Paranasal Manifestations of Early Stage Chronic Lymphocytic Leukemia

Yıl 2015, Cilt: 16 Sayı: 1, 9 - 12, 01.04.2015

Ceren Günel İrfan Yavaşoğlu İbrahim Meteoğlu Ali Toka Nihan Alkış

Öz

AMAÇ: Kronik lenfositik lösemi (KLL) en yaygın görülen yetişkin lösemi alt grubudur. Ancak paranazal sinüsler ve KLL arasındaki ilişkiyi araştıran az sayıda çalışma rapor edilmiştir. Bu çalışmada KLL’nin paranazal belirtilerini ve KLL hastalarının nazal mukozalarında Nuclear factor-ĸB (NF-kB) ve Tumor necrosis factor (TNF-α) salınımını saptamayı amaçlandı.GEREÇ VE YÖNTEMLER: Bu çalışma 40 hastayı içeren bir klinik çalışma olarak yapılmıştır. Grup KLL (n=20) herhangi bir tedavi almamış hematoloji kliniği tarafından takip edilen erken evre KLL hastalarından oluşturuldu. Kontrol grubu (n=20) burun tıkanıklığı nedeniyle konka cerrahisi geçirmiş hastalardan oluşturuldu. Tüm hastaların paranazal sinus tomografileri çekilip Lund Mackay sistemine gore skorlandı ve sinüzit bulguları kaydedildi. Tüm hastaların alt konka başından alınan biyopsi materyalleri, NF-kB and TNF-α primer antikorları ile immünohistokimyasal olarak boyandı.BULGULAR: İki grup arasında NF-κB (p=0.716) ve TNF-α (p=1.000) boyama skorlarına göre istatistiksel olarak anlamlı farklılık yoktu. Lund-Mackay skoru (p=0.004) kontrol grubuna göre KLLgrubunda anlamlı olarak daha yüksek bulundu. KLL grubunda en yaygın tanı maksiler sinüzit (n=8) iken, 14 hastada farklı lokalizasyonlarda sinüzit bulguları saptandı.SONUÇ: Bu çalışma erken evre KLL hastalarının akut rinosinüzite eğilimli olduğunu göstermektedir. Bununla birlikte, paranazal sinüsleri kapsayan inflamatuvar süreçte NF-kB ve TNF-α bir role sahip olmadığını düşünmekteyiz

Anahtar Kelimeler

Kronik lenfositik lösemi, NF-kB, TNF-α, Lund-Mackay skor, rinosinüzit

Erken Evre Kronik Lenfositik Löseminin Paranazal Belirtileri

Öz

OBJECTIVE: Chronic lymphocytic leukemia (CLL) is the most common adult leukemia. A few studies have been reported about the relationship between CLL and paranasal sinuses. We aimed to investigate the paranasal manifestations of CLL and to determine the expression of nuclear factor-ĸB (NF-kB) and tumor necrosis factor (TNF-α) in the nasal mucosa in patients with CLL. MATERIALS AND METHODS: This study was a clinical trial that involved 40 patients. Group CLL (n=20) consisted of patients with early-stage CLL who were followed-up at the hematology clinic and who did not receive any treatment. The control group (n=20) consisted of patients who had undergone concha surgery because of nasal obstruction. Paranasal sinus computer tomography scans of all patients were taken, they were scored on the basis of the Lund–Mackay system, and sinusitis findings were recorded. The biopsy material taken from the inferior concha head of all patients was immunohistochemically stained with primary antibodies against NF-kB and TNF-α. RESULTS: There were no statistically significant differences between the two groups with respect to NF-κB (p=0.716) and TNF-α staining scores (p=1.000). The Lund–Mackay scores were significantly higher in the CLL group than in the control group (p=0.004). Fourteen patients had sinusitis at different locations, while the most common diagnosis was maxillary sinusitis (n=8) in the CLL group. CONCLUSION: This study showed that patients with early-stage CLL tend to have rhinosinusitis. However, NF-kB and TNF-α may not have a role in the inflammatory process involving the paranasal sinuses in patients with CLL.

Anahtar Kelimeler

Chronic lymphocytic leukemia, NF-Κb, TNF-α, Lund–Mackay score, rhinosinusitis

Kaynakça

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