Helikobakter Pilori Enfeksiyonu ile Nötrofil-Lenfosit Oranı, Trombosit-Lenfosit Oranı Ve Nötrofil-Monosit Oranları Arasındaki İlişki

Öz

Amaç: Çalışmamızda nötrofil-lenfosit oranı, trombosit-lenfosit oranı, nötrofil-monosit oranı ve ortalama trombosit hacmi ile Helikobakter pilori pozitifliği ve şiddeti arasındaki ilişkiyi göstermeyi amaçladık. Yöntem ve Gereçler: Çalışmaya Temmuz 2021 ile Temmuz 2022 tarihleri arasında bir devlet hastanesinde dispeptik şikâyetleri nedeniyle üst gastrointestinal sistem endoskopisi yapılmış, aktif ve/veya kronik hastalığı olmayan 596 hasta dahil edildi. Demografik ve laboratuvar verileri hasta kayıtlarından retrospektif olarak elde edildi. Hastalar patoloji raporuna göre Helikobakter pilori pozitif ve negatif olarak iki gruba ayrıldı. Helikobakter pilori varlığı; yok, hafif, orta ve şiddetli olarak tanımlandı. Gruplar arasında hemogram parametreleri karşılaştırıldı. Bulgular: Hastaların (n=596) yaş ortalaması 41,8 ± 13,57 yıl, 374 (%62,8)’ü kadın ve 331 (%55,5)’i Helikobakter pilori pozitifti. Helikobakter pilori pozitif ve negatif hasta grupları arasında yaş, cinsiyet, lökosit, lenfosit, monosit, trombosit, hemoglobin, nötrofil-lenfosit oranı, trombosit-lenfosit oranı, nötrofil-monosit oranı ve ortalama trombosit hacmi değerleri açısından istatistiksel olarak anlamlı fark saptanmadı. Helikobakter pilori şiddetine göre hemogram parametreleri değerlendirildiğinde gruplar arasında sadece lenfosit düzeyleri açısından istatistiksel olarak anlamlı farklılık saptanmıştır (p = 0,028). Fakat bu farklılık klinik olarak anlamlı kabul edilmemiştir. Sonuç: Nötrofil-lenfosit oranı, trombosit-lenfosit oranı, nötrofil-monosit oranı ve ortalama trombosit hacminin son zamanlarda popüler olan ve birçok sistemik hastalıkta teşhis ve inflamasyonun derecesi konusunda kolay, erişilebilir ve ucuz parametreler olduğu düşünülüyor, ancak bizim çalışmamızda Helikobakter pilori pozitifliği ve şiddeti ile hemogram parametreleri arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır. Helikobakter pilori enfeksiyonu için bu parametrelerin prediktör olarak kabul edilebilmesi için daha fazla sayıda olgu içeren prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Helikobakter pilori
• nötrofil-lenfosit oranı
• trombosit-lenfosit oranı
• nötrofil-monosit oranı.

Association of Helicobacter Pylori Infection with Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Neutrophil-to-Monocyte Ratio

Abstract

Aim: In our study, we aimed to show the relationship between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume, and Helicobacter pylori positivity and severity. Material and Methods: In this study, we included 596 patients without active and/or chronic disease who underwent upper gastrointestinal system endoscopy due to dyspeptic complaints in a state hospital between July 2021 and July 2022. Demographic and laboratory data were obtained retrospectively from electronic patient records. The patients were divided into two groups as positive and negative for Helicobacter pylori according to the pathology report. Helicobacter pylori presence was defined as none, mild, moderate and severe. Hemogram parameters were compared between the groups. Results: Mean age of the patients (n=596) was 41.8±13.57 years, 374 (62.8%) were female, and 331 (55.5%) were Helicobacter pylori positive. There was no statistically significant difference between Helicobacter pylori positive and negative patient groups in terms of age, gender, leukocytes, lymphocytes, monocytes, platelets, hemoglobin, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume values. When the hemogram parameters were evaluated according to the severity of Helicobacter pylori, a statistically significant difference was found between the groups only in terms of lymphocyte levels (p=0.028). However, this difference was not considered clinically significant. Conclusion: Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, neutrophil-monocyte ratio and mean platelet volume are thought to be popular recently and easy, accessible and inexpensive parameters for diagnosis and degree of inflammation in many systemic diseases, but in our study, no statistically significant relationship was found between Helicobacter pylori positivity and severity and hemogram parameters. Prospective studies with larger numbers of cases are needed to accept these parameters as predictors for Helicobacter pylori infection.

Keywords

• Helicobacter pylori
• neutrophil-lymphocyte ratio
• thrombocyte-lymphocyte ratio
• neutrophil-monocyte ratio

Kaynakça

1. Lawson AJ. Helicobacter. In: Manual of Clinical Microbiology. Jorgensen JH, Landry ML, Warnock DW et al. (Eds.) Washington DC: ASM Press, 2015;900-15.
2. Brown LM. Helicobacter pylori: Epidemiology and routes of transmission. Epidemiol Rev. 2000;22:283-97.
3. Craanen ME, Dekker W, Blok P, et al. Intestinal metaplasia and Helicobacter pylori: An endoscopic bioptic study of the gastric antrum. Gut. 1992;33:16-20.
4. de Korwin JD, Ianiro G, Gibiino G, Gasbarrini A. Helicobacter pylori infection and extragastric diseases in 2017. Helicobacter. 2017;22.
5. Ruggiero P. Helicobacter pylori and inflammation. Curr Pharm Des. 2010;16:4225-36.
6. Altun E, Yildiz A, Cevik C, Turan G. The role of high sensitive C-reactive protein and histopathological evaluation in chronic gastritis patients with or without Helicobacter pylori infection. Acta Cir Bras. 2019;34:e201900310.
7. Lim HH, Jeong IH, An GD, et al. Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-to-lymphocyte ratio. J Clin Lab Anal. 2019;33:e22714.
8. Akıl E, Akıl MA, Varol S, et al. Echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio are novel inflammatory predictors of cerebral ischemic stroke. J Stroke Cerebrovasc Dis. 2014;23:2328-34.

9. Celikbilek A, Ismailogullari S, Zararsiz G. Neutrophil to lymphocyte ratio predicts poor prognosis in ischemic cerebrovascular disease. J Clin Lab Anal. 2014;28:27-31.
10. Yalın EA, Kayataş K. Investigation of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Parameters in Chronic Gastritis with Helicobacter Pylori. Haydarpasa Numune Med J. 2022;62:342-5
11. Hunt R, Armstrong D, Katelaris P. World Gastroenterology Organisation. 2015. Update. O’Connor A, O’Moráin C. Helicobacter pylori infection in Europe: current perspectives. Expert Rev Gastroenterol Hepatol. 2013;7:541-8.
12. Khoder G, Muhammad JS, Mahmoud I, et al. Prevalence of Helicobacter pylori and its associated factors among healthy asymptomatic residents in the United Arab Emirates. Pathogens. 2019;8:44.
13. Maleki I, Mohammadpour M, Zarrinpour N, et al. Prevalence of Helicobacter pylori infection in Sari Northern Iran; a population based study. Gastroenterol Hepatol Bed Bench. 2019;12:31-7.
14. Obaidat MM, Roess AA. First nationwide seroepidemiology and risk factors report of Helicobater pylori in Jordan. Helicobacter. 2019; 24:e12572.
15. Eshraghian A. Epidemiology of Helicobacter pylori infection among the healthy population in Iran and countries of the Eastern Mediterranean Region: A systematic review of prevalence and risk factors. World J Gastroenterol. 2014;20:17618-25.
16. Niknam R, Seddigh M, Fattahi MR, et al. Prevalence of Helicobacter pylori in patients with dyspepsia. Jundishapur J Microbiol. 2014;7:e12676.
17. Hamrah MH, Hamrah MS, Hamrah MH, et al. Prevalence of helicobacter pylori infection in dyspeptic patients in Andkhoy Afghanistan. Asian Pac J Cancer Prev. 2017;18:3123-227.
18. Satpathi P, Satpathi S, Mohanty S, et al. Helicobacter pylori infection in dyspeptic patients in an industrial belt of India. Trop Doct. 2017;47:2-6.
19. Shahzad S, Ahmad SM, Ali Z, et al. Endoscopic evidence of Helicobacter pylori in dyspeptic patients. Ann Sindh Med Uni. 2017;3:29-32.
20. Özaydın AN, Çalı Ş, Türkyılmaz AS, Hancıoğlu A. TURHEP Türkiye Helicobacter Pylori Prevalence Survey 2003. Istanbul: Marmara Health Education and Research Institute, 2007.
21. Konakcı N, Gülten M, İbanoğlu MS, et al.Helicobacter pylori prevalence in patients with chronic active gastritis. Journal of Uludag University Faculty of Medicine. 2010;36:7-10.
22. Kesli R, Göktürk HS, Erbayrak M, et al. Comparison of the diagnostic values of the 3 different stool antigen tests for the noninvasive diagnosis of Helicobacter pylori infection. J Investig Med. 2010;58:982-6.
23. Bilman FB, Ozdemir M, Baysal B, Kurtoglu MG. Prevalence of H. pylori in gastric biopsy specimen in the southeastern region of Turkey. J Infect Dev Ctries. 2016;10:1177-82.
24. Koç S, Gedikli MA. The role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratios in predicting H Pylori positivity and severity in patients with chronic gastritis. Cumhur Med J. 2022;44:87-91.
25. Kaplan M, Ates I, Yuksel M, et al. The role of the PLR-NLR combination in the prediction of the presence of Helicobacter pylori and its associated complications. Saudi J Gastroenterol. 2018;24:294.
26. Akar T. Can mean platelet volume IndIcate HelIcobacter posItIvIty and severIty of gastrIc InflammatIon? An original study and revIew of the lIterature. Acta Clin Croat. 2019;58:576-82.
27. Nalbant A, Aydin A. Association of Helicobacter pylori infection with vitamin D, CBC parameters, and blood group. Akademik Gastroenteroloji Dergisi. 2017;16:1-5
28. Akarsu M, Dikker O. Helikobakter Pilori pozitifliği ile Nötrofil Lenfosit oranı ve MPV ilişkisi [Association of Helicobacter Pylori infection with neutrophil-to-lymphocyte ratio and MPV]. Dicle Med J. 2019;46:201-7.
29. Guclu M, Agan AF. Association of severity of Helicobacter pylori infection with peripheral blood neutrophil to lymphocyte ratio and mean platelet volume. Euroasian J Hepatogastroenterol. 2017;7:11.
30. Malfertheiner P, Megraud F, Rokkas T, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022;8:2022-327745.
31. Papa A, Emdin M, Passino C, et al. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta. 2008;395:27-31.
32. Farah R, Khamisy-Farah R. Association of neutrophil to lymphocyte ratio with presence and severity of gastritis due to Helicobacter pylori infection. J Clin Lab Anal. 2014;28:219-23.
33. Ferhatoglu MF, Senol K, Kartal A, et al. The significance of neutrophil/lymphocyte ratio in the follow-up of Helicobacter Pylori eradication. Med J Ankara Tr Res Hosp. 2019;52:38-42.
34. Noris P, Melazzini F, Balduini CL. New roles for mean platelet volume measurement in the clinical practice? Platelets. 2016;27:607-12.
35. Bahali AG, Su O, Emiroglu N, et al. Evaluation of mean platelet volume in localized scleroderma. An Bras Dermatol. 2017;92:635-7.
36. Kılıç S, Reşorlu H, Işik S, et al. Association between mean platelet volume and disease severity in patients with psoriasis and psoriatic arthritis. Postepy Dermatol Alergol. 2017;34:126-30.
37. Icli A, Aksoy F, Turker Y, et al. Relationship between mean platelet volume and pulmonary embolism in patients with deep vein thrombosis. Heart Lung Circ. 2015;24:1081-6.
38. Bagir GS, Haydardedeoglu FE, Bakiner OS, et al. Mean platelet volume in Graves’ disease: A sign of hypermetabolism rather than autoimmunity? Pak J Med Sci. 2017;33:871-5.
39. Umit H, Ümit EG. Helicobacter pylori and mean platelet volume: A relation way before immune thrombocytopenia? Eur Rev Med Pharmacol Sci. 2015;19:2818-23.