mmj

Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi

2148-8118 2618-6020

Muğla Sıtkı Koçman Üniversitesi

Surgery

Cerrahi

Predictive Role of Neutrophil to Lymphocyte Ratio in Differentiation of Different Thyroid Pathologies

Farklı Tiroid Patolojilerinin Ayrımında Nötrofil Lenfosit Oranının Prediktif Rolü

https://orcid.org/0000-0003-4481-4279

Atak

İbrahim

Ali Osman Sönmez Onkoloji Hastanesi, Genel Cerrahi Kliniği, Bursa

https://orcid.org/0000-0003-0597-7948

Polat

Lütfi

Ali Osman Sönmez Onkoloji Hastanesi, Genel Cerrahi Kliniği, Bursa

https://orcid.org/0000-0003-4585-7828

Atak

Tuba

Çekirge Devlet Hastanesi, Genel Cerrahi Kliniği, Bursa

03 20 2019

6 1 16 20 09 16 2018 10 15 2018

2014

Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi

Theneutrophil/lymphocyte ratio (NLR) and platelete/ lymphocyte ratio (PLR) is asimple marker of systemic inflamatory response. The aim of this study was toexamine the relationship of NLR and PLR with thyroid cancer and differentbenign thyroidal pathologies such as multi nodular goiter and thyroiditis. 331patients who underwent thyroidectomy in general surgery department of ourhospital between 2015 and 2017 were evaluated. Laboratory findings, demographiccharacteristics and pathology reports of patients were retrospectivelyreviewed. Patients were devided into four groups according to pathologicalreports. 241 of 331 patients were diagnosed with MNG (MNG Group), 17 werethyroiditis (T group), 49 were thyroid carcinomas (TK Group) and 24 werethyroid carcinoma with thyroiditis (T-TK Group). Patients were also devided intotwo groups according to precence of malignancy as benign (n=258) and malign(n=73). NLR and PLR values of groups were compared. 292 (88.2%) of paitentswere female and 39 (11.8%) were male with a mean age was 50.52±12.08 years.There was no statistically significant difference between four groups in termsof NLR and PLR values (p>0.05). However, according to presence ofmalignancy, NLR values of malignantgroup was found to be statistically higher than the NLR values of benign group(p=0.039; p<0.05). There were no difference between two groups according toPLR values (p>0.05). In our study, there was no relationship betweendifferent thyroid pathologies and NLR and PLR. There is a need for prospective,randomized, large series of studies on the subject.

Nörtofil lenfositoranı (NLO) ve platelet lenfosit oranı (PLO) sistemik enflamatuar yanıtın basitbir göstergesidir ve bazı hastalıklarda prognostik olduğu gösterilmiştir. Buçalışma NLO ve PLO ile tiroid kanseri ve tiroidin multinodüler guatr vetiroidit gibi diğer benign hastalıkları arasındaki ilişkiyi ortaya koymak amacıile gerçekleştirildi. Hastanemiz genel cerrahi kliniğinde 2015-2017 yıllarıarasında tiroidektomi ameliyatı olan 331 hasta değerlendirildi. Hastalarınlaboratuar bulguları, demografik özellikleri ve patoloji raporları geriye dönükolarak incelendi. Patoloji raporlarına göre hastalar 4 gruba ayrıldı. 331hastanın 241’ine MNG (MNG Grup), 17’sine tiroidit (T Grup), 49’una tiroidkarsinomu (TK Grup), 24’üne ise tiroidit ile birlikte tiroid karsinomu (T-TKGrup) teşhisi konuldu. Hastalar ayrıca malignite varlığına göre göre benign(n=258) ve malign (n=73) olarak 2 gruba ayrıldı. Grupların NLO ve PLO değerlerikarşılaştırıldı. Hastaların 292’si kadın (%88.2), 39’u erkek (%11.8) oluportalama yaş 50.52±12.08 idi. Dört grup arasında NLO ve PLO değeri açısındanistatistiksel olarak anlamlı fark saptanmadı (p>0.05). Bununla birliktemalignite varlığına göre malign grubun NLO değeri, benign grubun NLO değerinegöre istatistiksel olarak anlamlı düzeyde yüksek saptandı (p=0.039; p<0.05).Malignite varlığına göre grupların PLO ölçümleri arasında istatistiksel olarakanlamlı farklılık saptanmadı (p>0.05). Bizim çalışmamızda farklı tiroidpatolojileri ile NLO ve PLO arasında ilişki saptanmadı. Konu ile ilgiliprospektif, randomize geniş serili çalışmalara ihtiyaç duyulmaktadır.

Goiter Neutrophil/Lymphocyte Ratio Thyroid Carcinomas

Guatr Tiroid Karsinomu Nötrofil/Lenfosit Oranı

1. Liebeskind A, Sikora AG, Komisar A, Slavit D, Fried K. Rates of malignancy in incidentally discovered thyroid nodules evaluated with sonography and fine-needle aspiration. J Ultrasound Med. 2005;24(5):629-34.

2. Pinchera A, Aghini-Lombardi F, Antonangeli L, Vitti P. Multinodular goiter. Epidemiology and prevention. Ann Ital Chir. 1996;67(3):317-25.

3. Gandolfi PP, Frisina A, Raffa M, et al. The incidence of thyroid carcinoma in multinodular goiter: retrospective analysis. Acta Biomed. 2004;75(2):114-7.

4. Cipolla C, Sandonato L, Graceffa G, et al. Hashimoto thyroiditis coexistent with papillary thyroid carcinoma. Am Surg. 2005:71(10);874-8.

5. Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140(4):317–22.

6. Yu X-M, Schneider DF, Leverson G, Chen H, Sippel RS. Follicular variant of papillary thyroid carcinoma is a unique clinical entity: a population-based study of 10,740 cases. Thyroid. 2013;23(10):1263–8.

7. Baykan H, Cihan YB, Ozyurt K. Roles of white blood cells and subtypes as inflammatory markers in skin cancer. 2015;16(6):2303-6.

8. Turkmen K, Erdur FM, Ozcicek F, et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17(3):391-6.

9. Zahorec R. Ratio of neutrophil to lymphocyte counts—Rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5-14.

10. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102(6):653-7.

11. Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol. 2006;97(7):993-6.

12. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436–44.

13. Noh H, Eomm M, Han A. Usefulness of pretreatment neutrophil to lymphocyte ratio in predicting disease-specific survival in breast cancer patients. J Breast Cancer. 2013;16(1):55–9.

14. Gomez D, Farid S, Malik HZ, Young AL, Toogood GJ, Lodge JP, et al. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma. World J Surg. 2008;32(8):1757-62.

15. Buyukkaya E, Karakas MF, Karakas E, et al. Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome. Clin Appl Thromb Hemost. 2014;20(2):159-63.

16. Canpolat F, Akpinar H, Eskioğlu F. Mean platelet volume in psoriasis and psoriatic arthritis. Clin Rheumatol. 2010;29(3):325-8.

17. Feng JF, Huang Y, Liu JS. Combination of neutrophil lymphocyte ratio and platelet lymphocyte ratio is a useful predictor of postoperative survival in patients with esophageal squamous cell carcinoma. Onco Targets Ther. 2013;7(6):1605–12.

18. Liu CL, Lee JJ, Liu TP, Chang YC, Hsu YC, Cheng SP. Blood neutrophil-to lymphocyte ratio correlates with tumor size in patients with differentiated thyroid cancer. J Surg Oncol. 2013;107(5):493-7.

19. Seretis C, Gourgiotis S, Gemenetzis G, Seretis F, Lagoudianakis E, Dimitrakopoulos G. The significance of neutrophil/lymphocyte ratio as a possible marker of underlying papillary microcarcinomas in thyroidal goiters: a pilot study. Am J Surg. 2013;205(6):691-6.

20. Vassilatou E, Fisfs M, Morphopoulos G, et al. Papillary thyroid carcinoma producing granulocyte-macrophage colony-stimulating factor is associated with neutrophilia and eosinophilia. Hormones (Athens). 2006;5(4):303-9.