Cilt Kanserlerinin Ayırıcı Tanısında İnflamatuar Belirteçlerin Yeri

Öz

Amaç: Bu çalışmanın amacı, cilt kanserinin ayırıcı tanısında ve ilk tanı anında lenf nodu metastazının öngörülmesinde inflamatuar belirteçlerin rolünün belirlenmesidir. Gereç ve YÖntem: Bazal hücreli karsinom, skuamöz hücreli karsinom veya malign melanom nedeniyle ameliyat edilen hastalar retrospektif olarak tarandı. NLR, LMR, PLR, SII ve Plt×NLR hesaplandı. Tümör tipi, ilk tanıda lenf nodu metastazının varlığı, tümör lokalizasyonu ile inflamatuvar ve hematolojik parametreler arasındaki ilişkiler araştırıldı. Tümör lokasyonu, baş boyun ve diğerleri olarak sınıflandırıldı. Bulgular: Çalışmaya toplam 257 hasta dahil edildi. Tümör yerleşimine göre WBC, NLR, PLR, LMR, SII veya Plt×NLR'de istatistiksel olarak anlamlı farklılık saptanmadı. Skuamöz hücreli karsinomalı hastalarda NLR, PRL, SII ve Plt×NLR değerleri bazal hücreli karsinomalı hastalara göre daha yüksekti. PLR düzeyi 180,7 ve üzerinde olan hastalarda ilk tanı anında lenf nodu metastazı riski 10.3 kat daha yüksekti. Plt×NLR 747 ve üzeri olan hastalarda ilk tanıda saptanan lenf nodu metastazı riski 8,9 kat daha fazlaydı. SII 414 ve üzeri olan hastalarda ilk tanıda saptanan lenf nodu metastazı riski 7,1 kat daha yüksekti. Sonuç: İnflamatuvar belirteçler cilt kanserlerinin ayırıcı tanısında ve lenf nodu metastazı riskinin belirlenmesinde yardımcı olabilir. Ancak tümör lokalizasyonuna göre bir farklılık göstermemektedir.

Anahtar Kelimeler

• Bazal hücreli karsinom
• skuamöz hücreli karsinom
• malign melanom
• nötrofil-lenfosit oranı (NLR)
• lenfosit-monosit oranı (LMR)
• Sistemik immün-enflamasyon indeksi (SII) trombosit/lenfosit oranı (PLR)
• Sistemik immün-enflamasyon indeksi (SII) trombosit/lenfosit oranı (PLR)

The Role of Inflammatory Markers in the Differential Diagnosis of Skin Cancers

Öz

Aim: The purpose of this study was to evaluate the role of WBC count, NLR, LMR, PLR, Systemic immune-inflammation index (SII) [(platelet count X neutrophil count) \ lymphocyte count] and platelet count (Plt)×NLR in the differential diagnosis of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma and to determine the effect of tumor type, prediction of lymph node metastasis at initial diagnosis and location on these inflammatory markers. Material and Method: Patients who underwent surgery for basal cell carcinoma, squamous cell carcinoma, or malignant melanoma were retrospectively screened. NLR, LMR, PLR, SII and Plt×NLR were calculated. Relationships between tumor type, prediction of lymph node metastasis at initial diagnosis, tumor localization and the inflammatory and hematological parameters of interest were investigated. Tumor location was classified as head and neck and others. Results: A total of 257 patients were included in the study. No statistically significant differences in WBC, NLR, PLR, LMR, SII or Plt×NLR were detected according to tumor location. The patients with squamous cell carcinoma had higher NLR, PRL, SII and Plt×NLR values than those with basal cell carcinoma. The risk of lymph node metastasis at the time of initial diagnosis was 10.3 times higher in patients with PLR levels of 180.7 and higher. The risk of lymph node metastasis detected at initial diagnosis was 8.9 times higher in patients with Plt×NLR of 747 and higher. The risk of lymph node metastasis detected at initial diagnosis was 7.1 times higher in patients with SII of 414 and higher. Conclusion: Inflammatory markers seem to be useful in the differential diagnosis of skin cancers and determined the risk of lymph node metastasis. However, it does not differ according to tumor localization.

Anahtar Kelimeler

• Basal cell carcinoma
• squamous cell carcinoma
• malignant melanoma
• neutrophil to lymphocyte ratio (NLR)
• lymphocyte to monocyte ratio (LMR)
• Systemic immune-inflammation index (SII)
• and platelet to lymphocyte ratio (PLR

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