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Endometrium Kanserli Hastalarda Preoperatif Tam Kan Sayımının Prognostik Parametreler ve Sağkalımla İlişkisi

Yıl 2018, Cilt: 28 Sayı: 2, 63 - 68, 01.03.2018

Zeliha Esin Çelik Güler Yavaş Burcu Sanal Yılmaz Tolgay Tuyan İlhan Çağdaş Yavaş Özlem Ata Çetin Çelik

Öz

Amaç: Çalışmamızda endometriyum adenokarsinomu tanılı hastalarda preoperatif tam kan sayımı parametrelerinin çeşitli klinikopatolojik prognostik parametrelerle ve sağkalım ile ilişkisi olup olmadığını değerlendirmeyi amaçladık.Gereç ve Yöntem: Ocak 2011-Aralık 2014 tarihleri arasında fakültemizde opere edilen ve endometrial adenokarsinom tanısı alan 144 hasta çalışmaya dahil edilmiştir. Hemogram parametrelerinden absolü beyaz küre sayısı BK , absolü platelet sayısı Plt hematokrit Hct , hemoglobin Hb değerleri yanı sıra absolü nötrofil sayısının absolü lenfosit sayısına bölümü olan NLR, absolü platelet sayısının absolü lenfosit sayısına bölümü olan PLR ve absolü monosit sayısının absolü lenfosit sayısına bölümü olan MLR oranlarının; tümör çapı, tümör derecesi, FIGO evresi, serviks invazyonu, pozitif lenf nodu sayısı, lenf nodunda ekstrakapsüler yayılım, lenfovasküler invazyon LVİ , myometrial invazyon derinliği gibi prognostik parametreler ve hastalıksız ve genel sağkalım süreleri ile olan ilişkisi istatistiksel metodlarla araştırılmıştır.Bulgular: Derece 3 tümöre sahip hastalarda BK sayısının derece 1 tümörlü hastalara göre anlamlı derecede düşük olduğu görüldü p=0.04 . LVİ olan olgularda PLR p=0.018 ve MLR p=0.028 LVİ olmayan hastalara göre daha düşük idi. Düşük evre olgularda evre I-II PLR, yüksek evreli olgulara göre evre II-III daha düşük tespit edildi p=0.03 . Tedavi öncesi bakılan tam kan parametreleri ile tümör çapı, serviks invazyonu, pozitif lenf nodu sayısı, lenf nodunda ekstrakapsüler yayılım, myometrial invazyon derinliği, hastalıksız sağkalım ve genel sağkalım arasında anlamlı bir ilişki saptanmadı p>0.05 .Sonuç: Endometriyum kanserinde tedavi öncesi tam kan sayımı parametrelerinin bir arada kullanılması, hastalığın prognozu ile ilgili fikir verebilir. Çalışmamızın sonuçlarının daha uzun takip süresine ve daha geniş olgu sayısına sahip çalışmalarla desteklenmesi gereklidir

Anahtar Kelimeler

Endometrium kanseri prognoz nötrofil lenfosit oranı platelet lenfosit oranı monosit lenfosit oranı

Kaynakça

  • Ulas A, Avci N, Kos T, et al. Are neutrophil/lymphocyte ratio and platelet/lymphocyte ratio associated with prog- nosis in patients with HER2-positive early breast cancer receiving adjuvant trastuzumab? J BUON. 2015 May- Jun;20(3):714-22.
  • Coussens LM, Werb Z. Inflammation and cancer. Nature 2002;420:860-7.
  • Acmaz G, Aksoy H, Unal D et al. Are neutrophil/lymp- hocyte and platelet/lymphocyte ratios associated with en- dometrial precancerous and cancerous lesions in patients with abnormal uterine bleeding? AsianPac J Cancer Prev. 2014;15(4):1689-92.
  • Fridlender ZG1, Albelda SM. Tumor-associated neutrop- hils: friend or foe? Carcinogenesis. 2012;33(5):949-55. doi: 10.1093/carcin/bgs123.
  • Ma JP, Wang Z, Lin JW et al. Neutrophil-lymphocyte ra- tio as a prognostic factor in gastric cancer. Zhonghua Wei Chang Wai Ke ZaZhi 2011;14:944-7.
  • Keizman D, Ish-Shalom M, Huang P et al. The associati- on of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival and overall survival of patients treated with sunitinib for metastatic renal cell- carcinoma. Eur J Cancer 2012;48:202-8.
  • Schmidt H, Bastholt L, Geertsen P et al. Elevated neutrop- hil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer 2005;93:273-8.
  • Teramukai S, Kitano T, Kishida Y et al. Pretreatment neut- rophil count as an independent prognostic factor in ad- vanced non-small-celllung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer 2009;45:1950-8.
  • Unal D, Eroglu C, Kurtul N, Oguz A, Tasdemir A. Are- neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? AsianPac J Cancer Prev 2013;14:5237-42.
  • Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for Epithelial ovarian cancer. J Gynecol Oncol 2012;23:265-73.
  • Asher V, Lee J, Innamaa A, Bali A. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Transl Oncol 2011;13:499-503.
  • Feng JF, Huang Y, Chen QX. Preoperative platelet lympho- cyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol 2014;12:58.
  • At Ali. Risk factors for endometrial cancer. CeskaGynekol. 2013 Nov;78(5):448-59.
  • Uçar T, Bekar M. Türkiye’de ve dünyada jinekolojik kanser- ler. Türk Jinekolojik Onkoloji Dergisi.2010; 13(3): 55-60.
  • http://kanser.gov.tr/daire-faaliyetleri/kanser-istatistikle- ri/2106-2014.
  • Haruma T, Nakamura K, NishidaT et al.Pre-treatment neutrophil to lymphocyte ratio is a predictor of prognosis in endometrial cancer. Anticancer Res. 2015;35(1):337-43.
  • Annual Report of Oncology Committee of Japan Society of Obstetrics and Gynecology, Tokyo, Japan 2013.
  • Rochet NM, Markovic SN, Porrata LF. The role of complete blood cell count in prognosis – watch this space Oncol He- matol Rev 2012; 8: 76–82.
  • Tamussino KF, Gucer F, Reich O, et al. Pretreatment he- moglobin, platelet count, and prognosis in endometrial carcinoma, Int J Gynecol Cancer, 2001;11(3):236–40.
  • Ayhan A, Bozdag G, Taskiran C, et al. The value of preo- perative platelet count in the prediction of cervical invol- vement and poor prognostic variables in patients with en- dometrial carcinoma, Gynecol Oncol, 2006;103(3):902–5.
  • Metindir J, Bilir Dilek G, Preoperative hemoglobin and platelet count and poor prognostic factors in patients with endometrial carcinoma, J Cancer Res Clin Oncol, 2009;135(1):125–9.
  • Margolis KL, Rodabough RJ, Thomson CA, et al. Pros- pective study of leukocyte count as a predictor of inci- dent breast, colorectal, endometrial, and lung cancer and mortality in postmenopausal women, Arch Intern Med, 2007;167(17):1837–44.
  • Balkwill F, Mantovani A, Inflammation and cancer: back to Wirchow?, Lancet, 2001;357(9255):539–45.
  • Moore MM, Chua W, Charles KA, Clarke SJ, Inflammation and cancer: causes and consequences, Clin Pharmacol Ther, 2010;87(4):504–8.
  • Ural ÜM, Şehitoğlu İ, Tekin YB, Şahin FK. Neutrophil-to-l- ymphocyte and platelet-to-lymphocyte ratios in patients with endometrial hyperplasia and endometrial cancer. J. Obstet. Gynaecol. Res. 2015;41(3): 445–8.
  • Munstedt K, Kovacic M, Zygmunt M, Von Georgi R, Im- pact of hemoglobin levels before and during chemotherapy on survival of patients with ovarian cancer, Int J Oncol, 2003;23(3):837–43.
  • Shimada H, Oohira G, Okazumi S, et al. Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma, J Am Coll Surg, 2004;198(5):737–41.
  • Ikeda M, Furukawa H, Imamura H, et al, Poor prognosis associated with thrombocytosis in patients with gastric cancer, Ann Surg Oncol, 2002;9(3):287–91.
  • Cox G, Walker RA, Andi A, et al. Prognostic significance of platelet and microvessel counts in operable non-small cell lung cancer, Lung Cancer, 2000;29(3):169–77.
  • Gonzalez Barcala FJ, Garcia Prim JM, Moldes Rodriguez M, et al. Platelet count: association with prognosis in lung cancer, Med Oncol, 2010;27(2):357–62.
  • Pedersen LM, Milman N, Prognostic significance of throm- bocytosis in patients with primary lung cancer, Eur Respir J, 1996;9(9):1826–30.
  • Tomita M, Shimizu T, Hara M, et al. Prognostic impact of thrombocytosis in resectable non-small cell lung cancer, In- teract Cardiovasc Thorac Surg, 2008;7(4):613–5.
  • Zhang JW, Huang L, Xu AM. Preoperative monocyte-l- ymphocyte and neutrophil-lymphocyte but not plate- let-lymphocyte ratios are predictive of clinical outcomes in resected patients with non-metastatic Siewert type II/ III adenocarcinoma of esophagogastric junction: a pros- pective cohort study (the AMONP corhort). Oncotarget. 2017;18;8(34):57516-27.
  • Evani SJ, Prabhu RG, Gnanaruban V, Finol EA, Ramasub- ramanian AK. Monocytes mediate metastatic breast tumor cell adhesion to endothelium under flow. FASEB journal. 2013;27:3017–29.
  • Condeelis J, Pollard JW. Macrophages: obligate partners for tumor cell migration, invasion, and metastasis. Cell. 2006;124:263–6.
  • Nitta H, Terui Y, Yokoyama M et al.. Absolute peripheral monocyte count at diagnosis predicts central nervous sys- tem relapse in diffuse large B-cell lymphoma. Haematologi- ca. 2015;100:87–90.
  • Huang SH, Waldron JN, Milosevic M et al. Prognostic va- lue of pretreatment circulating neutrophils, monocytes, and lymphocytes in oropharyngeal cancer stratified by human papillomavirus status. Cancer. 2015;121:545–55.
  • Li YL, Pan YY, Jiao Y et al. Peripheral blood lymphocyte/ monocyte ratio predicts outcome for patients with diffuse large B cell lymphoma after standard first-line regimens. Annals of hematology. 2014;93:617–26.
  • Koh YW, Shin SJ, Park C et al. Absolute monocyte count predicts overall survival in mantle cell lymphomas: correla- tion with tumour-associated macrophages. Hematol Oncol. 2014;32:178–86.
  • Szkandera J, Gerger A, Liegl-Atzwanger B et al. The lymp- hocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. International journal of cancer. 2014;135:362–70.
  • Cummings M, Merone L, Keeble C et al. Preoperative neutrophil:lymphocyte and platelet:lymphocyte ratios predict endometrial cancer survival. Br J Cancer. 2015 Jul 14;113(2):311-20.

Yıl 2018, Cilt: 28 Sayı: 2, 63 - 68, 01.03.2018

Zeliha Esin Çelik Güler Yavaş Burcu Sanal Yılmaz Tolgay Tuyan İlhan Çağdaş Yavaş Özlem Ata Çetin Çelik

Öz

Objective: To evaluate the relation of preoperative complete blood count CBC parameters with prognostic parameters and survival in patients with endometrial cancer. Materials and Methods: One hundred and forty four patients operated at our faculty and diagnosed as endometrial adenocarcinoma between January 2011 and December 2014 were included the present study. The relation of the CBC parameters including white blood cell count WBC , platelet count Plt , hematocrit Hct , hemoglobin Hb , neutrophil/lymphocyte ratio NLR , platelet/lymphocyte ratio PLR , monocyte/lymphocyte ratio MLR with prognostic parameters such as tumor size, tumor grade, International Federation of Gynecologists and Obstetricians FIGO stage, cervical involvement, positive lymph nodes, extracapsular extension of lymph nodes, lympho-vascular invasion LVI , myometrial invasion depth and disease free survival and overall survival investigated statistically.Results: Patients with grade III tumors had higher WBC count than those with grade I tumors p=0,04 . PLR and MLR was significantly lower in patients with LVI than those with no invasion p=0,018 and p=0,028 respectively . FIGO stage I-II patients had lower PLR than stage III-IV patients p=0.03 . No relation was determined between pretreatment CBC parameters and tumor size, cervical involvement, positive lymph nodes, extracapsular extension of lymph nodes, myometrial invasion depth and disease free survival and overall survival p>0.05 .Conclusion: Using of multiple pretreatment CBC parameters may provide information about the outcome of endometrial cancer patients. Further studies with larger series and long term follow-up are needed to support the results of the present study

Anahtar Kelimeler

Endometrial cancer prognosis neutrophil lymphocyte ratio platelet lymphocyte ratio monocyte lymphocyte ratio

Kaynakça

  • Ulas A, Avci N, Kos T, et al. Are neutrophil/lymphocyte ratio and platelet/lymphocyte ratio associated with prog- nosis in patients with HER2-positive early breast cancer receiving adjuvant trastuzumab? J BUON. 2015 May- Jun;20(3):714-22.
  • Coussens LM, Werb Z. Inflammation and cancer. Nature 2002;420:860-7.
  • Acmaz G, Aksoy H, Unal D et al. Are neutrophil/lymp- hocyte and platelet/lymphocyte ratios associated with en- dometrial precancerous and cancerous lesions in patients with abnormal uterine bleeding? AsianPac J Cancer Prev. 2014;15(4):1689-92.
  • Fridlender ZG1, Albelda SM. Tumor-associated neutrop- hils: friend or foe? Carcinogenesis. 2012;33(5):949-55. doi: 10.1093/carcin/bgs123.
  • Ma JP, Wang Z, Lin JW et al. Neutrophil-lymphocyte ra- tio as a prognostic factor in gastric cancer. Zhonghua Wei Chang Wai Ke ZaZhi 2011;14:944-7.
  • Keizman D, Ish-Shalom M, Huang P et al. The associati- on of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival and overall survival of patients treated with sunitinib for metastatic renal cell- carcinoma. Eur J Cancer 2012;48:202-8.
  • Schmidt H, Bastholt L, Geertsen P et al. Elevated neutrop- hil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer 2005;93:273-8.
  • Teramukai S, Kitano T, Kishida Y et al. Pretreatment neut- rophil count as an independent prognostic factor in ad- vanced non-small-celllung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer 2009;45:1950-8.
  • Unal D, Eroglu C, Kurtul N, Oguz A, Tasdemir A. Are- neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? AsianPac J Cancer Prev 2013;14:5237-42.
  • Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for Epithelial ovarian cancer. J Gynecol Oncol 2012;23:265-73.
  • Asher V, Lee J, Innamaa A, Bali A. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Transl Oncol 2011;13:499-503.
  • Feng JF, Huang Y, Chen QX. Preoperative platelet lympho- cyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol 2014;12:58.
  • At Ali. Risk factors for endometrial cancer. CeskaGynekol. 2013 Nov;78(5):448-59.
  • Uçar T, Bekar M. Türkiye’de ve dünyada jinekolojik kanser- ler. Türk Jinekolojik Onkoloji Dergisi.2010; 13(3): 55-60.
  • http://kanser.gov.tr/daire-faaliyetleri/kanser-istatistikle- ri/2106-2014.
  • Haruma T, Nakamura K, NishidaT et al.Pre-treatment neutrophil to lymphocyte ratio is a predictor of prognosis in endometrial cancer. Anticancer Res. 2015;35(1):337-43.
  • Annual Report of Oncology Committee of Japan Society of Obstetrics and Gynecology, Tokyo, Japan 2013.
  • Rochet NM, Markovic SN, Porrata LF. The role of complete blood cell count in prognosis – watch this space Oncol He- matol Rev 2012; 8: 76–82.
  • Tamussino KF, Gucer F, Reich O, et al. Pretreatment he- moglobin, platelet count, and prognosis in endometrial carcinoma, Int J Gynecol Cancer, 2001;11(3):236–40.
  • Ayhan A, Bozdag G, Taskiran C, et al. The value of preo- perative platelet count in the prediction of cervical invol- vement and poor prognostic variables in patients with en- dometrial carcinoma, Gynecol Oncol, 2006;103(3):902–5.
  • Metindir J, Bilir Dilek G, Preoperative hemoglobin and platelet count and poor prognostic factors in patients with endometrial carcinoma, J Cancer Res Clin Oncol, 2009;135(1):125–9.
  • Margolis KL, Rodabough RJ, Thomson CA, et al. Pros- pective study of leukocyte count as a predictor of inci- dent breast, colorectal, endometrial, and lung cancer and mortality in postmenopausal women, Arch Intern Med, 2007;167(17):1837–44.
  • Balkwill F, Mantovani A, Inflammation and cancer: back to Wirchow?, Lancet, 2001;357(9255):539–45.
  • Moore MM, Chua W, Charles KA, Clarke SJ, Inflammation and cancer: causes and consequences, Clin Pharmacol Ther, 2010;87(4):504–8.
  • Ural ÜM, Şehitoğlu İ, Tekin YB, Şahin FK. Neutrophil-to-l- ymphocyte and platelet-to-lymphocyte ratios in patients with endometrial hyperplasia and endometrial cancer. J. Obstet. Gynaecol. Res. 2015;41(3): 445–8.
  • Munstedt K, Kovacic M, Zygmunt M, Von Georgi R, Im- pact of hemoglobin levels before and during chemotherapy on survival of patients with ovarian cancer, Int J Oncol, 2003;23(3):837–43.
  • Shimada H, Oohira G, Okazumi S, et al. Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma, J Am Coll Surg, 2004;198(5):737–41.
  • Ikeda M, Furukawa H, Imamura H, et al, Poor prognosis associated with thrombocytosis in patients with gastric cancer, Ann Surg Oncol, 2002;9(3):287–91.
  • Cox G, Walker RA, Andi A, et al. Prognostic significance of platelet and microvessel counts in operable non-small cell lung cancer, Lung Cancer, 2000;29(3):169–77.
  • Gonzalez Barcala FJ, Garcia Prim JM, Moldes Rodriguez M, et al. Platelet count: association with prognosis in lung cancer, Med Oncol, 2010;27(2):357–62.
  • Pedersen LM, Milman N, Prognostic significance of throm- bocytosis in patients with primary lung cancer, Eur Respir J, 1996;9(9):1826–30.
  • Tomita M, Shimizu T, Hara M, et al. Prognostic impact of thrombocytosis in resectable non-small cell lung cancer, In- teract Cardiovasc Thorac Surg, 2008;7(4):613–5.
  • Zhang JW, Huang L, Xu AM. Preoperative monocyte-l- ymphocyte and neutrophil-lymphocyte but not plate- let-lymphocyte ratios are predictive of clinical outcomes in resected patients with non-metastatic Siewert type II/ III adenocarcinoma of esophagogastric junction: a pros- pective cohort study (the AMONP corhort). Oncotarget. 2017;18;8(34):57516-27.
  • Evani SJ, Prabhu RG, Gnanaruban V, Finol EA, Ramasub- ramanian AK. Monocytes mediate metastatic breast tumor cell adhesion to endothelium under flow. FASEB journal. 2013;27:3017–29.
  • Condeelis J, Pollard JW. Macrophages: obligate partners for tumor cell migration, invasion, and metastasis. Cell. 2006;124:263–6.
  • Nitta H, Terui Y, Yokoyama M et al.. Absolute peripheral monocyte count at diagnosis predicts central nervous sys- tem relapse in diffuse large B-cell lymphoma. Haematologi- ca. 2015;100:87–90.
  • Huang SH, Waldron JN, Milosevic M et al. Prognostic va- lue of pretreatment circulating neutrophils, monocytes, and lymphocytes in oropharyngeal cancer stratified by human papillomavirus status. Cancer. 2015;121:545–55.
  • Li YL, Pan YY, Jiao Y et al. Peripheral blood lymphocyte/ monocyte ratio predicts outcome for patients with diffuse large B cell lymphoma after standard first-line regimens. Annals of hematology. 2014;93:617–26.
  • Koh YW, Shin SJ, Park C et al. Absolute monocyte count predicts overall survival in mantle cell lymphomas: correla- tion with tumour-associated macrophages. Hematol Oncol. 2014;32:178–86.
  • Szkandera J, Gerger A, Liegl-Atzwanger B et al. The lymp- hocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. International journal of cancer. 2014;135:362–70.
  • Cummings M, Merone L, Keeble C et al. Preoperative neutrophil:lymphocyte and platelet:lymphocyte ratios predict endometrial cancer survival. Br J Cancer. 2015 Jul 14;113(2):311-20.
Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Original Article
Yazarlar

Zeliha Esin Çelik Bu kişi benim

Güler Yavaş Bu kişi benim

Burcu Sanal Yılmaz Bu kişi benim

Tolgay Tuyan İlhan Bu kişi benim

Çağdaş Yavaş Bu kişi benim

Özlem Ata Bu kişi benim

Çetin Çelik Bu kişi benim

Yayımlanma Tarihi 1 Mart 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 28 Sayı: 2

Kaynak Göster

Vancouver Çelik ZE, Yavaş G, Yılmaz BS, İlhan TT, Yavaş Ç, Ata Ö, Çelik Ç. Endometrium Kanserli Hastalarda Preoperatif Tam Kan Sayımının Prognostik Parametreler ve Sağkalımla İlişkisi. Genel Tıp Derg. 2018;28(2):63-8.


Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.