Varol GÜLSEREN, Mustafa KOCAER, İlker ÇAKIR, İsa Aykut ÖZDEMİR, Mehmet GÖKÇÜ, Muzaffer SANCI, Kemal GÜNGÖRDÜK

Grade I-II Küçük Tümörlü (<4 cm) Endometrioid Tip Endometriyum Kanserinde İnflamasyon Belirteçlerinin Prognostik Faktörler ile İlişkisi

Amaç: 40 mm’den küçük grade I-II endometrioid tip endometriyum kanseri (EEC) hastalarında ameliyat öncesi periferal kan örneğinden bakılan tam kan sayımında elde edilen nötrofil/ lenfosit oranı (NLO) ve platelet/ lenfosit oranı (PLO) değerleri ile prognostik faktörler (myometriyal invazyon derinliği, servikal invazyon, lenf nodu tutulumu, ve evre) arasındaki ilişkiyi araştırmakdır.Materyal metod: Bu çalışmada, Ocak 2013-Ocak 2016 tarihleri arasında Tepecik Eğitim ve Araştırma Hastanesi Jinekolojik Onkoloji kliniğinde, EEC tanısını alan ve histerektomi ve retroperitoneal lenfadenektomi işlemi yapılan hastaların kayıtlarını retrospektif olarak gözden geçirdik. Sadece 40 mm’den küçük tümörü olan ve grade I-II hastalar incelendi ve çalışmaya dahil edildi. EEC'de prediktif prognostik faktörlerin optimal eşik (cut-off) değerini belirlemek için ROC (Receiver operating characteristic) eğrisi analizi kullanıldı.Bulgular: Hastaların prognostik faktörlerinden derin myometriyal invazyon, servikal invazyon varlığı, lenf nodu metastazı varlığı ve ileri evre tümörü olanlarda NLO, PLO ve CA125 değerlerinin daha yüksek olduğu ve tüm sonuçların istatiksel olarak anlamlı olduğu tespit edildi. Yapılan ROC analizinde ileri evre, lenf nodu metastazı ve derin myometriyal invazyon için en yüksek eğri altında kalan alana sahip faktörün NLO olduğu bulundu. Ancak servikal invazyon için en yüksek eğri altında kalan alana PLO değerinin sahip olduğu gösterildi. Sonuç: Prognostik faktörlerden ileri evre, lenf nodu metastazı, derin myometriyal invazyon ve servikal stromal invazyon varlığında grade I-II <4 cm tümörü olan EEC hastalarında bakılan ortalama NLO, PLO ve CA125 değerlerinin daha yüksek olduğu gösterildi. Sistemik inflamasyon belirteçlerinin grade I-II tümör boyutu <4 cm olan EEC hastalarında kötü prognoz ile ilişkili olduğu saptandı.

Anahtar Kelimeler:

Nötrofil/ lenfosit oranı, Platelet/ lenfosit oranı, endometriyum kanseri

Relationship between inflammation markers and prognostic factors in grade I-II small-size (<4 cm) endometrioid type endometrial carcinoma

Objectives: To investigate the association between neutrophil / lymphocyte ratio (NLO) and platelet / lymphocyte ratio (PLO) values and prognostic factors (myometrial invasion, cervical invasion, lymph node involvement, and stage) in the complet blood count of patients with <40 mm grade I-II endometrioid type endometrial carcinoma (EEC).Materials and Methods: In this study, we retrospectively reviewed the records of patients who received EEC diagnosis and underwent hysterectomy and retroperitoneal lymphadenectomy in the gynecological clinic of Tepecik Training and Research Hospital between January 2013 and January 2016. Grade I-II patients with tumors size less than 40 mm were studied and included in the study. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of predictive prognostic factors in the EEC.Results: Patients with deep myometrial invasion, presence of cervical invasion, presence of lymph node metastasis and advanced stage tumors were found to be higher of NLO, PLO and CA125 values, and all results were found to be statistically significant. According to ROC curve analysis, NLO was found to be the factor with the highest area under curve for advanced stage, lymph node metastasis and deep myometrial invasion. However, the highest area under curve for cervical invasion was shown to have PLO value. Conclusion: In the grade I-II <4 cm tumors EEC patients who include advanced stage, lymph node metastasis, deep myometrial invasion and cervical stromal invasion were higher mean NLO, PLO and CA125 values. Systemic inflammation markers were found to be associated with poor prognosis in EEC patients with grade I-II tumor size <4 cm.

Keywords:

Neutrophil / lymphocyte ratio, Platelet / lymphocyte ratio, Endometrium cancer,

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