Sevde Nur FIRAT, Cavit CULHA, Şerife Mehlika KUŞKONMAZ, Işılay TAŞKALDIRAN

Erken Evre Differansiye Tiroid Kanserlerinde AST/ALT (De Ritis) Oranı

Amaç: Diferansiye tiroid kanserleri, endokrin kanserler arasında en sık olarak görülendir ve görüntüleme olanaklarının artması ile de sıklığı giderek artmaktadır. Çeşitli malignitelerde; karaciğer metastazı olmasa bile, artmış metabolizmaya, doku zedelenmesine ve hızlı tümör döngüsüne bağlı olarak AST değerinin ALT’ ye oranla arttığpı saptanmıştır. Bu oran De Ritis oranı olarak bilinmekte olup çalışmamızda erken evre tiroid kanserlerinde histopatalojik alt tip, multifokalite, hastalığın evresi ve risk grubu ile AST/ALT (De Ritis) oranı arasında bir ilişki olup olmadığını değerlendirmeyi planladık. Yöntem: Kliniğimizde 2016-2019 yılları arasında diferansiye tiroid kanseri tanısı almış 154 hasta çalışmaya dahil edildi. Hastaların preoperatif dönemdeki AST/ALT oranları kaydedildi. Postoperatif patoloji raporları değerlendirilerek her hastanın tümör evrelemesi Amerikan Ortak Kanser Komitesi (AJCC) 8‘e göre yapıldı. Hastaların operasyon öncesi De Ritis oranları ile postoperatif evreleme arasındaki korelasyon değerlendirildi. Bulgular: Çalışmamızda hastaların De Ritis değerinin ortalaması 1,18 olarak saptandı. De Ritis oranı ≥1,5 olan hasta oranı %15,9 idi. Preoperatif De Ritis oranı ile histopatolojik alt tip, vasküler invazyon, kapsül invazyonu, tümör çapı, lenf nodu tutulumu ve tümör evresi ile arasında istatistiksel olarak anlamlı fark saptanmadı. Sonuç: Çalışmamızda preoperatif De Ritis oranının, erken evre diferansiye tiroid kanserlerinde hastalık evresi ve risk durumuyla ilişkisi olmadığını saptadık. İleri evre diferansiye tiroid kanserlerindeki önemi için ek çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Diferansiye tiroid kanseri, AST/ALT, De Ritis oranı

AST/ALT (De Ritis) Ratio in Early Stage Differentiated Thyroid Cancer

Objective: Differentiated thyroid cancers are the most common endocrine cancers and their frequency is increasing with the increase in imaging possibilities. In various malignancies; Even in the absence of liver metastases, it was determined that AST value increased compared to ALT due to increased metabolism, tissue damage and rapid tumor turnover. This rate is known as the De Ritis rate, and in our study, we planned to evaluate whether there is a relationship between histopathological subtype, multifocality, disease stage and risk group and AST/ALT (De Ritis) ratio in early stage thyroid cancers. Method: A total of 154 patients diagnosed with differentiated thyroid cancer in our clinic between 2016 and 2019 were included in the study. The AST/ALT ratios of the patients in the preoperative period were recorded. Tumor staging of each patient was performed according to the American Joint Cancer Committee (AJCC) 8 by evaluating the postoperative pathology reports. The correlation between the patients' preoperative De Ritis rates and postoperative staging was evaluated. Results: In our study, the mean De Ritis value of the patients was found to be 1.18. The rate of patients with De Ritis rate ≥1.5 was 15.9%. There was no statistically significant difference between preoperative De Ritis rate and histopathological subtype, vascular invasion, capsule invasion, tumor diameter, lymph node involvement and tumor stage. Conclusion: In our study it was found that preoperative De Ritis ratio was not associated with disease stage and risk status in early stage differentiated thyroid cancers. Additional studies are needed for its importance in advanced differentiated thyroid cancers.

Keywords:

Differentiated thyroid cancer, De Ritis ratio, AST/ALT,

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