Nötrofil Lenfosit Oranı ve Monosit Lenfosit Oranı Çocukluk Çağı Tuberkülozu Tanısında Kullanılabilir mi?

Öz

Amaç: Nötrofil-lenfosit oranı (NLO) ve monosit-lenfosit oranı (MLO) birçok hastalıkta bakteriyemi, hastalık aktivitesi, nüks oranı, sürveyans ve prognozu değerlendirmek için kullanılan yararlı inflamasyon biyobelirteçleridir. Bu çalışmada, enflamasyon belirteçleri olarak kullanılıp kullanılamayacaklarını göstermek için tüberkülozlu 92 çocuğun NLO ve MLO'sunu 45 sağlıklı çocukla karşılaştırarak değerlendirdik. Çalışmamızın amacı, çocukluk çağı TB tanısında NLO ve MLO'nun tanısal değerini göstermektir.

Materyal ve Metot: Bu retrospektif çalışmada, 92 tüberkülozlu çocuğun hastane kayıtları gözden geçirildi. Hastaların NLO ve MLO değerleri 45 sağlıklı çocuktan oluşan kontrol grubu ile karşılaştırıldı.

Bulgular: NLO ve MLO değerleri arasında tüberküloz hastaları ve kontrol grupları arasında anlamlı fark bulundu (p <0.001). Tüberküloz hastalarını kontrollerden ayırmak için NLO> 1.41 kesme değeri optimaldi (duyarlılık %75, özgüllük %82,2, pozitif öngörü değeri %89,6, negatif öngörü değeri %61,7). MLO> 0.22 kesme değeri, tüberküloz hastalarını kontrollerden ayırmak için optimaldi (duyarlılık %50, özgüllük %91,1, pozitif öngörü değeri %93,3, negatif öngörü değeri %53,2).

Sonuç: NLO ve MLO’nun her ikisi de çocukluk çağı tüberkülozunda inflamasyon belirteci olarak kullanılabilir. Daha net bir karar vermek için ileriye dönük ve daha kapsamlı çalışmalara ihtiyaç vardır.  

Anahtar Kelimeler

• İnflamasyon
• lenfosit
• nötrofil
• tüberküloz

Can Neutrophil to Lymphocyte Ratio and Monocyte to Lymphocyte Ratio Be Used in the Diagnosis of Childhood Tuberculosis?

Abstract

Objective: Neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR) are useful biomarkers of inflammation used to evaluate bacteremia, disease activity, recurrence rate, surveillance and prognosis in many diseases. In this study, we evaluated NLR and MLR of 92 children with tuberculosis versus 45 healthy children to show whether they can be used as inflammation markers. Aim of this study was to evaluate the diagnostic valure of NLR and MLR in childhood tuberculosis.

Materials and Methods: In this retrospective study, hospital records of 92 children with tuberculosis were reviewed. The NLR and MLR values of the patients were compared with the control group of 45 healthy children.

Results: A significant difference was found between NLO and MLO values between tuberculosis and control groups (p <0.001). A cut off value of NLR>1.41was optimal for discriminating patients with tuberculosis from controls (sensitivity 75%, specifity 82.2%, positive predictive value 89.6%, negative predictive value 61.7%). A cut off value of MLR>0.22 was optimal for discriminating patients with tuberculosis from controls (sensitivity 50%, specifity 91.1%, positive predictive value 93.3%, negative predictive value 53.2%).

Conclusions: NLR and MLR can both be used as inflammation biomarkers in the diagnosis of childhood tuberculosis. Prospective and more comprehensive studies are needed to make a clearer decision. 

Keywords

• Inflammation
• lymphocyte
• neutrophil
• tuberculosis

Kaynakça

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