Rektum kanserinde patolojik tam yanıt ilişkili yeni bir prognostik index

Amaç: Rektal kanserlerin yaklaşık yarısı lokal ileri evrede tanı almaktadır. Neoadjuvan kemoradyoterapiyi takiben cerrahi uygulanan hastalarda patolojik tam yanıtı öngörecek biyobelirteçlerin saptanması önemlidir. Gereç ve Yöntem: Retrospektif planlanan çalışmaya neoadjuvan kemoradyoterapiyi takiben cerrahi geçirmiş ve adjuvan kemoterapi almış lokal ileri evre rektum kanserli 205 hasta dahil edildi. Neoadjuvan tedavi öncesinde bakılan tam kan sayımında inflamatuvar biyobelirteçler çalışıldı. Bulgular: Hastaların %20.5’inde patolojik tam yanıt saptandı. Nötrofil-lenfosit oranı, platelet-lenfosit oranı ve pan-immün inflamasyon değeri patolojik tam yanıt (+) grupta patolojik tam yanıt (-) gruptan anlamlı düşük bulundu. Pan-immün inflamasyon için cut-off ≤331.2 bulundu ve %90.4 ile en iyi tanısal test olarak saptandı. Sonuç: Rektum kanserinde neoadjuvan kemoradyoterapi, sonrasında cerrahi ve adjuvan kemoterapi standart tedavi yaklaşımı olarak önemini korumaktadır. Patolojik tam yanıt onkolojik sonuçları iyileştirdiğinden; rektum kanserinde de patolojik tam yanıtı öngörecek biyobelirteçlerin bilinmesi önemlidir. Nötrofil-lenfosit oranı, platelet-lenfosit oranı ve pan-immün inflamasyon değeri patolojik tam yanıt (+) grupta anlamlı düşük saptandı ve pan-immün inflamasyon en iyi tanısal test olarak saptandı.

Anahtar Kelimeler:

Rektum kanseri, patolojik tam yanıt, inflamatuvar biyobelirteçler, pan-immün inflamasyon değeri

A new prognostic index associated with pathological complete response in rectal cancer

Purpose: Approximately half of rectal cancer cases are diagnosed at a locally advanced stage. It is important to identify biomarkers that can predict pathological complete response in patients undergoing surgery following neoadjuvant chemoradiotherapy. Materials and Methods: This retrospective study included 205 patients with locally advanced rectal cancer who underwent surgery and adjuvant chemotherapy following neoadjuvant chemoradiotherapy. Inflammatory biomarkers were assayed in the complete blood count before neoadjuvant therapy. Results: A pathological complete response was detected in 20.5% of the patients. The neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and pan-immune inflammation value were significantly lower in the pathological complete response (+) group than in the pathological complete response (-) group. The cut-off of the pan-immune inflammation value was ≤ 331.2, and this parameter had the best diagnostic performance of 90.4%. Conclusion: Neoadjuvant chemoradiotherapy followed by surgery and adjuvant chemotherapy remains the standard treatment approach for rectal cancer. Since pathological complete response improves oncological outcomes, it is important to identify biomarkers that can predict pathological complete response in rectal cancer

Keywords:

rectal cancer, pathological complete response, inflammatory biomarkers, pan-immune inflammation value,

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