Emin DALDAL, Ahmet AKBAŞ, Mehmet Fatih DASİRAN, Hasan DAGMURA, Huseyin BAKİR, İsmail OKAN

Prognostic importance of neutrophil / lymphocyte and lymphocyte / crp ratio in cases with malignant bowel obstruction

The aim of this study is to present the importance of systemic inflammatory markers in patients with malignant bowel obstruction (MBO) due to intra-abdominal tumor metastasis. Patients who developed MBO due to end-stage intra-abdominal metastatic tumoral disease between October 2010 and September 2018 were retrospectively investigated. Clinical data such as age, sex, histopathological diagnosis of primary tumor and the level of obstruction due to tumor metastasis were recorded. Patients who were still receiving chemotherapy and had no metastatic involvement in the abdomen were excluded from the study. Patients with MBO who developed intra-abdominal metastasis from non-abdominal tumors were included. In the determination of the patients, whether or not the patient had previously operated for primary tumor was not taken into consideration. Neutrophil, lymphocyte ratio (NLR) and lymphocyte CRP ratio (LCR) were determined using laboratory data including the results of neutrophil, lymphocyte, C-reactive protein (CRP) and other basic hematological parameters. The effect of these values on survival as a prognostic factor was compared with statistical methods. There were 74 patients (28 females, 46 males) aged 60.5 ± 12.8 years (27-88) who developed MBO due to tumor metastasis in the abdomen. It was detected that the diagnosis of MBO developed an average of 11±7.5 months after the primary diagnosis. As a result of statistical evaluations, we found a positive correlation between serum LCR and survival (r=0.433; p=0.001) and a negative correlation between serum NLR and survival (r=-0.202; p=0.085). According to the Cox regression analysis, high NLR increases mortality risk (p= 0.01, OR = 1.050 [CI: 1.020-1.081]) and LCR increases the survival rate (p=0.02, OR = 0.014 [ C: 0.000 to 0.503]). NLR and LCR in metastatic tumor patients are closely related to the prognosis of the disease. High NLR and low LCR values can be used as an indicator to determine the poor prognosis of malignant patients. NLR and LCR can be used as a simple, fast and cost-effective biomarker. For this, further studies are needed.

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