygium. Turkiye Klinikleri J Ophthalmol. 2019. Article in press. Available from: https://www.turkiyeklinikleri.com/inpress_article/en-the-evaluation-of-neutrophil-to-lymphocyte-ratio-as-a-novel-marker-in-patients-with-pterygium-85477.html.