The Relationship Between Thrombocyte Lymphocyte Ratio With Tumor Morphology and Alpha Fetoprotein in Patients with Hepatocellular Carcinoma

Yıl 2020, Cilt: 14 Sayı: 2, 230 - 235, 20.01.2020

Ümit Karaoğullarından , Hikmet Akkız , Sedef Kuran , Oguz Uskudar , Halil Taskaynatan , Anıl Delik

https://doi.org/10.21763/tjfmpc.659799

Öz

Introduction: The aim of this study was to investigate the relationship between platelet lymphocyte ratio (PLR) and morphological and clinicopathological features of tumor in patients with hepatocellular carcinoma (HCC). Method: Patients diagnosed with HCC by imaging methods (dynamic-triphasic CT and dynamic-MR) and/or tissue sampling (biopsy, resectionor explant) were retrospectively reviewed. Demographic characteristics, etiology, arising from cirrhotic or non-cirrhotic, morphological characteristics of the tumor (tumor diameter, focality, vascular invasion) and; complete blood count, alpha-fetoprotein (AFP), platelet and lymphocyte counts were calculated at the time of diagnosis. Findings: A total of 223 patients were included in the present study. Of the 223 patients, 185 (82.9%) were male and 38 (17.1%) were female. There was a positive correlation between PLR and AFP (p = 0.05). PLR was significantly higher in patients with portal vein invasion (p = 0.001). PLR values were significantly higher in patients with solitary lesions than those with infiltrative lesions. PLR values were significantly higher in patients with infiltrative tumors than patients with two or more solitary lesions (p = 0.001). There was a positive correlation between maximal tumor diameter (MTD) and PLR in patients with non-infiltrative type tumor (p=0.01). Results: PLR is a cheap and easily applicable marker. It is positively correlated with poor prognostic factors such as vascular invasion, AFP and MTD. PLR can also be used as an additional prognostic biomarker to assess tumor aggressiveness.



Giriş: Bu çalışmada, hepatosellüler karsinom (HCC) tanılı hastalarda platelet lenfosit oranı (PLR) ile tümörün morfolojik ve klinikopatolojik özellikleri arasındaki ilişkinin belirlenmesi amaçlandı. Yöntem: Görüntüleme yöntemleri (dinamik-trifazik CT ve dinamik-MR) ve/veya doku örneklemesi (biyopsi, rezeksiyon veya eksplant) ile HCC tanısı alan hastalar retrospektif olarak incelendi. Hastaların demografik özellikleri, etyolojisi, sirotik veya non-sirotik zeminde gelişmesi, tümörün morfolojik özellikleri (tümör çapı, fokalitesi, vasküler invazyon), tanı anındaki tam kan sayımı, Alfa-fetoprotein (AFP), trombosit ve lenfosit değerleri hesaplandı. Bulgular: Çalışmaya 223 hasta dahil edildi. 223 hastanın 185’i (%82,9) erkek , 38’i (%17,1) kadındı. PLR ile AFP arasında pozitif korelasyon (p=0,05) saptanırken, portal ven invazyonu olan hastalarda PLR’nin istatistiksel olarak anlamlı derecede yüksek olduğu görüldü (p=0.001). PLR değeri soliter lezyonu olanlarda infiltratif gruptan anlamlı olarak fazlaydı. PLR değeri infiltratif grupta ise iki veya daha fazla nodulü olan gruba oranla istatistiksel olarak anlamlı düzeyde fazlaydı (p=0,001). İnfiltratif tip tümör dışındaki hastalarda maksimal tümör çapı (MTD) arttıkça PLR’nin de istatistiki olarak anlamlı biçimde arttığı izlendi (p=0,01). Sonuç: PLR, ucuz ve kolay ulaşılabilir bir belirteç olup AFP, vasküler invazyon ve MTD gibi kötü prognostik faktörlerle pozitif korele olarak değişmektedir. Tümörün agresifliğini değerlendirmek için PLR de ek bir prognostik biyomarker olarak kullanılabilir. 

Anahtar Kelimeler

Trombosit-lenfosit oranı, hepatosellüler kanser, prognosis.

Hepatosellüler Kanser Tanılı Hastalarda Trombosit Lenfosit Orani’nin Tümör Morfolojisi ve Alfa Fetoprotein ile İlişkisi

Öz

Giriş: Bu çalışmada hepatocellüler karsinom (HCC) tanılı hastalarda platelet lenfosit oranı (PLO) ile tümörün morfolojik ve klinikopatolojik özellikleri arasındaki ilişkinin belirlenmesi amaçlandı.
Yöntem: Görüntüleme yöntemleri (dinamik-trifazik CT ve dinamik-MR) ve/ve ya doku örneklemesi (biyopsi, rezeksiyon veya eksplant) ile HCC tanısı alan hastalar retrospektif olarak incelendi. Hastaların demografik özellikleri, etyolojisi, sirotik veya non-sirotik zeminde gelişmesi, tümörün morfolojik özellikleri (tumor çapı, fokalitesi, vasküler invazyon), tanı anındaki tam kan sayımı, Alfa-fetoprotein, trombosit ve lenfosit değerleri hesaplandı.
Bulgular: Çalışmaya 223 hasta dahil edildi. 223 hastanın 185 (%82,9)’i erkek , 38 (%17,1)’i kadındı. PLO ile AFP arasında pozitif korelasyon (p=0,05) saptanırken, portal ven invazyonu olan hastalarda PLO’nun istatistiksel olarak anlamlı derecede yüksek olduğu görüldü (p=0.001). PLO değeri soliter lezyonu olanlarda infiltratif gruptan anlamlı olarak fazlaydı. PLO değeri infiltratif grupta ise iki veya daha fazla nodulü olan gruptan istatistiksel anlamlı olarak fazlaydı (p=0,001). İnfiltratif tip tümör dışındaki hastalarda maksimal tümör çapı (MTD) arttıkça PLR’nin de istatistiki olarak anlamlı derece arttığı izlendi (p=0,01).
Sonuç: PLO; ucuz ve kolay ulaşılabilir bir belirteç olup; AFP , vasküler invazyon ve MTD gibi kötü prognostik faktörlerle pozitif korele olarak değişmektedir.Tümör agresifliği değerlendirmek için PLO da ek bir prognostik biyomarker olarak kullanılabilir.

Anahtar Kelimeler

Trombosit-lenfosit oranı, hepatosellüler kanser, prognoz

Kaynakça

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