Papiller Tiroid Karsinomada Tümör Büyüklüğü ve Metastazın Belirticisi Olarak Nötrofil Lenfosit Oranı

Öz

Amaç: Enflamasyon, tümör gelişimi ve ilerlemesi gibi birçok kanser özelliğinde kritik bir rol oynar. Son zamanlarda, nötrofil lenfosit oranı (NLR), inflamatuar yanıtın basit ve geçerli bir sistematik belirteci olarak değerlendirilmiştir. Bu çalışmanın amacı ameliyat öncesi nötrofil/lenfosit oranının prognostik değerini araştırmaktır. Gereç ve Yöntemler: Bu çalışmada 259 erişkin olgunun arşiv dosyaları retrospektif olarak değerlendirildi. İstatistiksel analizde Kolmogorov Smirnov testi, Mann Whitney U Testi, Kruskal Wallis ve Dunn çoklu karşılaştırma testleri kullanıldı. Bulgular: Nötrofil/lenfosit oranı ile TNM evrelemesi, lenf nodu ve uzak metastazlar arasında istatistiksel korelasyon bulundu (p<0.001). TNM evresi arttıkça nötrofil/lenfosit oranı da artışı saptandı (p=0,001). Ayrı bir alt grup olarak papiller mikrokarsinomlar ile nötrofil/lenfosit oranı arasında istatistiksel olarak anlamlı bir korelasyon bulundu (p=<0,001). Nötrofil/lenfosit kesim değerleri >1.644 >2.0906>1.644 olarak alındığında 1 cm'den büyük papiller tiroid kanserlerini, lenf nodu metastazı ve uzak metastazı öngörme duyarlılığı %85,4, %73,8 ve %96 olarak bulundu. Sonuç: Nötrofil/lenfosit oranı tümör boyutu ve metastaz varlığı ile ilişkilidir. Nötrofil/lenfosit oranı, doğru kesme noktaları belirlendiğinde tümörün boyutunu, lenf nodu tutulumunu ve uzak metastazı tahmin edilmesine yardımcı olabilir.

Anahtar Kelimeler

• Tiroid kanseri
• nötrofil lenfosit oranı
• karsinogenez

Prognostic Clue in Papillary Thyroid Carcinoma: Neutrophil Lymphocyte Ratio

Öz

Aim: Inflammation plays a critical role in many cancer features such as tumor development and progression. Recently, the neutrophil-lymphocyte ratio (NLR) has been evaluated as a simple and valid systematic marker of inflammatory response. The aim of this study was to investigate the prognostic value of the preoperative neutrophil / lymphocyte ratio. Material and Methods: In this study, archive files of 259 adult cases were evaluated retrospectively. Kolmogorov Smirnov test, Mann Whitney U Test, Kruskal Wallis and Dunn multiple comparison tests were used in the statistical analysis. Results: A statistical correlation was found between the neutrophil/lymphocyte ratio and T staging, lymph node and distant metastases (p<0.001). As the TNM stage increased, the neutrophil/lymphocyte ratio also increased (p=0.001). As a separate subgroup, a statistically significant correlation was found between papillary microcarcinomas and neutrophil/lymphocyte ratio (p=<0.001). When the neutrophil/ lymphocyte cut-off values were taken as >1,644 >2.0906>1,644, the sensitivity to predict papillary thyroid cancers larger than 1 cm, lymph node metastasis and distant metastasis was found to be 85.4%, 73.8%, and 96% respectively. Conclusion: Neutrophil/lymphocyte ratio is associated with tumor size and presence of metastasis. The neutrophil/lymphocyte ratio may help us predict the size of the tumor, lymph node involvement, and distant metastasis when the right cut-off points are established.

Anahtar Kelimeler

• Thyroid cancer
• neutrophil lymphocyte ratio
• carcinogenesis

Kaynakça

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