MODİFİYE SİSTEMİK İNFLAMASYON SKORU YÜKSEK DERECE DİSPLAZİLİ KOLOREKTAL POLİPLERDE İNVAZİV KARSİNOM VARLIĞINI ÖNGÖRMEDE KULLANILABİLİR

Öz

Amaç Son yıllarda sistemik inflamasyon skor (SIS) ve modifiye sistemik inflamasyon skor (mSIS) gibi skorların kolorektal kanserlerde prognostik ve prediktif değerleri araştırılmıştır. Bu çalışmada, basit labaratuvar testleri ile hesaplanan modifiye sistemik inflamatuar skorun (mSIS) high grade displazili (HGD) kolon poliplerinde invaziv karsinom varlığını öngörmedeki etkinliği araştırıldı. Gereç ve Yöntem Ocak 2019 -Ekim 2021 tarihleri arasında preoperatif HGD tanısıyla opere edilen 44 kolorektal polipli hastanın postoperatif verileri retrospektif olarak incelendi. Hastalar postoperatif histopatolojik inceleme sonuçlarına göre HGD, Tis veya adenomatöz polip ve invaziv karsinom olarak iki gruba ayrıldı. mSIS hesaplaması; mSIS 0 [albümin (ALB) ≥ 4.0 g/dL ve lenfosit/ monosit oranı (LMR) ≥ 3.4], mSIS 1 (ALB <4.0 g / dL veya LMR <3.4) ve mSIS 2 (ALB <4.0 g / dL ve LMR <3.4) şeklinde yapıldı. Bulgular Postoperatif patoloji sonuçları HGD, Tis veya adenomatöz polip olan 17 hastanın 14’ünde (%82,4) mSIS skoru 0 ve 3’ünde ise (%17,6) mSIS skoru 1 veya 2 olarak saptandı. Patoloji sonuçları invaziv karsinom olan 27 hastanın 7’sinin (%25,9) mSIS skoru 0 ve 20’sinin (%75,1) mSIS skoru 1 veya 2 olarak bulundu. Hastaların mSIS skorları ile patoloji sonuçları invaziv karsinom olan hastalar arasında anlamlı ilişki bulundu (p<0,05). Sonuç HGD’li hastalarda preoperatif dönemde mSIS skoru hesaplanarak mSIS 1 veya 2 olan hastalarda postoperatif patoloji sonuçlarının invaziv karsinom olabileceği öngörülebilir ve tedavi planını belirlemeye katkısı olabileceği sonucuna varıldı.

Anahtar Kelimeler

• kolorektal konser
• Modifiye sistemik inflamtuar skor
• inflamatuar belirteçler
• high-grade displazi

THE MODIFIED SYSTEMIC INFLAMMATION SCORE CAN BE USED TO PREDICT THE PRESENCE OF INVASIVE CARCINOMA IN COLORECTAL POLYPS WITH HIGH-GRADE DYSPLASIA

Öz

Objective In recent years, the prognostic and predictive values of scoring systems such as systemic inflammation score (SIS) and modified systemic inflammation score (mSIS) have been investigated in colorectal cancers. To investigate the efficacy of the modified systemic inflammatory score (mSIS) calculated by simple laboratory tests in predicting the presence of invasive carcinoma in colon polyps with high-grade dysplasia (HGD). Materials and Methods The postoperative data of 44 patients with colorectal polyps who underwent surgery with the diagnosis of preoperative HGD between January 2019 and October 2021 were retrospectively analyzed. According to the results of the postoperative histopathological examination, the patients were divided into two groups as HGD/intramucosal carsinom (Tis)/adenomatous polyp and invasive carcinoma. mSIS calculation was made as follows: mSIS 0 [albumin (ALB)≥4.0 g/dL and lymphocyte/ monocyte ratio (LMR)≥3.4], mSIS 1 (ALB<4.0 g/dL or LMR<3.4) and mSIS 2 (ALB<4.0 g/dL and LMR< 3.4). Results According to the postoperative pathology results, the mSIS score was 0 in 14 (82.4%) of 17 patients with Tis/adenomatous polyps, and 1 or 2 in three patients in this group (17.6%). Among the 27 patients with invasive carcinoma, mSIS was 0 in seven (25.9%) and 1 or 2 in 20 (75.1%). A significant correlation was found between mSIS and the pathology results of the patients with invasive carcinoma (p<0.05). Conclusion In patients with HGD, by calculating mSIS in the preoperative period, the postoperative pathology results in patients with mSIS 1 or 2 can be predicted to be invasive carcinoma, which can contribute to the determination of the appropriate treatment plan.

Anahtar Kelimeler

• High-grade dysplasia
• Colorectal Carcinoma
• Inflammatory markers
• Modified Systemic Inflammation Score

Kaynakça

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