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Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı

Yıl 2016, Cilt: 6 Sayı: 1, 25 - 29, 19.10.2016
https://doi.org/10.16899/ctd.07462

Öz

Giriş
Ektopik gebelik tüm gebeliklerin %2'sini oluşturmakta, aynı zamanda vakaların %95'ten fazlası fallop tüplerinde lokalizedir. Bu çalışmada; tubal gebeliklerde metotreksat tedavi başarısını değerlendirmek, ve nötrofil-lenfosit oranı, trombosit-lenfosit oranı ve tubal ektopik gebelik rüptürü arasındaki ilişkiyi incelemek amaçlanmıştır.
Gereç ve Yöntem
Bu retrospektif çalışma, Gaziosmanpasa Üniversitesi, Kadın Hastalıkları ve Doğum Anabilim Dalı'nda 2012 ve 2014 yılları arasında yapılmıştır. Veriler Statistical Package for Social Sciences (SPSS) yazılım versiyonu 20.0 (SPSS Inc., Chicago, IL) ile analiz edildi. Tüm karşılaştırmalarda çift taraflı p değeri < 0.05 olarak kabul edildi.
Bulgular
Nötrofil-lenfosit oranı rüptüre olup cerrahi tedavi geçirmiş hastalarda rüptüre olmayıp metotreksat tedavisi alan hastalara göre yüksek saptandı (p = 0.009). Beraberinde, nötrofil-lenfosit oranı metotreksat tedavisine yanıt veren hastalarda yanıt vermeyenlere göre yüksek bulundu (p = 0.027). 
Sonuç
Ektopik gebelik kese çapı ve B-HCG değeri yanında, nötrofil-lenfosit oranı ve platelet-lenfosit oranı metotreksat tedavisinin başarısını öngörmede yararlı belirteçler olabilirler.

Kaynakça

  • Walker JJ. Ectopic pregnancy. Clin Obstet Gynecol 2007; 50: 89–99.
  • Della-Giustina D, Denny M. Ectopic pregnancy. Emerg Med Clin 2003; 21: 565-84.
  • Varma R, Gupta J. Tubal ectopic pregnancy. BMJ Clin Evid 2009; 1406: PMC2907783.
  • 4. Fylstra DL. Tubal pregnancy: a review of current di- agnosis and treatment. Obstet Gynecol Surv 1998; 53: 320-28.
  • Shaw JLV, Dey SK, Critchley HOD, Horn AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update 2010; 16: 432- 44.
  • Tay JI, Moore J, Walke JJ. Ectopic pregnancy. BMJ 2000; 32: 916-19.
  • Kaplan BC, Dart RG, Moskos M, et al. Ectopic preg- nancy: prospective study with improved diagnostic accuracy. Ann Emerg Med 1996; 28: 10-17.
  • Barnhardt KT. Ectopic pregnancy. N Engl J Med 2009; 361: 379-87.
  • Stovall TG, Ling FW. Single-dose methotrexate: an ex- panded clinical trial. Am J Obstet Gynecol 1993;168: 1759-65.
  • Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 2003; 23: 2131-37.
  • Dominguez F, Yanez-Mo M, Sanchez-Madrid F, Simon C. Embryonic implantation and leukocyte transen- dothelial migration: different processes with similar players? FASEB J 2005; 19: 1056–60.
  • Yao Y, Simard AR, Shi FD, Hao J. IL-10-producing lym- phocytes in inflammatory disease. Int Rev Immunol 2013; 32: 324–36.
  • Scapini P, Cassatella MA. Social networking of human neutrophils within the immune system. Blood 2014; 124: 710–9.
  • Choi JL, Li S, Han JY. Platelet function tests: a review of progresses in clinical application. Biomed Res Int 2014; 456-569.
  • Templeton AJ, McNamara MG, Seruga B, et al. Prog- nostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014; 29: 106.
  • Templeton AJ, Ace O, McNamara MG et al. Prognostic a systematic review and meta-analysis. Canc Epide- miol Biomarkers Prev 2014; 23: 1204–12.
  • Sahin S, Sarıkaya S, Alcelik A, et al. Neutrophil to lym- phocyte ratio is a useful predictor of atrial fibrillation in patients with diabetes mellitus. Acta Medica Medi- terranea 2013; 29: 847–51
  • Ergelen M, Uyarel H, Altay S, Kul S, Ayhan E, Isik T, et al. Predictive value of elevated neutrophil to lympho- cyte ratio in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction. Clin Appl Thromb Hemost 2013; 228: 203-10.
  • Gul M, Uyarel H, Ergelen M, Ugur M, Isik T, Ayhan E et al. Predictive value of neutrophil to lymphocyte ratio in clinical outcomes of non-ST elevation myocardial in- farction and unstable angina pectoris: A 3-year follow- up. Clin Appl Thromb Hemost 2014; 20: 378-84.
  • Cedres S, Torrejon D, Martinez A, Martinez P, Navarro A, Zamora E, et al. Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer. Clin Transl Oncol 2012; 14: 864–69.
  • Li MX, Liu XM, Zhang XF, Zhang JF, Wang WL, Zhu Y, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: A systematic review and meta- analysis. Int J Cancer 2014; 134: 2403–13.
  • Hermanowicz A, Gibson PR, Jewell DP. The role of phagocytes in inflammatory bowel disease. Clin Sci (Lond) 1985; 69: 241–49.
  • Gewirtz AT, Liu Y, Sitaraman SV, Madara JL. Intestinal epithelial pathobiology: past, present and future. Best Pract Res Clin Gastroenterol 2002; 16: 851–67.
  • Torun S, Tunc BD, Suvaka B, Yildiz H, Tas A, Sayilir A, et al. Assessment of neutrophil-lymphocyte ratio in ulcerative colitis: A promising marker in predicting disease severity. Clin Res Hepatol Gastroenterol 2012; 36: 491–497.
  • Celikbilek M, Dogan S, Ozbakır O, Zararsız G, Hamit Kucuk H, Gursoy S, et al. Neutrophil–Lymphocyte Ra- tio as a Predictor of Disease Severityin Ulcerative Coli- tis. J Clin Lab Anal 2013; 27: 72–76.
  • Hajenius PJ, Mol F, Mol BW, Bossuyt PM, Ankum WM, van derVeen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev 2007; 24: CD000324.
  • Menon S, Colins J, Barnhart KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril 2007; 87: 481–484.
  • Sacher B, Keidar R, Golan A. The optimal cutoff serum level of human chorionic gonadotropin for efficacy of methotrexate treatment in women with extrauterine pregnancy. Int J Gynaecol Obstet 2012; 116: 101–04.
  • American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol 2008; 111: 1479–85.
  • Hajenius PJ, Mol F, Mol BWJ, Bossuyt PM, Ankum WM, van der Veen F. Interventions for tubal ectopic preg- nancy. Cochrane Database Syst Rev 2000; CD000324.
  • Practice Committee of American Society for Repro- ductive Medicine. Medical treatment of ectopic preg- nancy: a committee opinion. Fertil Steril 2013; 100: 638–44. 32. Sendy F, AlShehri E, AlAjmi A, Bamanie E, Appani S, Shams T. Failure Rate of Single Dose Metho- trexate in Managment of Ectopic Pregnancy 2015; Ar- ticle ID 902426.
  • Vagdatli E, Gounari E, Lazaridou E. Platelet distribu- tion width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010; 14: 28-3.
  • Turgut A, Sak ME, Ozler A. Alterations of peripheral blood cells in tubal ectopic pregnancy. Ginekol Pol 2013; 84: 193-196.
  • Artunc Ulkumen B, Gursoy Pala H, Calik E, Oruc Koltan S. Can mean platelet volume and platelet distrubition width be possible markers for ectopic pregnancy and tubal rupture? (MPV and PDW in ectopic pregnancy). Pak J Med 2014; 30: 252-55.

Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio on the prediction of methotrexate treatment success in tubal ectopic pregnancy

Yıl 2016, Cilt: 6 Sayı: 1, 25 - 29, 19.10.2016
https://doi.org/10.16899/ctd.07462

Öz

Objective
A %2 of all pregnancies composed of ectopic pregnancy, further more than 95% of cases localized on the fallopian tubes. The aim of this study is to assess the success of metotrexate treatment on tubal pregnancy, and the relation between the neutrophil-lymphocyte ratio and thrombocyte-lymphocyte ratio, and tubal ectopic pregnancy rupture.
Materials and Methods
This retrospective study was conducted in Gaziosmanpasa University, Department of Obstetrics and Gynecology between 2012 and 2014. Patients with a diagnosis of tubal ectopic pregnancy whose admitted to the Department of Obstetrics and Gynecology were enrolled in the study. The data was analyzed using the Statistical Package for Social Sciences (SPSS) software version 20 (SPSS Inc., Chicago, IL). A two-tailed p value <0.05 was regarded as statistically significant for all comparisons.
Results
The neurophil-lymphocyte ratio was significantly higher in ruptured surgical treated patients compared to unruptured-methotrexate treated patients (p = 0.009). Additionally, the neurophil-lymphocyte ratio was significantly higher in methotrexate responsive patients than in non-responsive ones (p = 0.027). 
Conclusion
Beside B-HCG level and ectopic pregnancy sac diameter, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio may be useful tools to predict the success of the methotrexate therapy.

Kaynakça

  • Walker JJ. Ectopic pregnancy. Clin Obstet Gynecol 2007; 50: 89–99.
  • Della-Giustina D, Denny M. Ectopic pregnancy. Emerg Med Clin 2003; 21: 565-84.
  • Varma R, Gupta J. Tubal ectopic pregnancy. BMJ Clin Evid 2009; 1406: PMC2907783.
  • 4. Fylstra DL. Tubal pregnancy: a review of current di- agnosis and treatment. Obstet Gynecol Surv 1998; 53: 320-28.
  • Shaw JLV, Dey SK, Critchley HOD, Horn AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update 2010; 16: 432- 44.
  • Tay JI, Moore J, Walke JJ. Ectopic pregnancy. BMJ 2000; 32: 916-19.
  • Kaplan BC, Dart RG, Moskos M, et al. Ectopic preg- nancy: prospective study with improved diagnostic accuracy. Ann Emerg Med 1996; 28: 10-17.
  • Barnhardt KT. Ectopic pregnancy. N Engl J Med 2009; 361: 379-87.
  • Stovall TG, Ling FW. Single-dose methotrexate: an ex- panded clinical trial. Am J Obstet Gynecol 1993;168: 1759-65.
  • Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 2003; 23: 2131-37.
  • Dominguez F, Yanez-Mo M, Sanchez-Madrid F, Simon C. Embryonic implantation and leukocyte transen- dothelial migration: different processes with similar players? FASEB J 2005; 19: 1056–60.
  • Yao Y, Simard AR, Shi FD, Hao J. IL-10-producing lym- phocytes in inflammatory disease. Int Rev Immunol 2013; 32: 324–36.
  • Scapini P, Cassatella MA. Social networking of human neutrophils within the immune system. Blood 2014; 124: 710–9.
  • Choi JL, Li S, Han JY. Platelet function tests: a review of progresses in clinical application. Biomed Res Int 2014; 456-569.
  • Templeton AJ, McNamara MG, Seruga B, et al. Prog- nostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014; 29: 106.
  • Templeton AJ, Ace O, McNamara MG et al. Prognostic a systematic review and meta-analysis. Canc Epide- miol Biomarkers Prev 2014; 23: 1204–12.
  • Sahin S, Sarıkaya S, Alcelik A, et al. Neutrophil to lym- phocyte ratio is a useful predictor of atrial fibrillation in patients with diabetes mellitus. Acta Medica Medi- terranea 2013; 29: 847–51
  • Ergelen M, Uyarel H, Altay S, Kul S, Ayhan E, Isik T, et al. Predictive value of elevated neutrophil to lympho- cyte ratio in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction. Clin Appl Thromb Hemost 2013; 228: 203-10.
  • Gul M, Uyarel H, Ergelen M, Ugur M, Isik T, Ayhan E et al. Predictive value of neutrophil to lymphocyte ratio in clinical outcomes of non-ST elevation myocardial in- farction and unstable angina pectoris: A 3-year follow- up. Clin Appl Thromb Hemost 2014; 20: 378-84.
  • Cedres S, Torrejon D, Martinez A, Martinez P, Navarro A, Zamora E, et al. Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer. Clin Transl Oncol 2012; 14: 864–69.
  • Li MX, Liu XM, Zhang XF, Zhang JF, Wang WL, Zhu Y, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: A systematic review and meta- analysis. Int J Cancer 2014; 134: 2403–13.
  • Hermanowicz A, Gibson PR, Jewell DP. The role of phagocytes in inflammatory bowel disease. Clin Sci (Lond) 1985; 69: 241–49.
  • Gewirtz AT, Liu Y, Sitaraman SV, Madara JL. Intestinal epithelial pathobiology: past, present and future. Best Pract Res Clin Gastroenterol 2002; 16: 851–67.
  • Torun S, Tunc BD, Suvaka B, Yildiz H, Tas A, Sayilir A, et al. Assessment of neutrophil-lymphocyte ratio in ulcerative colitis: A promising marker in predicting disease severity. Clin Res Hepatol Gastroenterol 2012; 36: 491–497.
  • Celikbilek M, Dogan S, Ozbakır O, Zararsız G, Hamit Kucuk H, Gursoy S, et al. Neutrophil–Lymphocyte Ra- tio as a Predictor of Disease Severityin Ulcerative Coli- tis. J Clin Lab Anal 2013; 27: 72–76.
  • Hajenius PJ, Mol F, Mol BW, Bossuyt PM, Ankum WM, van derVeen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev 2007; 24: CD000324.
  • Menon S, Colins J, Barnhart KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril 2007; 87: 481–484.
  • Sacher B, Keidar R, Golan A. The optimal cutoff serum level of human chorionic gonadotropin for efficacy of methotrexate treatment in women with extrauterine pregnancy. Int J Gynaecol Obstet 2012; 116: 101–04.
  • American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol 2008; 111: 1479–85.
  • Hajenius PJ, Mol F, Mol BWJ, Bossuyt PM, Ankum WM, van der Veen F. Interventions for tubal ectopic preg- nancy. Cochrane Database Syst Rev 2000; CD000324.
  • Practice Committee of American Society for Repro- ductive Medicine. Medical treatment of ectopic preg- nancy: a committee opinion. Fertil Steril 2013; 100: 638–44. 32. Sendy F, AlShehri E, AlAjmi A, Bamanie E, Appani S, Shams T. Failure Rate of Single Dose Metho- trexate in Managment of Ectopic Pregnancy 2015; Ar- ticle ID 902426.
  • Vagdatli E, Gounari E, Lazaridou E. Platelet distribu- tion width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010; 14: 28-3.
  • Turgut A, Sak ME, Ozler A. Alterations of peripheral blood cells in tubal ectopic pregnancy. Ginekol Pol 2013; 84: 193-196.
  • Artunc Ulkumen B, Gursoy Pala H, Calik E, Oruc Koltan S. Can mean platelet volume and platelet distrubition width be possible markers for ectopic pregnancy and tubal rupture? (MPV and PDW in ectopic pregnancy). Pak J Med 2014; 30: 252-55.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Çalışma
Yazarlar

Hatice Yılmaz Doğru

Çiğdem Kunt İşgüder Bu kişi benim

Asker Zeki Özsoy Bu kişi benim

İlhan Bahri Delibas Bu kişi benim

Bülent Cakmak Bu kişi benim

Akgul Arici Bu kişi benim

Yayımlanma Tarihi 19 Ekim 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 6 Sayı: 1

Kaynak Göster

APA Yılmaz Doğru, H., Kunt İşgüder, Ç., Özsoy, A. Z., Delibas, İ. B., vd. (2016). Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı. Çağdaş Tıp Dergisi, 6(1), 25-29. https://doi.org/10.16899/ctd.07462
AMA Yılmaz Doğru H, Kunt İşgüder Ç, Özsoy AZ, Delibas İB, Cakmak B, Arici A. Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı. J Contemp Med. Şubat 2016;6(1):25-29. doi:10.16899/ctd.07462
Chicago Yılmaz Doğru, Hatice, Çiğdem Kunt İşgüder, Asker Zeki Özsoy, İlhan Bahri Delibas, Bülent Cakmak, ve Akgul Arici. “Tubal Ektopik Gebeliklerde Metotreksat Tedavi başarısını öngörmede nötrofil-Lenfosit Oranı Ve Platelet-Lenfosit Oranı”. Çağdaş Tıp Dergisi 6, sy. 1 (Şubat 2016): 25-29. https://doi.org/10.16899/ctd.07462.
EndNote Yılmaz Doğru H, Kunt İşgüder Ç, Özsoy AZ, Delibas İB, Cakmak B, Arici A (01 Şubat 2016) Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı. Çağdaş Tıp Dergisi 6 1 25–29.
IEEE H. Yılmaz Doğru, Ç. Kunt İşgüder, A. Z. Özsoy, İ. B. Delibas, B. Cakmak, ve A. Arici, “Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı”, J Contemp Med, c. 6, sy. 1, ss. 25–29, 2016, doi: 10.16899/ctd.07462.
ISNAD Yılmaz Doğru, Hatice vd. “Tubal Ektopik Gebeliklerde Metotreksat Tedavi başarısını öngörmede nötrofil-Lenfosit Oranı Ve Platelet-Lenfosit Oranı”. Çağdaş Tıp Dergisi 6/1 (Şubat 2016), 25-29. https://doi.org/10.16899/ctd.07462.
JAMA Yılmaz Doğru H, Kunt İşgüder Ç, Özsoy AZ, Delibas İB, Cakmak B, Arici A. Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı. J Contemp Med. 2016;6:25–29.
MLA Yılmaz Doğru, Hatice vd. “Tubal Ektopik Gebeliklerde Metotreksat Tedavi başarısını öngörmede nötrofil-Lenfosit Oranı Ve Platelet-Lenfosit Oranı”. Çağdaş Tıp Dergisi, c. 6, sy. 1, 2016, ss. 25-29, doi:10.16899/ctd.07462.
Vancouver Yılmaz Doğru H, Kunt İşgüder Ç, Özsoy AZ, Delibas İB, Cakmak B, Arici A. Tubal ektopik gebeliklerde metotreksat tedavi başarısını öngörmede nötrofil-lenfosit oranı ve platelet-lenfosit oranı. J Contemp Med. 2016;6(1):25-9.