Publication: Larinksin skuamöz hücreli karsinomunda nötrofil/ lenfosit oranının önemi
Abstract
Amaç: İnflamasyon ile kanser arasındaki ilişki 19. yüzyıldan beri bilinmektedir. Ancak bu ilişkinin patogenezi ve patofizyolojisi yeni yeni araştırılmaya başlanmıştır. Yapılan çalışmalarda artmış nötrofil/ lenfosit oranının bazı malignitelerde kötü prognostik faktör olduğu gösterilmiştir. Literatürde larinks kanseri ile nötrofil/ lenfosit oranının arasındaki ilişkiyi araştıran bir çalışma bulunmamaktadır. Bu çalışmanın amacı larinks kanseri ile preoperatif nötrofil/ lenfosit oranının prognostik bir değerinin olup olmadığını belirlemektir. Yöntem: 2003- 2013 yılları arasında Marmara Üniversitesi Tıp Fakültesi KBB Anabilim dalında larinks kanseri nedeniyle parsiyel veya total larenjektomi operasyonu yapılan 139 hastanın preoperatif kan tahlilleri retrospektif olarak değerlendirildi. Hastaların nötrofil ve lenfosit değerleri dosyalarından elde edildi. Nötrofil/ lenfosit oranı preoperatif nötrofil miktarının lenfosit miktarına bölünmesi ile elde edildi. Larinks kanseri ile preoperatif nötrofil/ lenfosit oranı arasındaki ilişkiyi ortaya koymak için istatistiksel analiz değerlendirmesinde SPSS 15.0 ve Med Calc 12.3.0 paket programları kullanıldı. Bulgular: Nötrofil/ lenfosit oranının; ileri evre (Evre 3 ve 4) larinks kanserlerini, T4 larinks kanserini ve lenf nodu tutulumunu öngörme sensitivitesi farklı kesme değerleriyle sırasıyla %66.2, %83.9 ve %73.8 spesifitesi sırasıyla %76.7, %66.2 ve %65.2 olarak bulundu. T sınıflamasına göre yapılan evrelemede tümörün evresi ilerledikçe nötrofil/ lenfosit oranının anlamlı olarak arttığı tespit edildi.(p<0.001) Tümörün lenf nodu yayılımı ile nötrofil/ lenfosit oranı arasında istatiksiksel olarak anlamlı bir ilişki saptandı.(p=0.003) Sonuçlar: Larinks kanserlerinde hastalığın evresi ilerledikçe nötrofil/ lenfosit oranı yükselmektedir. Nötrofil/ lenfosit oranı; T4 larinks kanserini, ileri evre larinks kanserini (evre 3-4) ve lenf nodu tutulumunu öngörmemize yardımcı olabilecek basit, ucuz, tekrarlanabilir rutin olarak kullanılan tahlillerle elde edilebilen kıymetli bir veridir. trofil/ lenfosit oranı, prognostik faktör, larinks kanseri
Objective: Although between inflammation and cancer was recognized as early as 19. century but newly extensive research that the role of inflammation in cancer pathogenesis and progression has been acknowledged. In some studies, the increasing neutrophil/ lymphocyte rate is a prognostic factor for malignancy. Currently, no research has been conducted regarding laryngeal cancer. The aim of this study is to determine whether there is a prognostic value of the pre-operative neutrophil/ lymphocyte rate. Method: The pre-operative blood analyses of 139 patients having undergone partial or total laryngectomy due to laryngeal cancer have been evaluated retrospectively in the ENT Department at the School of Medicine at Marmara University between the years 2003-2013. The neutrophil and lymphocyte values of the patients were obtained from their files. The neutrophil/ lymphocyte rate was estimated by the division of the preoperative neutrophil amounts into the lymphocyte amount. SPSS 15.0 and Med Calc were used in the statistical analyses to determine the relationship of laryngeal cancer and the preoperative neutrophil/ lymphocyte rate. Findings: The sensitivity of the neutrophil/ lymphocyte rate in predicting advanced stage (Stage 3 and 4) laryngeal cancer, T4 laryngeal cancer and lymph node involvement was found 66.2%, 83.9% and 73.8%,respectively and its specificities were 76.7%, 66.2% and 65.2% respectively. As the stage of the tumor progressed, the neutrophil/ lymphocyte rates increased significantly according to the staging performed according to the TNM categorization (p<0.001). A statisticaly significant relationship between the lymph node dispersion of the tumor and the neutrophil/ lymphocyte rate was found (p=0.003). Conclusions: In laryngeal cancers, as the stage of the disease progresses, the neutrophil/ lymphocyte rate increases. The neutrophil lymphocyte rate is a simple, cost- effective, repeatable and routinely-used valuable datum predicting advanced stage (Stage 3 and 4) laryngeal cancer, T4 laryngeal cancers and lymph node involvement. Key Words: the neutrophil lymphocyte rate, prognostic factor, laryngeal cancer
Objective: Although between inflammation and cancer was recognized as early as 19. century but newly extensive research that the role of inflammation in cancer pathogenesis and progression has been acknowledged. In some studies, the increasing neutrophil/ lymphocyte rate is a prognostic factor for malignancy. Currently, no research has been conducted regarding laryngeal cancer. The aim of this study is to determine whether there is a prognostic value of the pre-operative neutrophil/ lymphocyte rate. Method: The pre-operative blood analyses of 139 patients having undergone partial or total laryngectomy due to laryngeal cancer have been evaluated retrospectively in the ENT Department at the School of Medicine at Marmara University between the years 2003-2013. The neutrophil and lymphocyte values of the patients were obtained from their files. The neutrophil/ lymphocyte rate was estimated by the division of the preoperative neutrophil amounts into the lymphocyte amount. SPSS 15.0 and Med Calc were used in the statistical analyses to determine the relationship of laryngeal cancer and the preoperative neutrophil/ lymphocyte rate. Findings: The sensitivity of the neutrophil/ lymphocyte rate in predicting advanced stage (Stage 3 and 4) laryngeal cancer, T4 laryngeal cancer and lymph node involvement was found 66.2%, 83.9% and 73.8%,respectively and its specificities were 76.7%, 66.2% and 65.2% respectively. As the stage of the tumor progressed, the neutrophil/ lymphocyte rates increased significantly according to the staging performed according to the TNM categorization (p<0.001). A statisticaly significant relationship between the lymph node dispersion of the tumor and the neutrophil/ lymphocyte rate was found (p=0.003). Conclusions: In laryngeal cancers, as the stage of the disease progresses, the neutrophil/ lymphocyte rate increases. The neutrophil lymphocyte rate is a simple, cost- effective, repeatable and routinely-used valuable datum predicting advanced stage (Stage 3 and 4) laryngeal cancer, T4 laryngeal cancers and lymph node involvement. Key Words: the neutrophil lymphocyte rate, prognostic factor, laryngeal cancer