Öz
Amaç:
Görüntüleme yöntemlerindeki son gelişmelere rağmen, böbrek kitlelerinin patolojisini tahmin etmede hala %10-20 oranı yetersizdir. Bu nedenle, hematolojik enflamatuvar belirteçlerin patoloji sonucunu tahmin etmede yararlı olup olmadığını incelemeyi amaçladık.
Yöntem:
Ocak 2010 ile Ekim 2020 tarihleri arasında böbrek kitlesi nedeniyle opere edilen 116 hasta çalışmaya dahil edildi. Retrospektif olarak preoperatif trombosit, nötrofiller, lenfosit sayıları ve oranları patoloji sonuçları ile karşılaştırıldı.
Bulgular:
Çalışmaya alınan 116 hastanın yaş ortalaması 55,36±13,93 yıl idi. Yirmi altı (%22,4) hastanın patoloji sonuçları benign iken 90’ı (%77,6) malign idi. Nötrofil sayısı ve nötrofil lenfosit oranı benign grupta anlamlı olarak daha düşüktü. Renal hücreli karsinomlu hastalarda yüksek Fuhrman derecelerinde trombosit sayısı ve trombosit lenfosit oranı daha yüksek iken lenfosit sayısı ise daha düşüktü.
Sonuç:
Hematolojik enflamatuvar belirteçler, ameliyattan öncesi böbrek kitlelerinin patoloji sonucunu tahmin etmede yararlıdır.
Anahtar Kelimeler: Böbrek neoplazmaları, kan trombositleri, lenfosit, nötrofil
Kaynakça
Li W, Cheng Y, Cheng Y, Ren H, Han N. Clinical efficacy of radical nephrectomy versus nephron-sparing surgery on localized renal cell carcinoma. Eur J Med Res 2014;19(1):1-6.
Lee CT, Katz J, Fearn PA, Russo P. Mode of presentation of renal cell carcinoma provides prognostic information. Urol Oncol 2002;7(4):135-140.
Şahin H, Akarken İ. Böbrek Tümörlerinde Etiyoloji, Klinik Tanı ve Evrelemesi. Turk Klin Urol 2019;12(4):1-9.
King SC, Pollack LA, Li J, King JB, Master VA. Continued increase in incidence of renal cell carcinoma, especially in young patients and high grade disease: United States 2001 to 2010. J Urol 2014;191(6):1665-1670.
Morra MN, Das S. Renal oncocytoma: a review of histogenesis, histopathology, diagnosis and treatment. J Urol 1993;150(2 Pt 1):295-302.
Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell 2010;140(6):883-899.
Yildirim M, Kılınç Y, Ceyhan A. Behçet hastalığı patogenezindeki yenilikler. Suleyman Demirel Univ Tıp Fak Derg 2009;16(3):29-34.
Waldner MJ, Neurath MF. Colitis-Associated Cancer: the role of t cells in tumor development. Semin Immunol 2009;31(2):249-256.
Karin M. Nuclear factor-kappaB in cancer development and progression. Nature 2006;441(7092):431-436.
Wu S, Rhee KJ, Albesiano E, Rabizadeh S, Wu X, Yen HR, et al. A human colonic commensal promotes colon tumorigenesis via activation of t helper type 17 t cell responses. Nat Med 2009;15(9):1016-1022.
Howard R, Kanetsky PA, Egan KM. Exploring the prognostic value of the neutrophil-to-lymphocyte ratio in cancer. Sci Rep 2019;9(1):1-10.
Duran İ, Avcı V, Nazik S, Altun E. Çocukluk çağı apandisit tanısında nötrofil lenfosit oranı ve trombosit lenfosit oranı. Turk Klin Biyokim Derg 2017;15(1):1-7.
Kaynar M, Yildirim ME, Gul M, Kilic O, Ceylan K, Goktas S. Benign prostatic hyperplasia and prostate cancer differentiation via platelet to lymphocyte ratio. Cancer Biomark 2015;15(3):317-323.
Karaoğullarından Ü, Akkız H, Kuran S, Uskudar O, Taskaynatan H, Delik A. The relationship between thrombocyte lymphocyte ratio with tumor morphology and alpha fetoprotein in patients with hepatocellular carcinoma. Turk J Fam Med and Primary Care 2020;14(2):230-235.
Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K. Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients with colorectal cancer. Br J Cancer 2013;109(2):401-407.
Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis 2003;6(4):283-287.
Mantovani A, Allavena P, Sica A, Ballkwill F. Cancer related inflammation. Nature 2008;454(7203):436-444.
Teramukai S, Kitano T, Kishida Y, Kawahara M, Kubota K, Komuta K, et al. Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer 2009;45(11):1950-1958.
Tangal S, Kutsal Ö, Yiğman M, Haliloğlu, A. Relation of neutrophil lymphocyte ratio with tumor characteristics in localized kidney tumors. New J Urol 2018;13(1):12-15.
Keizman D, Gottfried M, Ish-Shalom M, Maimon N, Peer A, Neumann A, et al. Pretreatment neutrophil-to-lymphocyte ratio in metastatic castration-resistant prostate cancer patients treated with ketoconazole: association with outcome and predictive nomogram. Oncologist 2012;17(12):1508-1514.
Mallappa S, Sinha A, Gupta S, Chadwick S. Preoperative neutrophil to lymphocyte ratio> 5 is a prognostic factor for recurrent colorectal cancer. Colorectal Dis 2013;15(3):323-328.
Sharaiha R, Halazun K, Mirza F, Port J, Lee P, Neugut A, et al. Elevated preoperative neutrophil: lymphocyte ratio as a predictor of postoperative disease recurrence in esophageal cancer. Ann Surg Oncol 2011;18(12):3362-3369.
Forget P, Machiels J, Coulie P, Berliere M, Poncelet A, Tombal B, et al. Neutrophil: lymphocyte ratio and intraoperative use of ketorolac or diclofenac are prognostic factors in different cohorts of patients undergoing breast, lung, and kidney cancer surgery. Ann Surg Oncol 2013;20(3):650-660.
Fogar P, Sperti C, Basso D, Sanzari M, Greco E, Davoli C, et al. Decreased total lymphocyte counts in pancreatic cancer: an index of adverse outcome. Pancreas 2006;32(1):22-28.
Gudhjartsson T, Hardarson S, Petursdottir V, Thoroddsen A, Magnusion J, Einarsson GV. Histological subtyping and nuclear gradingoi renal cell carcinoma and their implications for survival: a retrospective nation-wide study of 629 patients. Eur Urol 2005;48(4):593-600.
Viers B, Thompson R, Boorjian S, Lohse C, Leibovich B, Tollefson M. Preoperative neutrophil-lymphocyte ratio predicts death among patients with localized clear cell renal carcinoma undergoing nephrectomy. Urol Oncol 2014;32(8):1277-1284.
Arda E, Yuksel I, Cakiroglu B, Akdeniz E, Cilesiz N. Valuation of neutrophil/lymphocyte ratio in renal cell carcinoma grading and progression. Cureus 2018;10(1):1-9.
