Are Neutrophil, Platelet, and Eosinophil-to-Lymphocyte Ratio and Mean Platelet Volume Really Potential Predictor for Otitis Media with Chronic Effusion?

Abstract

Objective: Otitis media with effusion is an inflammatory disease characterized by fluid accumulation in the middle ear. The aim of this study is to investigate the predictive role of neutrophil, platelet, and eosinophil-to-lymphocyte ratio and mean platelet volume in adult patients having otitis media with effusion and to compare with control subjects; analyse whether they could be a potential predictor parameter to predict the disease progression.

Materials and Methods: In our study, we retrospectively analyzed 69 patients (44 male, 25 female) between the ages of 18-50 having only chronic otitis media with effusion, and 69 age- and sex matched (between ages of 18-50; 38 male, 31 female) healthy controls. Study and control groups were compared with each other for MPV, neutrophil-to-lymphocyte, platelet-to-lymphocyte, and eosinophil-to-lymphocyte ratios.

Results: NLR, PLR, ELR and MPV values in the patient group were 1.97, 112.69, 0.08 and 7.75 and the mean value of the control group was 1.90, 114.58, 0.06 and 7.62, respectively. There was no statistically significant difference between the groups (p = 0.646, 0.843, 0.16, 0.769, respectively).

Conclusion: Although there are other studies in the literature, we think that these values do not have a predictive value in the diagnosis of EOM. It is clear that further studies with large numbers of subjects are needed.

Keywords

• otitis media with effusion
• neutrophil / lymphocyte ratio
• platelet / lymphocyte ratio
• eosinophil / lymphocyte ratio
• MPV

Nötrofil, Platelet, Eosinofil/Lenfosit Oranları ve MPV’nin Efüzyonlu Otitis Media Tanısında Gerçekten Potansiyel Rolü Var mı?

Abstract

Amaç:

Efüzyonlu otitis media (EOM), orta kulakta sıvı birikimi ile karakterize inflamatuar bir hastalıktır. Bu çalışmanın amacı, EOM’li erişkin hastalarda nötrofil, platelet ve eozinofil-lenfosit oranı ve ortalama platelet hacminin prediktif rolünü araştırıp kontrol denekleri ile karşılaştırmak ve hastalığın ilerlemesini tahmin etmek için potansiyel bir belirleyici parametre olup olmadığını analiz etmektir.

Gereç ve Yöntemler:

Çalışmamızda 18-50 yaşları arasında sadece effüzyonlu kronik otitis media'lı 69 hasta (44 erkek, 25 kadın) ve yaş ve cinsiyet eşleştirilmiş 69 sağlıklı kontrol deneği (yaş aralığı 18-50; 38 erkek, 31 kadın) retrospektif olarak incelendi. Çalışma ve kontrol grupları, MPV, nötrofil-lenfosit, trombosit-lenfosit ve eozinofil-lenfosit oranları için birbirleriyle karşılaştırıldı.

Bulgular:

Hasta grubunda NLR, PLR, ELR ve MPV değerleri sırası ile 1,97; 112,69; 0,08 ve 7,75 olarak saptanırken kontrol grubunda sırası ile 1,90; 114,58; 0,06 ve 7,62 olarak bulundu ve gruplar arasında istatistiksel olarak anlamlı fark saptanmadı (sırasıyla p= 0.646, 0.843, 0.16, 0.769).

Sonuç:

Literatürde her ne kadar aksini belirten çalışmalar olsa da biz EOM tanısında bu değerlerin prediktif bir değerinin olmadığını düşünmekteyiz. Fazla sayıda denekle ileri çalışmalara ihtiyaç olduğu açıktır. 

Keywords

• efüzyonlu otitis media
• nötrofil/lenfosit oranı
• platelet/lenfosit oranı
• eosinofil/lenfosit oranı
• MPV

References

1. Referans1-Kim HS, Jung J, Dong SH, Kim SH, Jung SY, Yeo SG. Association Between High Neutrophil to Lymphocyte Ratio and Delayed Recovery From Bell's Palsy. Clin Exp Otorhinolaryngol. 2018; 15. doi: 10.21053/ceo.2018.01018. [Epub ahead of print]
2. Referans2-Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A. Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis. Biomed Res Int. 2018; 11;2018:2703518. doi: 10.1155/2018/2703518.
3. Referans3-Mochimaru T, Ueda S, Suzuki Y, Asano K, Fukunaga K. Neutrophil to lymphocyte ratio is a novel independent predictor of severe exacerbation in asthma patients. Ann Allergy Asthma Immunol. 2018; 30. pii: S1081-1206(18)31500-X. doi: 10.1016/j.anai.2018.11.029. [Epub ahead of print]
4. Referans4-Renaud S, Seitlinger J, St-Pierre D, Garfinkle R, Al Lawati Y, Guerrera F, et al. Prognostic value of neutrophil to lymphocyte ratio in lung metastasectomy for colorectal cancer. Eur J Cardiothorac Surg. 2018; 1. doi: 10.1093/ejcts/ezy388. [Epub ahead of print]
5. Referans5-Hasselbalch IC, Søndergaard HB, Koch-Henriksen N, Olsson A, Ullum H, Sellebjerg F, et al. The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis. Mult Scler J Exp Transl Clin. 2018; 28:4:2055217318813183. doi: 10.1177/2055217318813183.
6. Referans6-Cho Y, Kim JW, Yoon HI, Lee CG, Keum KC, Lee IJ. The Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Head and Neck Cancer Patients Treated with Radiotherapy. J Clin Med. 2018; 3:7. pii: E512. doi: 10.3390/jcm7120512.
7. Referans7- Kara A, Guven M, Yilmaz MS, Demir D, Elden H. Are neutrophil, platelet and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? Eur Arch Otorhinolaryngol. 2018; 275:409-413. doi: 10.1007/s00405-017-4821-3.
8. Referans8-Yenigun A, Sezen S, Calim OF, Ozturan O. Evaluation of the eosinophil-to-lymphocyte ratio in pediatric patients with allergic rhinitis. Am J Rhinol Allergy. 2016; 30:e21-5. doi: 10.2500/ajra.2016.30.4296.

9. Referans9- Eryilmaz MA, Derin S. Mean Platelet Volume as a Potential Predictor of Cholesteatoma in Children. J Craniofac Surg. 2016; 27:e575-8. doi: 10.1097/SCS.0000000000002881.
10. Referans10- Elbistanli MS, Koçak HE, Acipayam H, Yiğider AP, Keskin M, Kayhan FT. The Predictive Value of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio for the Effusion Viscosity in Otitis Media With Chronic Effusion. J Craniofac Surg. 2017; 28:e244-e247. doi: 10.1097/SCS.0000000000003452.
11. Referans11-Coates H, Thornton R, Langlands J, , Filion P, Keil AD, Vijayasekaran S, et al. The role of chronic infection in children with otitis media with effusion: evidence for intracellular persistence of bacteria. Otolaryngol Head Neck Surg 2008; 138:778–781
12. Referans12-Yellon RF, Leonard G, Marucha PT, Craven R, Carpenter RJ, Lehmann WB, et al. Characterization of cytokines present in middle ear effusions. Laryngoscope 1991; 101:165-169
13. Referans13- Smirnova MG, Kiselev SL, Gnuchev NV, J. P. Birchall, J. P. Pearson. Role of the proinflammatory cytokines tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6 and interleukin-8 in the pathogenesis of the otitis media with effusion. Eur Cytokine Netw 2002; 13:161–172
14. Referans14- Voudoukis E, Karmiris K, Koutroubakis IE. Multipotent role of platelets in inflammatory bowel diseases: a clinical approach. World J Gastroenterol. 2014; 28: 20:3180-90. doi: 10.3748/wjg.v20.i12.3180.
15. Referans15- Atan D, Apaydin E, Ozcan KM, Dere H. New diagnostic indicators in chronic otitis media with effusion: neutrophil to lymphocyte ratio and thrombocyte lymphocyte ratio. ENT Updates 2016;6:12–15
16. Referans16- Boztepe OF, Demir M, Gün T, Bilal N, Ensari NA, Doğru H. A novel predictive marker for the viscosity of otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2015; 79:2355-2358. doi:10.1016/j.ijporl.2015.10.043.