Can neutrophil / lymphocyte ratio be used as a predictor of the hepatic fibrosis in chronic hepatitis B patients
Öz
Aim: Assessing fibrosis in chronic hepatitis B (CHB) patients is important in preventing cirrhosis and hepatocellular
cancer development. Liver biopsy is the golden standard in evaluating fibrosis. Because liver biopsy is invasive and
has complications, non-invasive tests to demonstrate liver histopathology have become more important. There are
some studies that demonstrate the relationship between neutrophil/lymphocyte ratio (NLR) and fibrosis in nonalcoholic steatohepatitis and CHB patients. The purpose of the present study was to evaluate the relationship
between NLR and hepatic fibrosis in CHB patients.
Materials and Methods: Sixty-seven patients who were under follow-up by our hepatology outpatient clinic and had
liver biopsies were reviewed retrospectively. Demographics, laboratory parameters and values measured with liver
biopsy were recorded for each patient.
Results: The mean age of the study population was 48.6±11.7 years. Seventeen women (25.4%) and 50 men
(69.6%) were included in the study. Fibrosis degree was 0 in 8 patients, 1 in 15, 2 in 8, 3 in 18, 4 in 7, 5 in 9, and 6 in
2. No significant relationship was found between fibrosis degree which was detected by liver biopsy and NLR in CHB
patients (p=0.54).
Conclusion: NLR ratio was not considered to be an effective parameter to demonstrate fibrosis in CHB patients.
Anahtar Kelimeler
Kaynakça
- Lok ASF, McMahon BJ. AASLD practice guideline: Chronic hepatitis B: Update of therapeutic guidelines. Rom J Gastroenterol 2004;13(2):150-4.
- McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis 2005;25(Suppl 1):3-8.
- Bravo A, Sheth SG, Chopra S. Liver biopsy. N Eng J Med 2001;344(7):495-500.
- Mardini H, Record C. Detection of assessment and monitoring of hepatic fibrosis: Biochemistry or biopsy? Ann Clin Biochem 2005;42(Pt 6):441-7.
- Piccinino F, Sagnelli E, Pasquale G, Giusti G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68.276 biopsies. J Hepatol 1986;2(2):165-73.
- Lee IC, Huang YH, Chan CC. Impact of body mass index and viral load on liver histology in hepatitis B e antigen-negative chronic hepatitis B. Clin Nutr 2011;30(5):647-52.
- Ucar F, Sezer S, Ginis Z et al. APRI, the FIB-4 score, and Forns index have noninvasive diagnostic value for liver fibrosis in patient with chronic hepatitis B. Eur J Gastroenterol Hepatol 2013;25(9):1076-81.
- Martinez SM, Crespo G, Navasa M, Forns X. Noninvasive assesment of liver fibrosis. Hepatology 2011;53(1):325-35.
- Alkhouri N, Morris-Stiff G, Campbell C, et al. Neutrophil to lymphocyte ratio: New marker for predicting steatohepatitis and fibrosis in patient with nonalcoholic fatty liver disease. Liver Int 2012;32(2):297-302.
- Yeşil A, Coşgun A, Erdem E, Koçhan K, Gündüz F, Gönen C. The relationship between fibrosis level and blood neutrophil to lymphocyte ratio in chronic HBV patient. Akademik Gastroenteroloji 2013;12(2):66-8.
- Biyik M, Ucar R, Solak Y, et al. Blood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosis. Eur J Gastroenterol Hepatol. 2013;25(4):435-41.
- Gong J, Liang YL, Zhou W, et al. Prognostic value of neurophil to lymphocyte ratio associated with prognosis in HBV-infected patients. J Med Virol 2018;90(4):730-5.
- Çelikbilek M, Dogan S, Ozbakır O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013;27(1):72-6.
- Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophillymphocyte ratio: Experience in patients with cancer. Crit Rev Oncol Hematol 2013;88(1):218-30.
- Calvaruso V, Craxi A. Fibrosis in chronic viral hepatitis. Best Pract Res Clin Gastroenterol 2011;25(2):219-30.
- Kekilli M, Tanoglu A, Sakin YS, Kurt M, Ocal S, Bagci S. Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B? World J Gastroenterol 2015;21(18):5575-81.
Nötrofil / lenfosit oranı kronik hepatit B hastalarında karaciğer fibrozisini saptamada kullanılabilir mi?
Öz
Amaç: Kronik hepatit B (KHB) hastalarında fibrozis değerlendirmesi siroz ve hepatosellüler kanser gelişimini
önlemek açısından önemlidir. Karaciğer biyopsisi fibrozisi değerlendirmek için altın standarttır. Karaciğer biyopsisinin
invaziv olması ve komplikasyonlarının olması nedeniyle karaciğer histopatolojisini gösterecek noninvaziv testler önem
kazanmıştır. Nötrofil/lenfosit oranının (NLO) nonalkolik steatohepatitli ve KHB'li hastalarda fibrozis ile ilişkisini
gösteren bazı çalışmalar bulunmaktadır. Bu çalışmanın amacı KHB’li hastalarda NLO ile karaciğer fibrozisi arasındaki
ilişkiyi değerlendirmektir.
Gereç ve Yöntem: Hepatoloji polikliniğimizce takip edilen ve karaciğer biyopsisi olan 67 KHB’li hasta retrospektif
olarak değerlendirildi. Tüm hastaların demografik verileri, laboratuvar parametreleri ve karaciğer biyopsisinde
saptanan değerler kaydedildi.
Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 48,6±11,7 yıl idi. 17 hasta kadın (%25,4), 50 hasta erkekti
(%69,6). Fibrozis dereceleri 8 hastada 0, 15 hastada 1, 8 hastada 2, 18 hastada 3, 7 hastada 4, 9 hastada 5, 2
hastada 6 olarak değerlendirildi. KHB hastalarında karaciğer biyopsisinde saptanan fibrozis ile NLO arasındaki
ilişkiye bakıldığında iki parametre arasında anlamlı bir ilişki saptanmadı (p=0,54).
Sonuç: NLO oranı KHB'li hastalarda fibrozisi göstermede etkin bir parametre olarak görülmemiştir.
Anahtar Kelimeler
Kaynakça
- Lok ASF, McMahon BJ. AASLD practice guideline: Chronic hepatitis B: Update of therapeutic guidelines. Rom J Gastroenterol 2004;13(2):150-4.
- McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis 2005;25(Suppl 1):3-8.
- Bravo A, Sheth SG, Chopra S. Liver biopsy. N Eng J Med 2001;344(7):495-500.
- Mardini H, Record C. Detection of assessment and monitoring of hepatic fibrosis: Biochemistry or biopsy? Ann Clin Biochem 2005;42(Pt 6):441-7.
- Piccinino F, Sagnelli E, Pasquale G, Giusti G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68.276 biopsies. J Hepatol 1986;2(2):165-73.
- Lee IC, Huang YH, Chan CC. Impact of body mass index and viral load on liver histology in hepatitis B e antigen-negative chronic hepatitis B. Clin Nutr 2011;30(5):647-52.
- Ucar F, Sezer S, Ginis Z et al. APRI, the FIB-4 score, and Forns index have noninvasive diagnostic value for liver fibrosis in patient with chronic hepatitis B. Eur J Gastroenterol Hepatol 2013;25(9):1076-81.
- Martinez SM, Crespo G, Navasa M, Forns X. Noninvasive assesment of liver fibrosis. Hepatology 2011;53(1):325-35.
- Alkhouri N, Morris-Stiff G, Campbell C, et al. Neutrophil to lymphocyte ratio: New marker for predicting steatohepatitis and fibrosis in patient with nonalcoholic fatty liver disease. Liver Int 2012;32(2):297-302.
- Yeşil A, Coşgun A, Erdem E, Koçhan K, Gündüz F, Gönen C. The relationship between fibrosis level and blood neutrophil to lymphocyte ratio in chronic HBV patient. Akademik Gastroenteroloji 2013;12(2):66-8.
- Biyik M, Ucar R, Solak Y, et al. Blood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosis. Eur J Gastroenterol Hepatol. 2013;25(4):435-41.
- Gong J, Liang YL, Zhou W, et al. Prognostic value of neurophil to lymphocyte ratio associated with prognosis in HBV-infected patients. J Med Virol 2018;90(4):730-5.
- Çelikbilek M, Dogan S, Ozbakır O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013;27(1):72-6.
- Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophillymphocyte ratio: Experience in patients with cancer. Crit Rev Oncol Hematol 2013;88(1):218-30.
- Calvaruso V, Craxi A. Fibrosis in chronic viral hepatitis. Best Pract Res Clin Gastroenterol 2011;25(2):219-30.
- Kekilli M, Tanoglu A, Sakin YS, Kurt M, Ocal S, Bagci S. Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B? World J Gastroenterol 2015;21(18):5575-81.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Haziran 2019 |
| Gönderilme Tarihi | 15 Şubat 2018 |
| Yayımlandığı Sayı | Yıl 2019 |