THE PREDICTIVE EFFECT OF NEUTROPHIL AND PLATELET LYMPHOCYTE RATIOS ON MICROSCOPIC SENTINEL LYMPH NODE METASTASES IN STAGE 2 MALIGNANT MELANOMA PATIENTS

Yıl 2024, , 68 - 72, 04.06.2024

Erol Kozanoğlu , Bora Akalın , Dicle Aksoyler , Ömer Berköz , Alirza Jahangirov , Tarıkcan Kumbaşı , Ufuk Emekli , Atilla Arıncı

https://doi.org/10.26650/JARHS2024-1417909

Öz

Objective: Malignant melanoma is a life-threatening disease, and the stage affects both treatment and survival. Staging is based on the microscopic Breslow thickness of the tumor, ulceration, and lymph node status. This study compares the neutrophil and platelet lymphocyte ratios of patients with and without micrometastatic sentinel lymph nodes and assesses the predictive value of these ratios.

Materials and Methods: The study includes patients who had a sentinel lymph node biopsy between January 2017 and December 2021 that resulted in a T value of T2b or T3a with neither any regional lymph node metastasis (N0) nor any systemic metastasis (M0). These patients were diagnosed with Stage 2A melanoma. The study evaluates the relationships patients’ sentinel lymph node status and gender have with their neutrophil and platelet lymphocyte ratios.

Results: The study includes 65 patients, 24 of who are female and 41 of whom are male. The mean age is 55.58 years (Range = 18 to 87). The neutrophil, lymphocyte, and platelet counts and neutrophil and platelet lymphocyte ratio (NLR and PLR) did not significantly differ between the patients with and those without micrometastasis (p>0.05). The difference showed no significance whether adjusting for age and gender. A significant difference was found between the patients with and those without micrometastasis with respect to gender (p=0.009), with the percentage of males being significantly higher in the patients with micrometastasis.

Conclusion: Neutrophil and platelet lymphocyte ratios have not been found to be independent predictors of sentinel lymph node micrometastasis in Stage 2A malignant melanoma, with male patients in this stage having a higher risk of sentinel lymph node micrometastasis.

Anahtar Kelimeler

malignant melanoma, micrometastasis, neutrophil lymphocyte ratio, platelet lymphocyte ratio, sentinel lymph node biopsy

KLİNİK OLARAK EVRE 2 MALİGN MELANOM HASTALARINDA NÖTROFİL VE TROMBOSİT LENFOSİT ORANLARININ SENTİNEL LENF NODU MİKROSKOPİK METASTAZI HAKKINDAKI ÖNGÖRÜ ETKİLERİ

Öz

Amaç: Yaşamı tehdit eden bir deri kanseri olan malign melanomda hastalığın evresi tedavi yaklaşımını ve sağkalımı etkilemektedir. Malign melanomun evrelemesinde, tümörün mikroskopik olarak ölçülen Breslow kalınlığından, ülserasyondan ve olası bir lenf nodu tutulumundan faydalanılmaktadır. Bu çalışmada sentinel lenf nodu biyopsileri mikroskopik olarak metastazsız (negatif) ve metastazlı (pozitif) olan hastaların nötrofil lenfosit ve trombosit lenfosit oranları karşılaştırıldı ve bu oranların metastaz üzerinde bir öngörü etkisi olup olmadığı değerlendirildi.

Gereç ve Yöntem: Ocak 2017–Aralık 2021 tarihleri arasında sentinel lenf nodu biyopsisi ameliyatı yapılmış olan, Breslow kalınlığına göre T değeri T2b veya T3a olan, makroskopik lenf nodu metastazı olmayan (N0) ve sistemik (uzak) metastazı da olmayan (M0) evre 2A malign melanom hastaları çalışmaya dahil edildi. Sentinel lenf nodu biyopsisi durumları ile cinsiyet arasındaki ilişki ve sentinel lenf nodu biyopsisi ile nötrofil ve trombosit lenfosit oranları arasındaki ilişki değerlendirildi.

Bulgular: Çalışmaya 65 hasta dahil edildi. Hastaların 24’ü kadın, 41’I erkekti. Hastaların ortalama yaşı 55,58 idi (18–87). Yaş ve cinsiyete göre düzeltme yapmadan ve yapılarak gerçekleştirilen değerlendirmeler sonucunda mikrometastaz açısından nötrofil, lenfosit, platelet sayıları, nötrofil lenfosit oranı (NLO) ve platelet lenfosit oranları (PLO) değerleri bakımından istatistiksel olarak anlamlı fark saptanmadı (p>0,05). Sentinel lenf nodu biyopsisi mikrometastazı olan ve olmayan hastalar arasında cinsiyet bakımından istatistiksel olarak anlamlı fark olduğu saptandı (p=0,009). Mikrometastazlı grupta erkek yüzdesinin mikrometastazsız gruptan daha yüksek olduğu saptandı.

Sonuç: Evre 2A malign melanom hastalarında, nötrofil ve trombosit lenfosit oranları, sentinel lenf nodundaki mikroskobik metastazı bağımsız bir değişken olarak öngörememektedir. Bu evredeki erkek hastalarda sentinel lenf nodu mikrometastazı riski kadın hastalara göre daha yüksektir.

Anahtar Kelimeler

Malign melanoma, mikrometastaz, nötrofil lenfosit oranı, sentinel lenf nodu biyopsisi, trombosit lenfosit oranı

Kaynakça

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