Does neutrophil to lymphocyte ratio in peripheral blood predict endoscopic erosive esophagitis?

Yıl 2011, Cilt: 19 Sayı: 3, - , 01.12.2011

Fehmi Ateş Serkan Yaraş Bünyamin Sarıtaş Engin Altıntaş Orhan Sezgin Gülhan Orekici

https://doi.org/10.17940/endoskopi.74849

Öz

Background/aims: Gastroesophageal reflux disease is one of the important health problems today. Endoscopy, in contrast to its high diagnostic specificity, has a sensitivity of about 50% in gastroesophageal reflux disease. Some guidelines suggest obtaining a diagnosis clinically. Neutrophil to lymphocyte ratio in peripheral blood has been demonstrated as a parameter contributing to the diagnosis and prognosis in a large group of diseases. This study was planned to search the predictive value of the neutrophil to lymphocyte ratio on erosive esophagitis, if any. Materials and Methods: Sixty patients with established gastroesophageal reflux disease who underwent diagnostic endoscopy were included in the study. The patients were categorized as erosive esophagitis and non-erosive esophagitis according to the endoscopic signs. Any differences between these two groups with respect to the neutrophil to lymphocyte ratio were investigated. Results: Of the 60 patients included in the study, 49 (81.7%) had erosive esophagitis, and 11 (81.7%) had non-erosive esophagitis endoscopically. According to the neutrophil to lymphocyte ratio, there were no differences between these two groups (1.54 and 1.96, respectively). Conclusion: It should be kept in mind that neutrophil to lymphocyte ratio may be a prognostic marker for inflammatory conditions and also for gastroesophageal reflux disease, but further studies are necessary.

Anahtar Kelimeler

Gastroesophageal reflux disease, neutrophil to lymphocyte ratio, erosive esophagitis

Kan nötrofil/lenfosit oranının eroziv özofajitle ilişkisi

Öz

Giriş ve Amaç: Gastroözofegeal reflü hastalığı, önemli güncel sağlık sorunları ndan birisidir. Endoskopinin bu hastalık için tanısal özgüllüğü yüksek olsa da duyarlılığı yaklaşık %50 civarındadır. Gastroözofegeal reflü hastalığı tanı sının klinik olarak konulabileceği kılavuzlarda belirtilmektedir. Periferik kanda nötrofil lenfosit oranının, birçok hastalıkta tanı ve prognozun belirlenmesinde katkısı olduğu gösterilmiştir. Bu çalışma, nötrofil lenfosit oranının eroziv özofajitle ilişkisini araştırmak için planlanmıştır. Gereç ve Yöntem: Gastroözofegeal reflü hastalığı tanısı konan ve endoskopik inceleme yapılan 60 hasta çalışmaya dahil edildi. Hastalar endoskopik bulgularına göre eroziv reflü hastalığı ve eroziv olmayan reflü hastalığı olarak ikiye ayrıldı. Bu iki grup arasında nötrofil/lenfosit oranı açısından farklılık araştırıldı. Bulgular: Çalışmaya alınan 60 hastanın 49'unda (%81,7) eroziv reflü hastalığı, 11'inde (%18,3) eroziv olmayan reflü hastalığı saptandı. Eroziv reflü hastalığı ile eroziv olmayan reflü hastalığı grupları arasında nötrofil lenfosit oranı açısından ayırt edici özellik saptanmadı (sırasıyla 1,54 ve 1,96). Bu durum, eroziv olmayan reflü hastalığında da endoskopik olarak tanınamayan inflamatuvar değişikliklere bağlandı. Sonuç: İnflamatuvar durumların göstergesi olarak kullanılabilen artmış nötrofil/lenfosit oranı gastroözofageal reflü hastalığında da görülebilir. Bu konuda randomize, kontrollü daha büyük katılımlı, tedaviye yanıtın da değerlendirildiği çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Gaztroözofageal reflü hastalığı, nötrofil/lenfosit oranı, özofajit

Kaynakça

• Richter JE. Severe reflux esophagitis. Gastrointest Endosc Clin North Am 1994; 4:677-98.
• Rosaida MS, Goh KL. Gastro-oesophageal reflux disease, reflux oesopha- gitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroenterol Hepatol 2004;16:495-501.
• Labenz J, Jaspersen D, Kulig M, et al. Risk factors for erosive esophagi- tis: a multivariate analysis based on the ProGERD study initiative. Am J Gastroenterol 2004;99:1652-6.
• Ang TL, Fock KM, Ng TM, et al. A comparison of the clinical, demog- raphic and psychiatric profiles among patients with erosive and non-ero- sive reflux disease in a multi-ethnic Asian country. World J Gastroente- rol 2005;11:3558-61.
• Nakamura T, Shirakawa K, Masuyama H, et al. Minimal change oesop- hagitis: a disease with characteristic differences to erosive oesophagitis. Aliment Pharmacol Ther 2005;21 (Suppl 2):19-26.
• Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology 1996;111:85-92.
• Jilma B, Blann A, Pernerstorfer T, et al. Regulation of adhesion molecu- les during human endotoxemia. No acute effects of aspirin. Am J Respir Crit Care Med 1999;159:857-63.
• Dionigi R, Dominioni L, Benevento A, et al. Effects of surgical trauma of laparoscopic vs. open cholecystectomy. Hepatogastroenterology 1994;41:471-76.
• O’Mahony JB, Palder SB, Wood JJ, et al. Depression of cellular immunity after multiple trauma in the absence of sepsis. J Trauma 1984;24:869- 75.
• Zahorec R. Ratio of neutrophil to lymphocyte counts—Rapid and simp- le parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001;102:5-14.
• Reichlin T, Socrates T, Egli P, et al. Use of myeloperoxidase for risk stra- tification in acute heart failure. Clin Chem 2010;56:944-51.
• Baldus S, Heeschen C, Meinertz T, et al. Myeloperoxidase serum levels predict risk in patients with acute coronary syndromes. Circulation 2003;108:1440-5.
• Mehta J, Dinerman J, Mehta P, et al. Neutrophil function in ischemic he- art disease. Circulation 1989;79:549-56.
• Tousoulis D, Antoniades C, Koumallos N, Stefanadis C. Proinflamma- tory cytokines in acute coronary syndromes: from bench to bedside. Cytokine Growth Factor Rev 2006;17:225-33.
• Tamhane UU, Aneja S, Montgomery D, et al. Association between admis- sion neutrophil to lymphocyte ratio and outcomes in patients with acu- te coronary syndrome. Am J Cardiol 2008;102:653-7.
• Duffy BK, Gurm HS, Rajagopal V, et al. Usefulness of an elevated neut- rophil to lymphocyte ratio in predicting long-term mortality after percu- taneous coronary intervention. Am J Cardiol 2006; 97:993-6.
• Tsujimura A, Kawamura N, Ichimura T, et al. Telomerase activity in ne- edle biopsied uterine myoma-like tumors: differential diagnosis between uterine sarcomas and leiomyomas. Int J Oncol 2002;20:361-5.
• Blake-Mortimer JS, Sephton SE, Carlson RW, et al. Cytotoxic T lymphocyte count and survival time in women with metastatic breast cancer. Breast J 2004;10:195-9.
• Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ: Neutrophil- lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg On- col 2005, 91:181-4.
• Halazun KJ, Aldoori A, Malik HZ, et al. Elevated preoperative neutrop- hil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol 2008;34:55-60.
• Halazun KJ, Hardy MA, Rana AA, et al. Negative impact of neutrophil- lymphocyte ratio on outcome after liver transplantation for hepatocellu- lar carcinoma. Ann Surg 2009;250:141-51.
• Sarraf KM, Belcher E, Raevsky E, et al. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg 2009;137:425-8.
• Ommen SR, Hodge DO, Rodeheffer RJ, et al. Predictive power of the re- lative lymphocyte concentration in patients with advanced heart failure. Circulation 1998;97:19-22.
• Acanfora D, Gheorghiade M, et al. Relative lymphocyte count: a prog- nostic indicator of mortality in elderly patients with congestive heart fa- ilure. Am Heart J 2001;142:167-73.
• Huehnergarth KV, Mozaffarian D, Sullivan MD, et al. Usefulness of rela- tive lymphocyte count as an independent predictor of death/urgent transplant in heart failure. Am J Cardiol 2005;95:1492-5.
• Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperative neutrophil- lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154:995-1002.
• Fennerty MB, Castell D, Fendrick AM, et al. The diagnosis and treatment of gastroesophageal reflux disease in the managed care environment. Arch Intern Med 1996;156:477-84.