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NLR Oranı ve MPV Değeri Foliküler Neoplazi, Önemi Belirsiz Atipi ve Kuşkulu Sitolojide Maligniteyi Öngörmede Yararlı mıdır?

Amaç: Sistemik enflamasyonun bir göstergesi olan nötrofil-lenfosit oranı (NLR) ve ortalama trombosit hacmi (MPV) birçok çalışmada karsinogenez ile ilişkili bulunmuştur. Bu çalışmanın amaç bu iki parametrenin tiroit malignitesini saptamadaki prediktif değerlerini araştırmaktı. Gereç ve Yöntem: Üçüncü basamak bir sağlık kuruluşunda Ocak 2010 ile Aralık 2017 tarihleri arasında tiroit ince iğne aspirasyon biyopsisi (İİAB) sonucu önemi belirsiz atipi, foliküler neoplazi, kuşkulu sitoloji raporlanan ve bu nedenle total tiroidektomi ya da hemitiroidektomi uygulanan hastaların incelendi. 225 hastanın verileri retrospektif olarak tarandı ve 144 hasta (29 kadın/115 erkek) çalışmaya dahil edildi. Bulgular: Preoperatif NLR değerleri kesin patoloji sonucu malign gelen hastalar ile benign gelenler arasında kıyas yapıldığında malign olanlarda istatistiksel olarak anlamlı saptandı (p=0,002). Preoperatif MPV değerleri ise istatistiksel olarak anlamsız bulundu. İİAB guruplarına göre kıyas yapıldığında ise sadece kuşkulu sitolojide anlamlılık saptadık (p=0,001), diğer guruplarda anlamlılık saptamadık. Sonuç: NLR benign ve malign hastalık ayrımında faydalı olabilmektedir fakat İİAB gurupları arasında maligniteyi öngörmede bize hala net bir veri sunamamaktadır.

Are NLR Rate and MPV Values Useful in Predicting Malignancy in Follicular Neoplasia, Atypia of Undetermined Significance and Suspicious Cytology?

Objectives: Neutrophil-to-lymphocyte ratio (NLR), an indicator of systemic inflammation, and mean platelet volume (MPV) have been found to beassociated with carcinogenesis in many studies. The aim of this study was to investigate the predictive values of these two parameters in detectingthyroid malignancy.Materials and Methods: Patients who were reported to have atypia of undetermined significance, follicular neoplasia and suspected cytology asa result of thyroid fine needle aspiration biopsy (FNAB) in a tertiary health care facility between January 2010 and December 2017 and who hadundergone total thyroidectomy or hemithyroidectomy due to this were evaluated. The data of 225 patients were retrospectively reviewed, and 144patients (29 females/115 males) were included in the study.Results: When patients found to be malignant and benign as a result of the pathology results were compared, preoperative NLR values weredetected to be statistically significant in malignant patients (p=0.002). Preoperative MPV values were found to be statistically insignificant. Whencompared in terms of FNAB groups, we found a significance only in suspicious cytology (p=0.001) but found no significance in the other groups.Conclusion: NLR may be useful in the differentiation of benign and malignant diseases but still cannot provide clear data for predicting malignancybetween FNAB groups.

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