The Impact of Neutrophil-Lymphocyte Ratio and LENT Score on Prognosis in Malignant Pleural Effusions

Öz

Background: This study aims to investigate the clinical impact of serum neutrophil-to-lymphocyte ratio (NLR), Eastern Coope-rative Oncology Group (ECOG) performance status, and LENT risk score (which includes serum lactate dehydrogenase (LDH), ECOG performance status, blood neutrophil-to-lymphocyte ratio (NLR), and tumor type (T)) on mortality and prognosis in patients with malignant pleural effusion. Materials and Methods: This retrospective, observational, single-center study evaluated the outcomes of 73 patients who were followed between October 2022 and July 2024 due to malignant pleural effusion (MPE) and paramalignant pleural effu-sion (PMPE). Results: The mean age of the included patients was 66.493 ± 13.988 years. A statistically significant relationship was found between survival time and the presence of comorbidities (p=0.017), metastatic disease (p=0.045), and the side of pleural effusion (p=0.032). In the analysis of treatment modalities, a statistically significant correlation was observed between survival time and patients who underwent thoracentesis (p=0.033). Evaluating NLR results revealed significantly higher values in patients requiring intensive care monitoring (p=0.006) and in the mortality group (p=0.014). In the ECOG performance status analysis, a statistically significant association was found in patients monitored in the intensive care unit (p=<0.001), while no significant relationship was observed in mortality analysis (p=0.203). According to the LENT risk score results, a statistically significant correlation was found in patients requiring intensive care follow-up (p=<0.001) and in the mortality analysis (p=0.003). Conclusions: Observing a statistically significant relationship between thoracentesis, as the least invasive method, and the number of survival days in patients suggests the importance of determining the prognosis when selecting a treatment appro-ach. In cases of pleural effusion observed in patients with malignancy, whether or not they have a diagnosis of MPE, it can be suggested that the NLR may be used for rapid prognosis assessment when calculating the LENT score is deemed unsuitable. Its affordability and ease of calculation present significant advantages.

Anahtar Kelimeler

• ECOG Performance Status
• LENT Score
• Malignant Pleural Effusion
• Neutrophil-to-Lymphocyte Ratio
• Paramalignant Pleural Effusion

Nötrofil-Lenfosit Oranı ve LENT Skorunun Malign Plevral Efüzyonlarda Prognoza Etkisi

Öz

Amaç: Bu çalışmanın amacı; malign plevral efüzyon ile izlenen hastaların serum nötrofil/lenfosit oranı, Doğu Kooperatif Onkoloji (ECOG) performans skoru ve LENT (serum laktat dehidrogenaz (LDH), ECOG performans skoru, Kan Nötrofil/Lenfosit Oranı (NLO), Tümör tipi (T)) risk skorunun mortalite ve prognoz üzerindeki klinik etkisini araştırmaktır. Materyal ve metod: Retrospektif, gözlemsel ve tek merkezli olan bu çalışmada Ekim 2022 ile Temmuz 2024 tarihleri arasında malign plevral efüzyon (MPE) ve paramalign plevral efüzyon (PMPE) nedeniyle takip edilen 73 hastanın sonuçları değerlendi-rilmiştir. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalamasının 66.493 ± 13.988 yıl olduğu tespit edildi. Eşlik eden komorbiditeler (p=0.017), metastatik hastalık varlığı (p=0.045) ve plevral mayinin görüldüğü taraf (p=0.032) ile sağkalım süresi arasında istatistiksel olarak anlamlı bir ilişki bulundu. Uygulanan tedavi yöntemleri açısından yapılan değerlendirmede, torasentez uygulanan hastalar ile sağkalım süresi arasında istatistiksel açıdan anlamlı ilişki tespit edildi (p=0.033). NLO sonuçları değerlendirildiğinde, yoğun bakım takibi yapılan hastalarda (p=0.006) ve mortalite grubunda (p=0.014) istatistik-sel olarak anlamlı derecede yüksek olduğu görüldü. ECOG performans skoru analizinde, yoğun bakımda izlenen olgularda (p=<0.001) istatistiksel olarak anlamlı bir ilişki bulunur-ken, mortalite analizi (p=0.203) açısından değerlendirildiğinde anlamlı bir ilişki saptanmadı. LENT risk skor sonuçlarına göre, yoğun bakımda takip edilen olgularda (p=<0.001) ve mortalite analizinde (p=0.003) istatistiksel olarak anlamlı ilişki olduğu görüldü. Sonuç: Çalışmamızda; minimal invaziv girişimlerden biri olan torasentez uygulanan hastalar ile sağkalım süresi arasındaki istatistiksel olarak anlamlı ilişki, hastaya yönelik tedavi yönteminin seçiminde prognozun belirlenmesinin önemli olduğunu ortaya koymaktadır. Malignite nedeniyle takip edilen hastalarda plevral mayi tespit edildiğinde, LENT skorlamasının uygun olmadığı durumlarda prognozun hızlı değerlendirilmesi açısından NLO değerinin kullanılabileceği düşünülmektedir. NLO’nun düşük maliyetli ve kolay hesaplanabilir olması, klinik karar sürecinde avantaj sağlayabilecek bir parametre olduğunu göstermektedir.

Anahtar Kelimeler

• ECOG Performans Skalası
• LENT Skoru
• Malign Plevral Efüzyon
• Nötrofil-Lenfosit Oranı
• Paramalign Plevral Efüzyon

Kaynakça

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