Sevil ÖZER SARI, Hüseyin KÖSEOĞLU, Mustafa AKAR, Tevfik SOLAKOĞLU, Osman ERSOY

Nötrofil / lenfosit oranı kronik hepatit B hastalarında karaciğer fibrozisini saptamada kullanılabilir mi?

Amaç: Kronik hepatit B (KHB) hastalarında fibrozis değerlendirmesi siroz ve hepatosellüler kanser gelişimini önlemek açısından önemlidir. Karaciğer biyopsisi fibrozisi değerlendirmek için altın standarttır. Karaciğer biyopsisinin invaziv olması ve komplikasyonlarının olması nedeniyle karaciğer histopatolojisini gösterecek noninvaziv testler önem kazanmıştır. Nötrofil/lenfosit oranının (NLO) nonalkolik steatohepatitli ve KHB'li hastalarda fibrozis ile ilişkisini gösteren bazı çalışmalar bulunmaktadır. Bu çalışmanın amacı KHB’li hastalarda NLO ile karaciğer fibrozisi arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Hepatoloji polikliniğimizce takip edilen ve karaciğer biyopsisi olan 67 KHB’li hasta retrospektif olarak değerlendirildi. Tüm hastaların demografik verileri, laboratuvar parametreleri ve karaciğer biyopsisinde saptanan değerler kaydedildi. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 48,6±11,7 yıl idi. 17 hasta kadın (%25,4), 50 hasta erkekti (%69,6). Fibrozis dereceleri 8 hastada 0, 15 hastada 1, 8 hastada 2, 18 hastada 3, 7 hastada 4, 9 hastada 5, 2 hastada 6 olarak değerlendirildi. KHB hastalarında karaciğer biyopsisinde saptanan fibrozis ile NLO arasındaki ilişkiye bakıldığında iki parametre arasında anlamlı bir ilişki saptanmadı (p=0,54). Sonuç: NLO oranı KHB'li hastalarda fibrozisi göstermede etkin bir parametre olarak görülmemiştir.

Can neutrophil / lymphocyte ratio be used as a predictor of the hepatic fibrosis in chronic hepatitis B patients

Aim: Assessing fibrosis in chronic hepatitis B (CHB) patients is important in preventing cirrhosis and hepatocellular cancer development. Liver biopsy is the golden standard in evaluating fibrosis. Because liver biopsy is invasive and has complications, non-invasive tests to demonstrate liver histopathology have become more important. There are some studies that demonstrate the relationship between neutrophil/lymphocyte ratio (NLR) and fibrosis in nonalcoholic steatohepatitis and CHB patients. The purpose of the present study was to evaluate the relationship between NLR and hepatic fibrosis in CHB patients. Materials and Methods: Sixty-seven patients who were under follow-up by our hepatology outpatient clinic and had liver biopsies were reviewed retrospectively. Demographics, laboratory parameters and values measured with liver biopsy were recorded for each patient. Results: The mean age of the study population was 48.6±11.7 years. Seventeen women (25.4%) and 50 men (69.6%) were included in the study. Fibrosis degree was 0 in 8 patients, 1 in 15, 2 in 8, 3 in 18, 4 in 7, 5 in 9, and 6 in 2. No significant relationship was found between fibrosis degree which was detected by liver biopsy and NLR in CHB patients (p=0.54). Conclusion: NLR ratio was not considered to be an effective parameter to demonstrate fibrosis in CHB patients.

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