Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Sistemik İnflamatuar Belirteçlerin Post-Kemoterapi Retroperitoneal Rezidü Kitle Patolojisini Tahmin Etmedeki Rolü: Retrospektif Klinik Çalışma
The Role of Systemic Inflammatory Markers in Predicting Post-Chemotherapy Retroperitoneal Residual Mass Pathology: Retrospective Clinical Study
Abdullah GÜLa, Özgür EKİCİb, Salim ZENGİNa, Sinan AVCIc
aSağlık Bilimleri Üniversitesi Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Bursa, Türkiye
bNusaybin Devlet Hastanesi, Üroloji Kliniği, Mardin, Türkiye
cBursa Şehir Hastanesi, Üroloji Kliniği, Bursa, Türkiye
J Reconstr Urol. 2022;12(2):64-9
doi: 10.5336/urology.2022-89329
Article Language: TR
Full Text
ÖZET
 Amaç: Kemoterapi sonrası retroperitoneal lenf nodu diseksiyonu (RPLND) uygulanan metastatik seminom dışı germ hücreli testis tümörü (NSGCT) hastalarında, preoperatif inflamasyon belirteçleri (nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR)) ve görüntüleme bulgularının RPLND patolojisi ile ilişkili olup olmadığını araştırmaktır. Gereç ve Yöntemler: Kliniğimizde Ocak 2016-Şubat 2022 tarihleri arasında RPLND yapılmış hastalar geriye dönük tarandı. Preoperatif hematolojik ve biyokimyasal parametreler, bilgisayarlı tomografi (BT) bulguları, orşiektomi ve RPLND histopatoloji bulguları kaydedildi. Hastalar patolojisi canlı tümör/teratom olanlar Grup 1 ve benign (nekroz-fibroz) olanlar Grup 2 şeklinde ayrıldı. Gruplar arasında NLR, PLR, De Ritis oranı, serum tümör belirteçleri ve abdominopelvik BT'de saptanan ek büyük boyuttaki retroperitoneal lenf nodunun uzunluğu, hem orşiektomi öncesi, hem kemoterapi öncesi, hem de RPLND öncesi dönemlerde karşılaştırıldı. Bulgular: Toplamda13 hasta çalışmaya dahil edildi (Grup 1: 10 hasta, Grup 2: 3 hasta). Gruplar arasında yaş ortalaması benzerken, orşiektomi öncesi hematolojik ve serum belirteçleri açısından fark saptanmadı (p>0,05). Kemoterapi öncesi hematolojik ve serum belirteçleri 2 grupta da benzerken, abdominopelvik BT'deki en büyük lenfadenopati (LAP) boyutları Grup 1'de anlamlı düzeyde yüksekti (p=0,03). Benzer şekilde RPLND öncesi hematolojik ve serum belirteçleri 2 grupta da benzerken, abdominopelvik BT'deki en büyük LAP boyutları Grup 1'de anlamlı düzeyde yüksekti (p=0.03). Sonuç: RPLND tümör histolojisinin preoperatif öngörüsünde basit kan testlerinin kullanımı pratik gibi gözükse de, bu tahmin için henüz tümör boyutundan başka anlamlı parametre bulunamamıştır.

Anahtar Kelimeler: Nötrofil lenfosit oranı; platelet lenfosit oranı; De Ritis oranı; retroperitoneal tümörler; testis tümörleri
ABSTRACT
 Objective: To investigate whether preoperative inflammation markers (NLR, PLR) and imaging findings are associated with retroperitoneal lymph node dissection (RPLND) pathology in patients with metastatic non-seminomatous germ cell testicular tumor (NSGCT) who underwent RPLND after chemotherapy. Material and Methods: The data of the patients who underwent RPLND in our clinic between January 2016 and February 2022 were retrospectively analyzed. Preoperative hematological and biochemical parameters, computed tomography (CT) findings, orchiectomy and RPLND histopathology findings were recorded. The patients were divided into 2 groups according to RPLND pathology: Group 1 as viable tumor/teratoma and Group 2 as benign (necrosis-fibrosis) pathology. NLR, PLR, De Ritis ratio, serum tumor markers, and the length of the additional largest retroperitoneal lymph node detected on abdominopelvic CT between the groups were compared in the pre-orchiectomy, pre-chemotherapy and pre-RPLND periods. Results: A total of 13 patients were included in the study (Group 1: 10 patients and Group 2: 3 patients). While the mean age was similar between the groups, there was no difference in terms of hematological and serum markers before orchiectomy (p>0.05). While pre-chemotherapy hematological and serum markers were similar in both groups, the largest lymphadenopathy (LAP) sizes at abdominopelvic CT were significantly higher in Group 1 (p=0.03). Likewise, pre-RPLND hematological and inflammation markers were similar in both groups, while the largest LAP sizes at abdominopelvic CT were significantly higher in Group 1 (p=0.03). Conclusion: Although the use of blood test samples for preoperatively prediction of RPLND tumor histology seems practical, no significant parameter other than tumor size has yet been found.

Keywords: Neutrophil lymphocyte ratio; platelet lymphocyte ratio; De Ritis ratio; retroperitoneal neoplasms; testicular neoplasms
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