REKÜRRENTVE/VEYA METASTATIK JINEKOLOJIK TÜMÖRLERDE TEDAVİ ÖNCESİ NÖTROFİL-LENFOSİT ORANI VE TROMBOSİT-LENFOSİT ORANI TERAPÖTİK ETKİYE SAHİP MİDİR?

AMAÇ: Bu çalışmada radyoterapive/veya radyokemoterapi uygulanan jinekolojik malignitelerde tedavi öncesi nötrofil-lenfosit (NLR) ve trombosit-lenfosit (PLR) oranlarının sağkalım üzerine etkisi incelenmiştir.dıkları ve yan etkilerini incelemek amacıyla planlanmıştır.GEREÇ VE YÖNTEM: 2009 - 2014 yılları arasında kliniğimize tüm tedavileri yapılmış ve rutin takipleri sırasında nüks ve/veya metastaz gelişmiş 82 hasta retrospektif olarak incelenmiştir. Tüm hastaların tedavi öncesi tam kan parametreleri incelenip, sağkalım üzerindeki etkileri Kaplan Meier ve ROC eğrisi ile analiz edildi.BULGULAR: Hastaların ortanca yaşı 57,5 (30-82) ve ortanca takip süresi 26 aydı. Kan değerlerine göre medyan WBC: 7.34, RBC: 4.33, hb: 11.7, hct: 36.4, MCV: 85.8, MCH: 27.6, MCHC: 32.1, plt: 270050, lenfosit: 1,66, nötrofil: 4.79, monosit: 0.56, eozinofiller: 0.11, bazofiller: 0.1. idi. ROC analizine göre, istatistiksel olarak PLR değeri 174 ve NLR değeri 2.06 idi. Genel sağkalım oranları 2 ve 3 yılda % 78 ve % 57 idi. Tek değişkenli analizde tedavi öncesi kan tablosunda WBC > 7.34 (p = 0.01), trombosit sayısı> 270050 (p = 0.021) ve mutlak nötrofil sayısı> 4.79 (p = 0.04) olması sağkalım üzerine olumsuz etkisi görüldü. ROC analizinin sonucunda bulunan, NLR oranının>2.06 sağkalımı olumsuz etkilediği (p = 0.005) ancak PLR oranı sağkalımı etkilemediği tespit edildi.SONUÇ: Gelecekte, jinekolojik kanser teşhisi alan hastaların çok basit ve ucuz bir kan testi ile tedavi şekli belirlenebilir. Yüksek NLR, hastalara daha agresif bir tedavi yapılması gerektiğini gösteren bir parametre olarak kullanılabilir.

Anahtar Kelimeler:

Radyoterapi, Jinekolojik kanserler, Nötrojil lenfosit oranı

DOES PRETREATMENT NEUTROPHIL‑LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO HAVE A THERAPEUTIC EFFECTS IN RECURRENT AND/OR METASTATIC GYNECOLOGICAL MALIGNANCIES?

OBJECTIVE: In this study, the effect of pre-treatment neutrophil-to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on gynecological malignancies that applied radiotherapy and /or radiochemotherapy was investigated.MATERIAL AND METHODS: The data obtained from 82 patients who applied to our clinic between 2009- 2014 and developed recurrence and/or metastasis during their routine follow-up were retrospectively evaluated. Pre-treatment whole blood parameters of all patients were examined, and their effects on survival were analyzed by Kaplan Meier and the ROC curve.RESULTS: The median age was 57.5 (30-82), follow-up was 26 months. According to the blood values median WBC: 7.34, RBC: 4.33, hb: 11.7, hct: 36.4, MCV: 85.8, MCH: 27.6, MCHC: 32.1, plt: 270050, lymphocyte: 1,66, neutrophils: 4.79, monocytes: 0.56, eosinophils: 0.11, basophils: 0.1.Statistically; according to the ROC analysis, the boundary PLR value was 174 and the NLR value was 2.06. Overall survival rates were 2 and 3 years 78% , 57% . In univariate analysis the pre-treatment blood values; WBC > 7.34 (p = 0.01), the platelet value > 270050 (p = 0.021) and the absolute neutrophil value > 4.79 (p = 0.04) found to have a negative effect on survival. At the end of the ROC analysis, the NLR ratio was found to be above 2.06, adversely affecting survival (p = 0.005), but the PLR rate did not affect survival.CONCLUSIONS: In the future, the treatment method of patients diagnosed with gynecological cancer can be determined with a very simple and inexpensive blood test. High NLR before treatment can be used as a parameter indicating a more aggressive treatment approach may be required in patients.

Keywords:

radiotherapy gynecological cancer, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio,

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