Preoperatif tam kan sayımı belirteçleri ve De-Ritis oranının testis tümörünün tanısındaki prediktif yeri
Öz
Amaç: Preoperatif tam kan ve biyokimyasal parametrelerden nötrofil-lenfosit oranı (NLO), trombosit-lenfosit oranı (TLO), lenfosit-monosit oranı (LMO), sistemik immün-inflamasyon (SII) indeksi ve De-Ritis oranının testis tümörü tanısındaki yerinin belirlenmesi.
Gereç ve Yöntem: Ekim 2010 ile Aralık 2019 tarihleri arasında kliniğimizde testis tümörü nedeniyle inguinal orşiektomi yapılan hastaların ve kontrol grubu olarak varikoselektomi yapılan hastaların verileri retrospektif olarak incelendi. Verileri eksik olan, 18 yaşın altında olan veya ek morbiditesi olan hastalar çalışma dışında bırakıldı. NLO, TLO, LMO, SII indeksi ve De-Ritis oranı için kestirim değerleri belirlendi ve bu parametrelerin testis tümörü tanısındaki yeri incelendi.
Bulgular: Çalışmaya dahil edilen hastaların 34’ünü (%14,1) testis tümörlü hastalar, 207’sini (%85,9) varikoselektomi yapılan hastalar oluşturmaktaydı. Hastaların ameliyat esnasındaki ortanca yaşlarının 27 (23-32) yıl olduğu görüldü. Testis tümörlü hastaların 18’inde (%52,9) seminom, 12’sinde (%35,3) mikst germ hücreli tümör, 3’ünde (%8,8) yolk sac tümörü ve 1’inde (%2.9) embriyonel karsinom izlendi. Testis tümörlü hastaların %61,8’inin T2 evresinde ve %35,3’ünde metastaz olduğu belirlendi. NLO, TLO, LMO ve SII indeksi için sırasıyla kestirim değerleri 1,76, 133,43, 7,81 ve 571,63 olarak belirlendi. De-Ritis oranı için istatistiksel olarak anlamlı bir kestirim değeri bulunamadı (p=0.183). Çok değişkenli analiz yapıldığında, sadece SII indeksinin testis tümörünün öngörülmesinde anlamlı olduğu görüldü (p<0.001).
Sonuç: SII indeksi testis tümörü tanısında kullanılabilecek prediktif bir faktördür.
Anahtar Kelimeler
Kaynakça
- Park JS, Kim J, Elghiaty A, Ham WS. Recent global trends in testicular cancer incidence and mortality. Medicine (Baltimore). 2018; 97: e12390.
- Leao R, Ahmad AE, Hamilton RJ. Testicular Cancer Biomarkers: A Role for Precision Medicine in Testicular Cancer. Clin Genitourin Cancer. 2019; 17: e176-e83.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008; 454: 436-44.
- Han X, Liu S, Yang G, et al. Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: A systemic review, meta-analysis, and meta-regression of observational studies. Gynecol Oncol. 2021; 160: 351-60.
- Templeton AJ, McNamara MG, Seruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106: dju124.
- Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014; 20: 6212-22.
- De Ritis F, Coltorti M, Giusti G. An enzymic test for the diagnosis of viral hepatitis; the transaminase serum activities. Clin Chim Acta. 1957; 2: 70-4.
- Knittelfelder O, Delago D, Jakse G, et al. The AST/ALT (De Ritis) Ratio Predicts Survival in Patients with Oral and Oropharyngeal Cancer. Diagnostics (Basel). 2020;10.
- Su S, Liu L, Li C, Zhang J, Li S. Prognostic Role of Pretreatment De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase Ratio) in Urological Cancers: A Systematic Review and Meta-Analysis. Front Oncol. 2020; 10: 1650.
- Arda E, Arikan G, Akdere H, Akgul M, Yuksel I. Predictive and prognostic impact of preoperative complete blood count based systemic inflammatory markers in testicular cancer. Int Braz J Urol. 2020; 46: 216-23.
- Imamoglu GI, Eren T, Baylan B, Karacin C. May High Levels of Systemic Immune-Inflammation Index and Hematologic Inflammation Markers Suggest a Further Stage in Testicular Tumours? Urol Int. 2019; 103: 303-10.
- Olcucu MT, Karamik K, Yilmaz K, Okuducu Y, Cakir S, Ates M. Preoperative Inflammation Markers and De Ritis Ratio in Predicting Clinical Presentation and Prognosis of Patients with Testicular Germ Cell Tumors. J Coll Physicians Surg Pak. 2020; 30: 1041-6.
- Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000; 100: 57-70.
- Ding PR, An X, Zhang RX, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer. Int J Colorectal Dis. 2010; 25: 1427-33.
- Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis. 2003; 6: 283-7.
- Solanki SL, Kaur J, Gupta AM, et al. Cancer related nutritional and inflammatory markers as predictive parameters of immediate postoperative complications and long-term survival after hepatectomies. Surg Oncol. 2021;37:101526.
- Wei C, Yu Z, Wang G, Zhou Y, Tian L. Low Pretreatment Albumin-to-Globulin Ratio Predicts Poor Prognosis in Gastric Cancer: Insight From a Meta-Analysis. Front Oncol. 2020; 10: 623046.
- Ilktac A, Dogan B, Ersoz C, Akcay M, Akbulut H. The relationship of neutrophil to lymphocyte ratio with testicular cancer. Int Braz J Urol. 2020; 46: 101-7.
- Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of systemic immune-inflammation index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020; 20: 499.
- Ji Y, Wang H. Prognostic prediction of systemic immune-inflammation index for patients with gynecological and breast cancers: a meta-analysis. World J Surg Oncol. 2020; 18: 197.
- Chovanec M, Cierna Z, Miskovska V, et al. Systemic immune-inflammation index in germ-cell tumours. Br J Cancer. 2018; 118: 831-8.
- Fankhauser CD, Sander S, Roth L, et al. Systemic inflammatory markers have independent prognostic value in patients with metastatic testicular germ cell tumours undergoing first-line chemotherapy. Br J Cancer. 2018; 118: 825-30.
- Kang M, Shin SJ, Sung HH, et al. Clinical Significance of Pre-to-Postoperative Dynamics of Aspartate Transaminase/Alanine Transaminase Ratio in Predicting the Prognosis of Renal Cell Carcinoma after Surgical Treatment. Dis Markers. 2020; 2020: 8887605.
- Wu J, Chen L, Wang Y, Tan W, Huang Z. Prognostic value of aspartate transaminase to alanine transaminase (De Ritis) ratio in solid tumors: a pooled analysis of 9,400 patients. Onco Targets Ther. 2019; 12: 5201-13.
- Wu J, Li S, Wang Y, Hu L. Pretreatment Aspartate Aminotransferase-to-Alanine Aminotransferase (De Ritis) Ratio Predicts the Prognosis of Nonmetastatic Nasopharyngeal Carcinoma. Onco Targets Ther. 2019; 12: 10077-87.
- Gorgel SN, Akin Y, Koc EM, Kose O, Ozcan S, Yilmaz Y. Impact of increased aspartate aminotransferase to alanine aminotransferase (De Ritis) ratio in prognosis of testicular cancer. Investig Clin Urol. 2019; 60: 169-75.
- Guner E, Seker KG, Arikan Y, Huseynov C, Sam E, Ozdal OL. The utility of De Ritis Ratio in predicting prognosis in testicular cancer. Aktuelle Urol. 2020; 51: 285-9.
The predictive role of preoperative full blood count markers and the De-Ritis ratio in the diagnosis of testicular tumor
Öz
Aim: To determine the value of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation (SII) index and De-Ritis ratio, which are among preoperative whole blood and biochemical parameters, in the diagnosis of testicular tumor.
Materials and Methods: The data of patients who underwent inguinal orchiectomy for testicular tumor in our clinic between October 2010 and December 2019 and patients who underwent varicocelectomy, as a control group, were retrospectively analyzed. Patients with missing data, under 18 years of age or with additional morbidity were excluded from the present study. Prediction values for NLR, PLR, LMR, SII index and De-Ritis ratio were determined and the value of these parameters in the diagnosis of testicular tumor was examined.
Results: Thirty-four (14.1%) patients underwent inguinal orchiectomy while 207 (85.9%) patients underwent varicocelectomy in the present study. The median age of the patients during surgery was 27 (23-32) years. The number of patients with seminoma, mixt germ cell tumor, yolk sac tumor and embryonal carcinoma was 18 (52.9%), 12 (35.3%), 3 (8.8%) and 1 (2.9%), respectively. It was determined that 61.8% of the patients with testicular tumors were in the T2 stage and 35.3% had metastasis. The cut-off values for NLR, PLR, LMR and SII index were determined as 1.76, 133.43, 7.81 and 571.63, respectively. There was no statistically significant cut-off value for De-Ritis ratio (p = 0.183). The only significant factor for predicting testicular tumor was SII index in multivariate analysis (p <0.001).
Conclusion: SII index is a predictive factor that can be used in the diagnosis of testicular tumor.
Anahtar Kelimeler
Kaynakça
- Park JS, Kim J, Elghiaty A, Ham WS. Recent global trends in testicular cancer incidence and mortality. Medicine (Baltimore). 2018; 97: e12390.
- Leao R, Ahmad AE, Hamilton RJ. Testicular Cancer Biomarkers: A Role for Precision Medicine in Testicular Cancer. Clin Genitourin Cancer. 2019; 17: e176-e83.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008; 454: 436-44.
- Han X, Liu S, Yang G, et al. Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: A systemic review, meta-analysis, and meta-regression of observational studies. Gynecol Oncol. 2021; 160: 351-60.
- Templeton AJ, McNamara MG, Seruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106: dju124.
- Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014; 20: 6212-22.
- De Ritis F, Coltorti M, Giusti G. An enzymic test for the diagnosis of viral hepatitis; the transaminase serum activities. Clin Chim Acta. 1957; 2: 70-4.
- Knittelfelder O, Delago D, Jakse G, et al. The AST/ALT (De Ritis) Ratio Predicts Survival in Patients with Oral and Oropharyngeal Cancer. Diagnostics (Basel). 2020;10.
- Su S, Liu L, Li C, Zhang J, Li S. Prognostic Role of Pretreatment De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase Ratio) in Urological Cancers: A Systematic Review and Meta-Analysis. Front Oncol. 2020; 10: 1650.
- Arda E, Arikan G, Akdere H, Akgul M, Yuksel I. Predictive and prognostic impact of preoperative complete blood count based systemic inflammatory markers in testicular cancer. Int Braz J Urol. 2020; 46: 216-23.
- Imamoglu GI, Eren T, Baylan B, Karacin C. May High Levels of Systemic Immune-Inflammation Index and Hematologic Inflammation Markers Suggest a Further Stage in Testicular Tumours? Urol Int. 2019; 103: 303-10.
- Olcucu MT, Karamik K, Yilmaz K, Okuducu Y, Cakir S, Ates M. Preoperative Inflammation Markers and De Ritis Ratio in Predicting Clinical Presentation and Prognosis of Patients with Testicular Germ Cell Tumors. J Coll Physicians Surg Pak. 2020; 30: 1041-6.
- Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000; 100: 57-70.
- Ding PR, An X, Zhang RX, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer. Int J Colorectal Dis. 2010; 25: 1427-33.
- Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis. 2003; 6: 283-7.
- Solanki SL, Kaur J, Gupta AM, et al. Cancer related nutritional and inflammatory markers as predictive parameters of immediate postoperative complications and long-term survival after hepatectomies. Surg Oncol. 2021;37:101526.
- Wei C, Yu Z, Wang G, Zhou Y, Tian L. Low Pretreatment Albumin-to-Globulin Ratio Predicts Poor Prognosis in Gastric Cancer: Insight From a Meta-Analysis. Front Oncol. 2020; 10: 623046.
- Ilktac A, Dogan B, Ersoz C, Akcay M, Akbulut H. The relationship of neutrophil to lymphocyte ratio with testicular cancer. Int Braz J Urol. 2020; 46: 101-7.
- Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of systemic immune-inflammation index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020; 20: 499.
- Ji Y, Wang H. Prognostic prediction of systemic immune-inflammation index for patients with gynecological and breast cancers: a meta-analysis. World J Surg Oncol. 2020; 18: 197.
- Chovanec M, Cierna Z, Miskovska V, et al. Systemic immune-inflammation index in germ-cell tumours. Br J Cancer. 2018; 118: 831-8.
- Fankhauser CD, Sander S, Roth L, et al. Systemic inflammatory markers have independent prognostic value in patients with metastatic testicular germ cell tumours undergoing first-line chemotherapy. Br J Cancer. 2018; 118: 825-30.
- Kang M, Shin SJ, Sung HH, et al. Clinical Significance of Pre-to-Postoperative Dynamics of Aspartate Transaminase/Alanine Transaminase Ratio in Predicting the Prognosis of Renal Cell Carcinoma after Surgical Treatment. Dis Markers. 2020; 2020: 8887605.
- Wu J, Chen L, Wang Y, Tan W, Huang Z. Prognostic value of aspartate transaminase to alanine transaminase (De Ritis) ratio in solid tumors: a pooled analysis of 9,400 patients. Onco Targets Ther. 2019; 12: 5201-13.
- Wu J, Li S, Wang Y, Hu L. Pretreatment Aspartate Aminotransferase-to-Alanine Aminotransferase (De Ritis) Ratio Predicts the Prognosis of Nonmetastatic Nasopharyngeal Carcinoma. Onco Targets Ther. 2019; 12: 10077-87.
- Gorgel SN, Akin Y, Koc EM, Kose O, Ozcan S, Yilmaz Y. Impact of increased aspartate aminotransferase to alanine aminotransferase (De Ritis) ratio in prognosis of testicular cancer. Investig Clin Urol. 2019; 60: 169-75.
- Guner E, Seker KG, Arikan Y, Huseynov C, Sam E, Ozdal OL. The utility of De Ritis Ratio in predicting prognosis in testicular cancer. Aktuelle Urol. 2020; 51: 285-9.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 13 Haziran 2022 |
| Gönderilme Tarihi | 18 Ağustos 2021 |
| Yayımlandığı Sayı | Yıl 2022Cilt: 61 Sayı: 2 |
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https://doi.org/10.16899/jcm.1210142
