Abdullah Çetin TANRIKULU, Abdurrahman ABAKAY, Cengizhan SEZGİ, Hadice ŞEN, Özlem ABAKAY, Fatih METEROĞLU, Halide KAYA, Abdurrahman ŞENYİĞİT

YÜKSEK RDW VE MPV SEVİYELERİNİN PERİKARD TUTULUMU OLAN MEZOTELYOMA İLE İLİŞKİSİ

Malign Mezotelyoma (MM) agresif ve kötü prognozlu bir tümördür. Ortalama trombosit hacmi (MPV) trombosit fonksiyonlarını gösterir. Kırmızı kan hücresi dağılım genişliği (RDW) ise dolaşımda bulunan eritrositlerin bir ölçüsüdür ve kalp yetmezliğinde belirteç olarak kullanılmaktadır. Her iki parametrede çeşitli hastalıklarda prognostik öneme sahip olabilmektedir. Perikard tutulumu olan hastalarda MPV ve RDW değerlerinin klinik önemini araştırmak amacıyla 70 (34 perikard tutulumu olan, 36 olmayan) hasta çalışmaya alındı. Perikard tutulumu olarak Toraks Bilgisayarlı Tomografide ve/veya trans-torasik ekokardiyografide perikard tutulumu olması kabul edildi. MM hastalarının yaş ortalaması 57,5 yıl olarak bulundu. Otuz sekiz (% 54,3) erkek ve 32 (% 45,7) kadın hasta çalışmaya alındı. Toplam 44 hastada (% 62,9) çevresel asbest teması pozitifti ve ortalama süresi ise 27,3 yıldı. Perikard tutulumu olan hastaların yaş ortalaması 51,3 tutulumu olmayanların ise 63,3 yıl idi tutulum olanlar anlamlı olarak daha gençti (p= 0,000). Perikard tutulumu olan hastaların ortalama RDW değeri % 20 iken tutulumu olmayan hastaların ortalama RDW değeri ise ve tutulum olanlarda RDW anlamlı olarak daha yüksekti (p= 0,000). Perikard tutulumu ile asbest temas süresi, trombosit ve MPV arasında ise anlamlı bir fark yoktu. Bu çalışma sonucunda RDW'nin bu hastalığın özellikle perikard tutulumu olan hastaların takibinde faydalı bir parametre olabileceğini düşünmekteyiz. Fakat bu konuda geniş serili ve prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

MPV, RDW, perikard tutulumu, mezotelyoma

HIGH RDW AND MPV LEVELS ASSOCIATED MESOTHELIOMA WITH PERICARDIAL INVOLVEMENT

Malignant mesothelioma (MM) is aggressive and has a poor prognosis tumor. Mean platelet volume (MPV) indicates that platelet function. Red blood cell distribution width (RDW) is a measure of the circulation erythrocytes and is used as a marker of heart failure. Both parameters may have prognostic importance in several diseases. In order to investigate the clinical significance of MPV and RDW in pericardial involvement patients 70 (34 pericardial involvement, not 36) patients included in the study. Pericardial invasion in the thoracic computed tomography and / or transthoracic echocardiography was accepted to have pericardial involvement. Mean age of MM patients 57.5 years. Thirty-eight (54.3%) were male and 32 (45.7%) female patients were included in the study. In a total of 44 patients (62.9%) were determined for environmental asbestos exposure and the mean exposure time 27.3 years. Mean age of patients with pericardial involvement were 51.3 years and non-involvement were 63.3 years and patients with pericardial involvement significantly younger than noninvolvement (p=0.000). The mean RDW was 20% in patients with pericardial involvement while the mean RDW was 16% in non- involvement and RDW was significantly higher in patients with involvement (p=0.000). Duration of exposure to asbestos, there was no significant difference between platelets and MPV values. There was no significant difference between pericardial involvements; platelets, duration of exposure to asbestos and MPV. Results of this study RDW may be useful parameter follow-up of patients with this disease, especially with pericardial involvement. However, large series, and prospective studies are needed about this issue.

Keywords:

MPV, RDW, pericardial involvement, mesothelioma,

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1. Robinson BWS, Musk AW, Lake RA. Malignant mesothelioma. Lancet 2005; 366: 397-408.
2. Sterman DH, Albelda SM. Advances in the diagnosis,evaluation, and management of malignant pleural mesothelioma. Respirology 2005; 10: 266-83.
3. Lagrotteria DD, Tsang B, Elavathil LJ, Tomlinson CW. A case of primary malignant pericardial mesothelioma. Can J Cardiol 2005; 21: 185-7.
4. Carter P, Eggleston JC. Tumours of Lower respiratory tract. In: Atlas of Tumor Pathology, Fascicle 17. Armed Forces Institute of Pathology, Washington, DC 1980;331.
5. Wedzicha JA, Cotter FE, Empey DW. Platelet size in patients with chronic airflow obstruction with and without hypoxaemia. Thorax. 1988;43(1):61-4.
6. Kario K, Matsuo T, Nakao K. Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haematol 1992;14(4):281-7.
7. Bessman JD, Gilmer PR Jr, Gardner FH. Improved classification of anemias by MCV and RDW. Am J Clin Pathol 1983;80:322-6.
8. Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion 2005;20:83-90.
9. Chiari MM, Bagnoli R, De Luca PD, Monti M, Rampoldi E, Cunietti E. Influence of acute inflammation on iron and nutritional status indexes in older inpatients. J Am Geriatr Soc 1995;4:767-71.
10. Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, Liebenthal C, Niebauer J, Hooper J, Volk HD, Coats AJ, Anker SD. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 2000;19:3060-7.
11. Braun E, Domany E, Kenig Y, Mazor Y, Makhoul BF, Azzam ZS. Elevated red cell distribution width predicts poor outcome in young patients with community acquired pneumonia. Critical Care 2011 15:R194.
12. Tanrikulu AC, Senyigit A, Dagli CE, Babayigit C, Abakay A. Environmental malignant pleural mesothelioma in SoutheastTurkey. Saudi Med J. 2006 Oct;27(10):1605-1607.
13. Senyiğit A, Bayram H, Babayiğit C, Topçu F, Nazaroğlu H, Bilici A, Leblebici IH. Malignant pleural mesothelioma caused by environmental exposure to asbestos in the Southeast of Turkey: CT findings in 117 patients. Respiration. 2000;67(6):615-622.
14. Senyiğit A, Babayiğit C, Gökirmak M, Topçu F, Asan E, Coşkunsel M, Işik R, Ertem M. Incidence of malignant pleural mesothelioma due to environmental asbestos fiber exposure in the southeast of Turkey. Respiration. 2000; 67(6):610-6.
15. Ozsu S, Abul Y, Gulsoy A, Bulbul Y, Yaman S, Ozlu T. Red Cell Distribution Width in Patients with Obstructive Sleep Apnea Syndrome. Lung 2012 190:319–326.
16. Grant BJ, Kudalkar DP, Muti P, McCann SE, Trevisan M, Freudenheim JL, Schünemann HJ.. Relation Between Lung Function and RBC Distribution Width in a Population-Based Study. Chest 2003;124;494-500.
17. Sincer I, Zorlu A, Yilmaz MB, Dogan OT, Ege MR, Amioglu G, Aydin G, Ardic I, Tandogan I. Relationship between red cell distribution width and righ ventricular dysfunction in patients with chronic obstructive pulmonary disease. heart & lung 2012 (4 1) 2 3 8-2 4 3.