Uterin sarkomların preoperatif tahmininde sistemik i̇nflamasyon belirteçlerinin rolü

Yıl 2024, Cilt: 24 Sayı: 3, 111 - 117

Görkem Ülger , Kasım Akay

Öz

Amaç: Bu çalışmanın amacı, preoperatif sistemik inflamasyon belirteçlerine dayalı olarak hesaplanan pan-immün inflamasyon değeri (PIV) ve sistemik immün-inflamasyon indeksi (SII) skorlarının uterin sarkomu öngörmedeki rolünü araştırmaktır.
Gereç ve Yöntem: Mersin Üniversitesi Tıp Fakültesi Hastanesi Jinekolojik Onkoloji Cerrahisi kliniğinde Ocak 2018 ile Aralık 2023 tarihleri arasında myoma uteri ön tanısı ile histerektomi yapılan ve histopatolojik olarak uterin sarkom tanısı alan 42 hasta ile aynı dönemde myoma uteri ön tanısı ile histerektomi yapılan ve patolojik olarak myoma uteri tanısı alan 218 hasta çalışmaya dahil edildi. Yaş, gravida, parite, preoperatif tam kan parametreleri ve karaciğer fonksiyon testleri retrospektif olarak incelendi. Hastaların SII ve PIV değerleri hesaplandı.
Bulgular: Sarkom grubunda medyan yaş 60 (39-87) yıl, myoma uteri grubunda ise 49 (35-82) yıl olarak bulundu (p=0.000). Sarkom grubunda ortanca gravida 3 (0-11), myoma uteri grubunda ise 2 (0-10) olarak bulundu (p=0.009). Sarkom grubunda ortanca parite 3 (0-11), myoma uteri grubunda ise 2 (0-8) olarak bulundu (p=0.003). Sarkom grubunda ortanca nötrofil sayısı 5.18 (1.79-10.15) × 103/µL, myoma uteri grubunda ise 4.37 (1.80-12.74) × 103/µL olarak bulundu (p=0.042). Sarkom grubunda ortanca ALT değeri 14 (6-28) U/L, myoma uteri grubunda ise 16 (6-84.4) U/L olarak bulundu (p=0.036). Sarkom grubunda medyan SII değeri 791.4 (247.8-3971), myoma uteri grubunda ise 621.9 (142.9-2892.5) olarak bulundu (p=0.011). Sarkom grubunda medyan PIV değeri 374.8 (126.4-2740.7), myoma uteri grubunda ise 319.5 (52.9-2863.6) olarak bulundu (p=0.026).
Sonuç: Bu çalışma, uterin sarkomlu hastalarda preoperatif SII ve PIV değerlerinin, myoma uterili hastalara göre anlamlı derecede yüksek olduğunu göstermektedir. Bu bulgular, SII ve PIV’nin uterin sarkom için preoperatif bir belirteç olarak kullanılabileceğini düşündürmektedir.

Anahtar Kelimeler

Uterin sarkom, myoma uteri, SII, PIV, inflamasyon

The role of systemic inflammation markers in the preoperative prediction of uterine sarcomas

Öz

Aim: To investigate the role of systemic immune-inflammation index (SII) and pan-immune inflammation value (PIV) in predicting uterine sarcoma preoperatively.
Material and Method: This retrospective study included 42 patients diagnosed with uterine sarcoma and 218 patients diagnosed with uterine leiomyoma after hysterectomy performed with a preoperative diagnosis of uterine leiomyoma at Mersin University Faculty of Medicine Hospital between January 2018 and December 2023. Age, gravidity, parity, preoperative complete blood count parameters, and liver function tests were retrospectively reviewed. SII, and PIV were calculated for all patients.
Results: The median age was 60 (39-87) years in the sarcoma group and 49 (35-82) years in the uterine leiomyoma group (p=0.000). The median gravidity was 3 (0-11) in the sarcoma group and 2 (0-10) in the uterine leiomyoma group (p=0.009). The median parity was 3 (0-11) in the sarcoma group and 2 (0-8) in the uterine leiomyoma group (p=0.003). The median neutrophil count was 5.18 (1.79-10.15) × 103/µL in the sarcoma group and 4.37 (1.80-12.74) × 103/µL in the uterine leiomyoma group (p=0.042). The median ALT level was 14 (6-28) U/L in the sarcoma group and 16 (6-84.4) U/L in the uterine leiomyoma group (p=0.036). The median SII was 791.4 (247.8-3971) in the sarcoma group and 621.9 (142.9-2892.5) in the uterine leiomyoma group (p=0.011). The median PIV was 374.8 (126.4-2740.7) in the sarcoma group and 319.5 (52.9-2863.6) in the uterin leiomyoma group (p=0.026).
Conclusion: This study demonstrates that preoperative SII and PIV values are significantly higher in patients with uterine sarcoma compared to those with uterin leiomyoma. These findings suggest that SII and PIV may be used as a preoperative marker for uterine sarcoma.

Anahtar Kelimeler

Uterine sarcoma, myoma uteri, SII, PIV, inflammation

Kaynakça

• Rahaman J, Cohen CJ. Gynecologic sarcomas. Holland-Frei Cancer Medicine. 2016:1-9.
• Mahadevan P. Pathology of Uterine Sarcomas. Uterine Cancer: Diagnosis and Treatment: Springer; 2015. p. 123-43.
• Cho Hy, Kim K, Kim YB, No JH. Differential diagnosis between uterine sarcoma and leiomyoma using preoperative clini-cal characteristics. Journal of Obstetrics and Gynaecology Research. 2016;42(3):313-8.
• Kurnit KC, Previs RA, Soliman PT, Westin SN, Klopp AH, Fellman BM, et al. Prognostic factors impacting survival in early stage uterine carcinosarcoma. Gynecologic oncology. 2019;152(1):31-7.
• Wojdat R, Malanowska E. An evaluation of a Myomscore in the preoperative assessment of uterus myomatosus: a new diagnostic standard? The experience at the Mathilden Hospital in Herford, Germany. Gynecological Surgery. 2020;17(1):9.
• Suzuki A, Aoki M, Miyagawa C, Murakami K, Takaya H, Kotani Y, et al., editors. Differential diagnosis of uterine leiom-yoma and uterine sarcoma using magnetic resonance images: a literature review. Healthcare; 2019: MDPI.
• Shinko D, Diakos CI, Clarke SJ, Charles KA. Cancer-related systemic inflammation: the challenges and therapeutic op-portunities for personalized medicine. Clinical Pharmacology & Therapeutics. 2017;102(4):599-610.
• Tong L, Wang S, Zhang R, Wu Y, Xu D, Chen L. High Levels of SII and PIV are the Risk Factors of Axillary Lymph Node Metastases in Breast Cancer: A Retrospective Study. International Journal of General Medicine. 2023;16(null):2211-8.
• Sylman JL, Mitrugno A, Atallah M, Tormoen GW, Shatzel JJ, Tassi Yunga S, et al. The predictive value of inflammation-related peripheral blood measurements in cancer staging and prognosis. Frontiers in oncology. 2018;8:78.
• Liu J, Wang Z. Advances in the preoperative identification of uterine sarcoma. Cancers. 2022;14(14):3517.
• Mariconde JM, Rosato O. # 828 Uterine sarcomas in patients under 40 years of age. BMJ Specialist Journals; 2023.
• Hosh M, Antar S, Nazzal A, Warda M, Gibreel A, Refky B. Uterine sarcoma: analysis of 13,089 cases based on surveillan-ce, epidemiology, and end results database. International Journal of Gynecologic Cancer. 2016;26(6).
• Huang Y, Chen Y, Zhu Y, Wu Q, Yao C, Xia H, et al. Postoperative systemic immune-inflammation index (SII): a superior prognostic factor of endometrial cancer. Frontiers in Surgery. 2021;8:704235.
• Bartl T, Bekos C, Postl M, Alexander R, Polterauer S, Stefanie A, et al. The systemic immune-inflammation index (SII) is an independent prognostic parameter of survival in patients with invasive vulvar cancer. Journal of Gynecologic Onco-logy. 2021;32(1).
• Tang J-N, Goyal H, Yu S, Luo H. Prognostic value of systemic immune-inflammation index (SII) in cancers: A systematic review and meta-analysis. Journal of Laboratory and Precision Medicine. 2018;3(3).
• Fest J, Ruiter R, Mulder M, Groot Koerkamp B, Ikram MA, Stricker BH, et al. The systemic immune-inflammation index is associated with an increased risk of incident cancer—A population-based cohort study. International journal of cancer. 2020;146(3):692-8.
• Wang F, Dai X, Chen H, Hu X, Wang Y. Clinical characteristics and prognosis analysis of uterine sarcoma: a single-institution retrospective study. BMC Cancer. 2022;22(1):1050.
• Jeong MJ, Park JH, Hur SY, Kim CJ, Nam HS, Lee YS. Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Fac-tor in Uterine Sarcoma. Journal of Clinical Medicine. 2020;9(9):2898.
• Suh DS, Song YJ, Roh H-J, Lee SH, Jeong DH, Lee TH, et al. Preoperative Blood Inflammatory Markers for the Differenti-ation of Uterine Leiomyosarcoma from Leiomyoma. Cancer Management and Research. 2021;13(null):5001-11.
• Jeong YY, Lee EJ, Cho EB, Ryu JM, Choi YS. The role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio as a supplemental tool for differential diagnosis of uterine myoma and sarcoma. CEOG. 2021;48(4):901-6.