SİSTEMİK İMMÜN-İNFLAMASYON İNDEKSİNİN TUBAL EKTOPİK GEBELİKTEKİ ROLÜ

Yıl 2024, Cilt: 25 Sayı: 1 - OCAK 2024 SAYISI, 70 - 75, 17.01.2024

Özlem Erten , Cenk Soysal

https://doi.org/10.18229/kocatepetip.1207403

Öz

AMAÇ: Çalışmamızda, ektopik gebelik tanısı konan gebeler ile sağlıklı gebeler arasında hematolojik inflamasyon parametrelerinden sistemik immün inflamasyon indeksinin (SII) karşılaştırılması amaçlanmıştır.
GEREÇ VE YÖNTEM: Bu retrospektif vaka kontrol çalışması Temmuz 2021 – Ekim 2022 tarihleri arasında üçüncü basamak Eğitim Araştırma Hastanesi’nde yapıldı. 55 tubal toplam ektopik gebeliği olan gebeler ve 106 sağlıklı gebe olmak üzere 161 hasta dahil edildi. Hastaların demografik bilgileri ve laboratuar parametreleri kaydedildi. Hastalar tubal ektopik gebelik ve kontrol grubu olmak üzere iki gruba ayrılıp SII, monosit lenfosit oranı (MLR), nötrofil lenfosit oranı (NLR) ve platelet lenfosit oranı (PLR) inflamasyon markerları açısından karşılaştırıldı. SII değeri şu şekilde hesaplandı: trombosit sayısı x (nötrofil/lenfosit).
BULGULAR: Sağlıklı gebelerle karşılaştırıldığında SII, NLR, PLR ve MLR açısıdan ektopik gebelik grubunda anlamlı bir fark bulunmadı (p=0.308, p=0.216, p=0.124 ve p=0.071). Tubal ektopik gebelik grubu incelendiğinde rüptüre ektopik gebeliklerde rüptüre olmayan tubal ektopik gebeliklere göre SII, NLR ve PLR’de anlamlı değişim olmaz iken (p=0.706, 0.354, 0.071) ve MLR düzeyinde azalma bulundu (p=0.018).
SONUÇ: Ektopik gebelikteki inflamatuar süreç literatürde sınırlı sayıda çalışma ile halen tartışılmakla birlikte çalışmamızın sonucu olarak tubal ektopik gebelikte SII, NLR, PLR düzeyleri sağlıklı gebelikere göre değişmezken rüptüre ektopik gebeliklerde MLR düzeyinin azaldığını ortaya koyduk.

Anahtar Kelimeler

Ektopik gebelik, Tam kan sayımı, İnflamasyon

THE ROLE OF THE SYSTEMIC IMMUNE-INFLAMMATION INDEX IN TUBAL ECTOPIC PREGNANCY

Öz

OBJECTIVE: In our study, it was aimed to compare the systemic immune-inflammation index (SII), one of the inflammation parameters, between pregnant women diagnosed with ectopic pregnancy and healthy pregnant women.
MATERIAL AND METHODS: This retrospective case-control study was conducted at a tertiary education and research hospital between July 2021 and October 2022. A total of 161 patients, which 55 pregnant women with tubal ectopic pregnancies and 106 healthy pregnant women were included. Demographic information and laboratory parameters of the patients were recorded. The patients were divided into two groups as tubal ectopic pregnancy and control group and compared in terms of SII, monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) inflammation markers. The SII value was calculated as: platelet count x (neutrophil/lymphocyte).
RESULTS: No significant difference was found in the ectopic pregnancy group in terms of SII, NLR, PLR and MLR when compared with healthy pregnant women (p=0.308, p=0.216, p=0.124 and p=0.071). When the tubal ectopic pregnancy group was examined, there was no significant change in SII, NLR and PLR in ruptured ectopic pregnancies compared to non-ruptured tubal ectopic pregnancies (p=0.706, 0.354, 0.071) and a decrease in MLR levels was found (p=0.018).
CONCLUSIONS: Although the inflammatory process in ectopic pregnancy is still being discussed with a limited number of studies in the literature, as a result of our study, we revealed that SII, NLR, PLR levels did not change in tubal ectopic pregnancy compared to healthy pregnancies, while MLR levels decreased in ruptured ectopic pregnancies.

Anahtar Kelimeler

Ectopic pregnancy, Complete blood count, Inflammation

Kaynakça

• 1. Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005;173(8):905-12.
• 2. Weström L, Bengtsson LP, Mårdh PA. Incidence, trends, and risks of ectopic pregnancy in a population of women. British Medical Journal (Clinical research ed). 1981;282(6257):15-8.
• 3. Segal S, Mercado R, Rivnay B. Ectopic pregnancy early diagnosis markers. Minerva Ginecologica. 2010;62(1):49-62.
• 4. Lyons RA, Saridogan E, Djahanbakhch O. The reproductive significance of human Fallopian tube cilia. Human Reproduction Update. 2006;12(4):363-72.
• 5. Pisarska MD, Carson SA, Buster JE. Ectopic pregnancy. Lancet (London, England). 1998;351(9109):1115-20.
• 6. Shaw JL, Dey SK, Critchley HO, Horne AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Human Reproduction Update. 2010;16(4):432-44.
• 7. Fest J, Ruiter R, Mulder M, et al. The systemic immune-inflammation index is associated with an increased risk of incident cancer-A population-based cohort study. International Journal of Cancer. 2020;146(3):692-8.
• 8. Jomrich G, Gruber ES, Winkler D, et al. Systemic Immune-Inflammation Index (SII) Predicts Poor Survival in Pancreatic Cancer Patients Undergoing Resection. J Gastrointest Surg. 2020;24(3):610-8.
• 9. Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. European Journal of Clinical Investigation. 2020;50(5):13230.
• 10. Paliogiannis P, Satta R, Deligia G, et al. Associations between the neutrophil-to-lymphocyte and the platelet-to-lymphocyte ratios and the presence and severity of psoriasis: a systematic review and meta- analysis. Clinical and Experimental Medicine. 2019;19(1):37-45.
• 11. Zinellu A, Paliogiannis P, Sotgiu E, et al. Blood Cell Count Derived Inflammation Indexes in Patients with Idiopathic Pulmonary Fibrosis. Lung. 2020;198(5):821-7.
• 12. Bouyer J, Coste J, Shojaei T, et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. American Journal of Epidemiology. 2003;157(3):185-94.
• 13. Barnhart KT. Clinical practice. Ectopic pregnancy. The New England Journal of Medicine. 2009;361(4):379-87.
• 14. Cartwright J, Duncan WC, Critchley HO, Horne AW. Serum biomarkers of tubal ectopic pregnancy: current candidates and future possibilities. Reproduction (Cambridge, England). 2009;138(1):9-22.
• 15. Artunc Ulkumen B, Pala HG, Calik E, et al. Can Mean Platelet Volume and Platelet Distrubition Width be Possible Markers for Ectopic Pregnancy and Tubal Rupture? (MPV and PDW in Ectopic Pregnancy). Pakistan Journal of Medical Sciences. 2014;30(2):352-5.
• 16. Cabar FR, Fettback PB, Pereira PP, Zugaib M. Serum markers in the diagnosis of tubal pregnancy. Clinics (Sao Paulo). 2008;63(5):701-8.
• 17. Guérin P, El Mouatassim S, Ménézo Y. Oxidative stress and protection against reactive oxygen species in the pre-implantation embryo and its surroundings. Human Reproduction Update. 2001;7(2):175-89.
• 18. Yıldırım Köpük Ş, Özer N, Çekmez Y, Erel Ö, Kıran G. The relationship between serum thiol levels and thiol/disulfide homeostasis in women with tubal ectopic pregnancy. Journal of Gynecology Obstetrics and Human Reproduction. 2021;50(9):102175.
• 19. Rajendiran S, Senthil Kumar GP, Nimesh A, Dhiman P, Shivaraman K, Soundararaghavan S. Diagnostic significance of IL-6 and IL-8 in tubal ectopic pregnancy. J Obstet Gynaecol. 2016;36(7):909-11.
• 20. Xing Z, Gauldie J, Cox G, et al. IL-6 is an antiinflammatory cytokine required for controlling local or systemic acute inflammatory responses. The Journal of Clinical Investigation. 1998;101(2):311-20.
• 21. Ma L, Li Z, Xi S, et al. Tubal ectopic pregnancy occurrence is associated with high expressions of prokineticin receptors and aberrant secretion of inflammatory cytokines. American Journal of Translational Research. 2020;12(9):5741-51.
• 22. Zakizadeh F, Mahmoudzadeh-Sagheb H, Asemi-Rad A, et al. Upregulation of elafin expression in the fallopian tube of ectopic tubal pregnancies compared to the normal tubes. Journal of Reproductive Immunology. 2020;141:103136.
• 23. Tokgoz S, Kayrak M, Akpinar Z, Seyithanoğlu A, Güney F, Yürüten B. Neutrophil lymphocyte ratio as a predictor of stroke. J Stroke Cerebrovasc Dis. 2013;22(7):1169-74.
• 24. Peng Y, Li Y, He Y, et al. The role of neutrophil to lymphocyte ratio for the assessment of liver fibrosis and cirrhosis: a systematic review. Expert Review of Gastroenterology & Hepatology. 2018;12(5):503-13.
• 25. Wang Y, Ju M, Chen C, et al. Neutrophil-to-lymphocyte ratio as a prognostic marker in acute respiratory distress syndrome patients: a retrospective study. Journal of Thoracic Disease. 2018;10(1):273-82.
• 26. Zhou M, Li L, Wang X, Wang C, Wang D. Neutrophil-to-Lymphocyte Ratio and Platelet Count Predict Long-Term Outcome of Stage IIIC Epithelial Ovarian Cancer. Cell Physiol Biochem. 2018;46(1):178-86. 27. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-22.
• 28. Turgut E, Yildirim M, Sakcak B, et al. Predicting miscarriage using systemic immune-inflammation index. J Obstet Gynaecol Res. 2022;48(3):587-92.
• 29. He B, Wu J. Clinical Value of PLR, MLR, and NWR in Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer. Comput Math Methods Med. 2022(26);2022:8005975.
• 30. Chen H, Wu X, Wen Z, et al. The Clinicopathological and Prognostic Value of NLR, PLR and MLR in Non-Muscular Invasive Bladder Cancer. Arch Esp Urol. 2022;75(5):467-471.
• 31. Dogru, S, Atci A , Akkus F, Erdogan A, Acar A. Predictability of Hematological Parameters in the Diagnosis of Cesarean Scar Pregnancy. Journal of Laboratory Physicians. 2023;38(8);168-172.
• 32. Wang Q, Liu F, Zhao Y, Cui B, Ban Y. Can neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios be useful markers for predicting missed abortion in the first trimester of pregnancy?. J Obstet Gynaecol Res. 2020;46(9):1702-1710.
• 33. Onat T, Aydoğan Kırmızı D, Demir Çaltekin M, et al. Hematologic inflammation markers be the indicator of early pregnancy loss?. J Surg Med. 2020; 4(11): 952-55