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

Yıl 2021, Cilt: 28 Sayı: 3, 507 - 513, 13.09.2021
https://doi.org/10.17343/sdutfd.962273

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.

Kaynakça

  • 1. F. Bray, J. Ferlay, I. Soerjomataram, R.L. Siegel, L.A. Torre, A. Jemal, Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries, CA: a cancer journal for clinicians, 68 (2018) 394-424.
  • 2. L.H. Nguyen, A. Goel, D.C. Chung, Pathways of colorectal carcinogenesis, Gastroenterology, 158 (2020) 291-302.
  • 3. E. Gorgun, C. Benlice, J.M. Church, Does cancer risk in colonic polyps unsuitable for polypectomy support the need for advanced endoscopic resections? Journal of the American College of Surgeons, 223 (2016) 478-484.
  • 4. O. Engin, Colon Polyps and Colorectal Cancer, Springer2020.
  • 5. J.H. Jang, E. Balik, D. Kirchoff, W. Tromp, A. Kumar, M. Grieco, D.L. Feingold, V. Cekic, L. Njoh, R.L. Whelan, Oncologic colorectal resection, not advanced endoscopic polypectomy, is the best treatment for large dysplastic adenomas, Journal of Gastrointestinal Surgery, 16 (2012) 165-172.
  • 6. S. Jones, W.-d. Chen, G. Parmigiani, F. Diehl, N. Beerenwinkel, T. Antal, A. Traulsen, M.A. Nowak, C. Siegel, V.E. Velculescu, Comparative lesion sequencing provides insights into tumor evolution, Proceedings of the National Academy of Sciences, 105 (2008) 4283-4288.
  • 7. P.J. Pickhardt, B.D. Pooler, D.H. Kim, C. Hassan, K.A. Matkowskyj, R.B. Halberg, The natural history of colorectal polyps: overview of predictive static and dynamic features, Gastroenterology Clinics, 47 (2018) 515-536.
  • 8. J.S. Levine, D.J. Ahnen, Adenomatous polyps of the colon, New England Journal of Medicine, 355 (2006) 2551-2557.
  • 9. M. Climent, É.J. Ryan, Á. Stakelum, Y.L. Khaw, B. Creavin, A. Lloyd, D. Alhassan, H.M. Mohan, R. Kennelly, K. Sheahan, Systemic inflammatory response predicts oncological outcomes in patients undergoing elective surgery for mismatch repair- deficient colorectal cancer, International journal of colorectal disease, 34 (2019) 1069-1078.
  • 10. Y. Suzuki, K. Okabayashi, H. Hasegawa, M. Tsuruta, K. Shigeta, T. Kondo, Y. Kitagawa, Comparison of preoperative inflammation- based prognostic scores in patients with colorectal cancer, Annals of surgery, 267 (2018) 527-531.
  • 11. R.D. Dolan, S.T. McSorley, J.H. Park, D.G. Watt, C.S. Roxburgh, P.G. Horgan, D.C. McMillan, The prognostic value of systemic inflammation in patients undergoing surgery for colon cancer: comparison of composite ratios and cumulative scores, British journal of cancer, 119 (2018) 40-51.
  • 12. F. Wang, W. He, C. Jiang, G. Guo, B. Ke, Q. Dai, J. Long, L. Xia, Prognostic value of inflammation-based scores in patients receiving radical resection for colorectal cancer, BMC cancer, 18 (2018) 1-10.
  • 13. H. Ataş, B. Korukluoğlu, B.A. Özdemir, N. Yakşi, B. Saylam, M. Tez, Diagnostic value of modified systemic inflammation score for prediction of malignancy in patients with indeterminate thyroid nodules, The American Journal of Surgery, 221 (2021) 117-121.
  • 14. J.-X. Lin, J.-P. Lin, J.-W. Xie, J.-b. Wang, J. Lu, Q.-Y. Chen, L.-l. Cao, M. Lin, R. Tu, C.-H. Zheng, Prognostic importance of the preoperative modified systemic inflammation score for patients with gastric cancer, Gastric Cancer, 22 (2019) 403-412.
  • 15. H. AtaŞ, B. KorukluoĞlu, B. ÇomÇali, N. YakŞİ, B. Saylam, M. Tez, Can preoperative modified systemic inflammation score (mSIS) be used to predict malignancy in persistent nondiagnostic thyroid nodules?, Turkish Journal of Medical Sciences, (2021).
  • 16. T. Suzuki, Y. Ishibashi, H. Tsujimoto, S. Nomura, K. Kouzu, Y. Itazaki, T. Sugihara, M. Harada, N. Ito, H. Sugasawa, A Novel Systemic Inflammatory Score Combined With Immunoinflammatory Markers Accurately Reflects Prognosis in Patients With Esophageal Cancer, in vivo, 34 (2020) 3705-3711.
  • 17. M. Shibutani, K. Maeda, H. Nagahara, T. Fukuoka, S. Matsutani, K. Kimura, R. Amano, K. Hirakawa, M. Ohira, The prognostic value of the systemic inflammatory score in patients with unresectable metastatic colorectal cancer, Oncology letters, 16 (2018) 666-672.
  • 18. S. Rüth, J. Spatz, M. Anthuber, Is There an Indication for Surgical Resection in Colorectal Adenoma?, Visceral Medicine, 30 (2014) 46-51.
  • 19. R. Rodrigues, S. Geyl, J. Albouys, C. De Carvalho, M. Crespi, T. Tabouret, A. Taibi, S. Durand-Fontanier, R. Legros, M. Dahan, Effect of implementing a regional referral network on surgical referral rate of benign polyps found during a colorectal cancer screening program: A population-based study, Clinics and Research in Hepatology and Gastroenterology, 45 (2021) 101488.
  • 20. A. Emmanuel, S. Gulati, M. Burt, B.H. Hayee, A. Haji, Colorectal endoscopic submucosal dissection: patient selection and special considerations, Clinical and experimental gastroenterology, 10 (2017) 121.
  • 21. S. Tanaka, H. Kashida, Y. Saito, N. Yahagi, H. Yamano, S. Saito, T. Hisabe, T. Yao, M. Watanabe, M. Yoshida, JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection, Digestive Endoscopy, 27 (2015) 417-434.
  • 22. J.M. McDonald, R. Moonka, R.H. Bell Jr, Pathologic risk factors of occult malignancy in endoscopically unresectable colonic adenomas, The American journal of surgery, 177 (1999) 384- 387.
  • 23. R. Loungnarath, M.G. Mutch, E.H. Birnbaum, T.E. Read, J.W. Fleshman, Laparoscopic colectomy using cancer principles is appropriate for colonoscopically unresectable adenomas of the colon, Diseases of the colon & rectum, 53 (2010) 1017-1022.
  • 24. L. Bujanda, A. Cosme, I. Gil, J.I. Arenas-Mirave, Malignant colorectal polyps, World journal of gastroenterology: WJG, 16 (2010) 3103.
  • 25. T. Yao, S. Shiono, Differences in the pathological diagnosis of colorectal neoplasia between the East and the West: Present status and future perspectives from Japan, Digestive Endoscopy, 28 (2016) 306-311.
  • 26. H. Ikematsu, Y. Yoda, T. Matsuda, Y. Yamaguchi, K. Hotta, N. Kobayashi, T. Fujii, Y. Oono, T. Sakamoto, T. Nakajima, Longterm outcomes after resection for submucosal invasive colorectal cancers, Gastroenterology, 144 (2013) 551-559.

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

Yıl 2021, Cilt: 28 Sayı: 3, 507 - 513, 13.09.2021
https://doi.org/10.17343/sdutfd.962273

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.

Kaynakça

  • 1. F. Bray, J. Ferlay, I. Soerjomataram, R.L. Siegel, L.A. Torre, A. Jemal, Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries, CA: a cancer journal for clinicians, 68 (2018) 394-424.
  • 2. L.H. Nguyen, A. Goel, D.C. Chung, Pathways of colorectal carcinogenesis, Gastroenterology, 158 (2020) 291-302.
  • 3. E. Gorgun, C. Benlice, J.M. Church, Does cancer risk in colonic polyps unsuitable for polypectomy support the need for advanced endoscopic resections? Journal of the American College of Surgeons, 223 (2016) 478-484.
  • 4. O. Engin, Colon Polyps and Colorectal Cancer, Springer2020.
  • 5. J.H. Jang, E. Balik, D. Kirchoff, W. Tromp, A. Kumar, M. Grieco, D.L. Feingold, V. Cekic, L. Njoh, R.L. Whelan, Oncologic colorectal resection, not advanced endoscopic polypectomy, is the best treatment for large dysplastic adenomas, Journal of Gastrointestinal Surgery, 16 (2012) 165-172.
  • 6. S. Jones, W.-d. Chen, G. Parmigiani, F. Diehl, N. Beerenwinkel, T. Antal, A. Traulsen, M.A. Nowak, C. Siegel, V.E. Velculescu, Comparative lesion sequencing provides insights into tumor evolution, Proceedings of the National Academy of Sciences, 105 (2008) 4283-4288.
  • 7. P.J. Pickhardt, B.D. Pooler, D.H. Kim, C. Hassan, K.A. Matkowskyj, R.B. Halberg, The natural history of colorectal polyps: overview of predictive static and dynamic features, Gastroenterology Clinics, 47 (2018) 515-536.
  • 8. J.S. Levine, D.J. Ahnen, Adenomatous polyps of the colon, New England Journal of Medicine, 355 (2006) 2551-2557.
  • 9. M. Climent, É.J. Ryan, Á. Stakelum, Y.L. Khaw, B. Creavin, A. Lloyd, D. Alhassan, H.M. Mohan, R. Kennelly, K. Sheahan, Systemic inflammatory response predicts oncological outcomes in patients undergoing elective surgery for mismatch repair- deficient colorectal cancer, International journal of colorectal disease, 34 (2019) 1069-1078.
  • 10. Y. Suzuki, K. Okabayashi, H. Hasegawa, M. Tsuruta, K. Shigeta, T. Kondo, Y. Kitagawa, Comparison of preoperative inflammation- based prognostic scores in patients with colorectal cancer, Annals of surgery, 267 (2018) 527-531.
  • 11. R.D. Dolan, S.T. McSorley, J.H. Park, D.G. Watt, C.S. Roxburgh, P.G. Horgan, D.C. McMillan, The prognostic value of systemic inflammation in patients undergoing surgery for colon cancer: comparison of composite ratios and cumulative scores, British journal of cancer, 119 (2018) 40-51.
  • 12. F. Wang, W. He, C. Jiang, G. Guo, B. Ke, Q. Dai, J. Long, L. Xia, Prognostic value of inflammation-based scores in patients receiving radical resection for colorectal cancer, BMC cancer, 18 (2018) 1-10.
  • 13. H. Ataş, B. Korukluoğlu, B.A. Özdemir, N. Yakşi, B. Saylam, M. Tez, Diagnostic value of modified systemic inflammation score for prediction of malignancy in patients with indeterminate thyroid nodules, The American Journal of Surgery, 221 (2021) 117-121.
  • 14. J.-X. Lin, J.-P. Lin, J.-W. Xie, J.-b. Wang, J. Lu, Q.-Y. Chen, L.-l. Cao, M. Lin, R. Tu, C.-H. Zheng, Prognostic importance of the preoperative modified systemic inflammation score for patients with gastric cancer, Gastric Cancer, 22 (2019) 403-412.
  • 15. H. AtaŞ, B. KorukluoĞlu, B. ÇomÇali, N. YakŞİ, B. Saylam, M. Tez, Can preoperative modified systemic inflammation score (mSIS) be used to predict malignancy in persistent nondiagnostic thyroid nodules?, Turkish Journal of Medical Sciences, (2021).
  • 16. T. Suzuki, Y. Ishibashi, H. Tsujimoto, S. Nomura, K. Kouzu, Y. Itazaki, T. Sugihara, M. Harada, N. Ito, H. Sugasawa, A Novel Systemic Inflammatory Score Combined With Immunoinflammatory Markers Accurately Reflects Prognosis in Patients With Esophageal Cancer, in vivo, 34 (2020) 3705-3711.
  • 17. M. Shibutani, K. Maeda, H. Nagahara, T. Fukuoka, S. Matsutani, K. Kimura, R. Amano, K. Hirakawa, M. Ohira, The prognostic value of the systemic inflammatory score in patients with unresectable metastatic colorectal cancer, Oncology letters, 16 (2018) 666-672.
  • 18. S. Rüth, J. Spatz, M. Anthuber, Is There an Indication for Surgical Resection in Colorectal Adenoma?, Visceral Medicine, 30 (2014) 46-51.
  • 19. R. Rodrigues, S. Geyl, J. Albouys, C. De Carvalho, M. Crespi, T. Tabouret, A. Taibi, S. Durand-Fontanier, R. Legros, M. Dahan, Effect of implementing a regional referral network on surgical referral rate of benign polyps found during a colorectal cancer screening program: A population-based study, Clinics and Research in Hepatology and Gastroenterology, 45 (2021) 101488.
  • 20. A. Emmanuel, S. Gulati, M. Burt, B.H. Hayee, A. Haji, Colorectal endoscopic submucosal dissection: patient selection and special considerations, Clinical and experimental gastroenterology, 10 (2017) 121.
  • 21. S. Tanaka, H. Kashida, Y. Saito, N. Yahagi, H. Yamano, S. Saito, T. Hisabe, T. Yao, M. Watanabe, M. Yoshida, JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection, Digestive Endoscopy, 27 (2015) 417-434.
  • 22. J.M. McDonald, R. Moonka, R.H. Bell Jr, Pathologic risk factors of occult malignancy in endoscopically unresectable colonic adenomas, The American journal of surgery, 177 (1999) 384- 387.
  • 23. R. Loungnarath, M.G. Mutch, E.H. Birnbaum, T.E. Read, J.W. Fleshman, Laparoscopic colectomy using cancer principles is appropriate for colonoscopically unresectable adenomas of the colon, Diseases of the colon & rectum, 53 (2010) 1017-1022.
  • 24. L. Bujanda, A. Cosme, I. Gil, J.I. Arenas-Mirave, Malignant colorectal polyps, World journal of gastroenterology: WJG, 16 (2010) 3103.
  • 25. T. Yao, S. Shiono, Differences in the pathological diagnosis of colorectal neoplasia between the East and the West: Present status and future perspectives from Japan, Digestive Endoscopy, 28 (2016) 306-311.
  • 26. H. Ikematsu, Y. Yoda, T. Matsuda, Y. Yamaguchi, K. Hotta, N. Kobayashi, T. Fujii, Y. Oono, T. Sakamoto, T. Nakajima, Longterm outcomes after resection for submucosal invasive colorectal cancers, Gastroenterology, 144 (2013) 551-559.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma Makaleleri
Yazarlar

Tezcan Akın 0000-0001-8786-6269

Serhat Ocaklı 0000-0002-3176-4914

Gizem Güneş 0000-0001-5761-4052

İbrahim Doğan 0000-0001-7413-1837

Merve Akın 0000-0001-7224-4774

Erdinç Çetinkaya 0000-0001-9249-1502

Hüseyin Berkem 0000-0002-1326-3163

Sadettin Er 0000-0003-0712-3153

Mesut Tez 0000-0001-5282-9492

Yayımlanma Tarihi 13 Eylül 2021
Gönderilme Tarihi 6 Temmuz 2021
Kabul Tarihi 24 Ağustos 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 28 Sayı: 3

Kaynak Göster

Vancouver Akın T, Ocaklı S, Güneş G, Doğan İ, Akın M, Çetinkaya E, Berkem H, Er S, Tez M. THE MODIFIED SYSTEMIC INFLAMMATION SCORE CAN BE USED TO PREDICT THE PRESENCE OF INVASIVE CARCINOMA IN COLORECTAL POLYPS WITH HIGH-GRADE DYSPLASIA. SDÜ Tıp Fak Derg. 2021;28(3):507-13.

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