Neutrophil-to-lymphocyte and basophil-to-lymphocyte ratios in children with adenoid vegetation: Can they be prognostic markers?

Aim: Adenoid vegetation often causes open-mouth sleeping, snoring, breathing diffiulties and it is also associated with manyinflammatory diseases. In the treatment, adenoidectomy is performed to get rid of these symptoms and to prevent the futurecomplications. In recent years, it has been reported that the neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in variousdiseases. Researches on the basophil-to-lymphocyte (BLR) ratio have been increasing. The aim of our study is to compare NLR andBLR before and after adenoidectomy and to determine whether these markers can be used as prognostic factors.Material and Methods: The patients 2 to16 years old who underwent adenoidectomy in our clinic from January 2016 to June 2019were included in our study. The postoperative hospital application data of them were analyzed. Routine hemograms for surgery andpostoperative hemograms (except inflammatory conditions) were used for calculating the NLR and BLR.Results: One hundred and twelve patients were included in the study. When the preoperative and postoperative NLR values (1.3335and 1.1152, respectively) were compared, there was a statistically signifiant decrease in the postoperative period (p = 0.02).However, when the BLR values were compared preoperatively and postoperatively (0.0054 and 0.0050, respectively), there was nostatistically signifiant difference in the postoperative period (p = 0.59).Conclusion: There are very few studies in the literature that evaluates NLR before and after adenoidectomy. To our knowledge, ourresearch is the fist study to evaluate BLR before and after adenoidectomy. In contrast to the literature, a signifiant difference in NLRwas found out in our study. It has been determined that NLR can be used as a prognostic marker in adenoidectomy. More researchesare needed for BLR in this area.

PDF

___

1. Korkmaz M, Korkmaz H, Kucuker F, et al. Evaluation of the association of sleep apnea-related systemic inflammation with CRP, ESR, and neutrophil-tolymphocyte ratio. Med Sci Monit 2015;13:477-81.
2. Kim J, Bhattacharjee R, Dayyat E, et al. Increased cellular proliferation and inflammatory cytokines in tonsils derived from children with obstructive sleep apnea. Paediatr Res 2009;66:423-28.
3. Aksakal C, Sahin M. Evaluation of neutrophil/ lymphocyte ratio and platelet/lymphocyte ratio in recurrent epistaxis in childhood: Case controlled study. Pan Afr Med J 2019;2;32:154.
4. Hartnell A, Heinemann A, Conroy DM, et al. Identifiation of selective basophil chemoattractants in human nasal polyps as insulin-like growth factor-1 and insulin-like growth factor-2. J Immunol 2004;173:6448-57.
5. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-7.
6. Huang W, Huang J, Liu Q, et al. Neutrophil-lymphocyte ratio is a reliable predictive marker for earlystage diabetic nephropathy. Clin Endocrinol (Oxf) 2015;82:229-33.
7. Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: A review. Expert Rev Cardiovasc Ther 2013;11:55-9.
8. Derin S, Erdogan S, Sahan M, et al. Neutrophil– lymphocyte ratio in patients with adenoidectomy. Journal of Clinical and Diagnostic Research 2016;10:3-5.
9. Zahorec R. Ratio of neutrophil to lymphocyte counts– rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001;102:5- 14.
10. Cho JH, Lee DH, Lee NS, et al. Size assessment of adenoid and nasopharyngeal airway by acoustic rhinometry in children. J Laryngol Otol 1999;113:899- 905.
11. Izu SC, Itamoto CH, Pradella-Hallinan M, et al. Obstructive sleep apnea syndrome (OSAS) in mouth breathing children. Braz J Otorhinolaryngol 2010;76:552-6.
12. Muzumdar HV, Sin S, Nikova M, et al. Changes in heart rate variability after adenotonsillectomy in children with obstructive sleep apnea. Chest 2011;139:1050-9.
13. Potsic WP. Assessment and treatment of adenotonsillar hypertrophy in children. Am J Otolaryngol 1992;13:259-64.
14. Haapaniemi JJ. Adenoids in school-aged children. J Laryngol Otol 1995;109:196-202.
15. Bozkus F, Dikmen N, Samur A, et al. Does the neutrophil-to-lymphocyte ratio have any importance between subjects with obstructive sleep apnea syndrome with obesity and without obesity? Tuberk Toraks 2018;66:8-15.
16. Wongrakpanich S, George G, Chaiwatcharayut W, et al. The prognostic signifiance of neutrophilto-lymphocyte and platelet- to-lymphocyte ratios in patients with multiple myeloma. J Clin Lab Anal 2016;30:1208-13.
17. Brescia G, Barion U, Zanotti C, et al. Pre- and postoperative blood neutrophil-to-lymphocyte and eosinophil-to-lymphocyte ratios in patients with sinonasal polyps: A preliminary investigation. Allergy Asthma Proc 2017;1;38:64-9.
18. Celik M. The value of blood parameters as a diagnostic inflammatory biomarker for inverted papilloma. Ann Med Res 2019;26:2386-90.
19. Arruda-Olson AM, Reeder GS, Bell MR, et al. Neutrophilia predicts death and heart failure after myocardial infarction: A community-based study. Circ Cardiovasc Qual Outcomes 2009;2:656-62.
20. Rudiger A, Burckhardt OA, Harpes P, et al. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med 2006;24:451-4.
21. Duffy BK, Gurm HS, Rajagopal V, et al. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006;97:993-6.
22. Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154:995-1002.
23. Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J Natl Cancer Inst 2014;106:124.
24. Yenigun A. The effiacy of tonsillectomy in chronic tonsillitis patients as demonstrated by the neutrophilto-lymphocyte ratio. J Laryngol Otol 2015;129:386- 91.
25. Yang Z, Zhang Z, Lin F, et al. Comparisons of neutrophil-, monocyte-, eosinophil-, and basophil- lymphocyte ratios among various systemic autoimmune rheumatic diseases. APMIS 2017;125:863-71.
26. Kokoglu K, Sahin MI. Use of neutrophil, eosinophil, basophil, and platelet to lymphocyte ratio to predict patient satisfaction after septoplasty plus inferior turbinate reduction. J Craniofac Surg 2019;30:1022-6
27. Zhong W, Su W, Zhang Y, et al. Basophils as a primary inducer of the T helper type 2 immunity in ovalbumininduced allergic airway inflammation. Immunology 2014;142:202-15.
28. De Monte L, Wörmann S, Brunetto E, et al. Basophil recruitment into tumor-draining lymph nodes correlates with Th2 inflammation and reduced survival in pancreatic cancer patients. Cancer Res 2016;76:1792-803.
29. Ameli F, Brocchetti F, Tosca MA, et al. Adenoidal hypertrophy and allergic rhinitis: is there an inverse relationship? Am J Rhinol Allergy 2013;27:5-10.