.: ORİJİNAL ARAŞTIRMA
The Association Between Mean Platelet Volume, Platelet Distribution Width, Platelet Count and Varicocele
Ortalama Trombosit Hacmi, Trombosit Dağılım Genişliği ve Trombosit Sayısının Varikosel ile İlişkisi
J Reconstr Urol. 2020;10(3):88-92
doi: 10.5336/urology.2020-76294
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: The relationship between the increase in the mean platelet volume, which is the determinant of platelet activation, and vascular pathologies is known. Therefore, in order to elucidate varicocele etiopathogenesis, we aimed to examine whether there is an any connection among MPV and varicocele. Material and Methods: 348 patients who underwent unilateral varicocelectomy in our clinic between 2013 and 2019 were prospectively comprised in the study. Patient's age, MPV in complete blood count, platelet distribution width (PDW), platelet count (PC) and mean varicose vein diameters were recorded. These parameters were compared between patient groups (Group 1 is level 1 varicocele patients; Group 2 is level 2 varicocele patients and Group 3 is level 3 varicocele patients), which were divided according to the varicocele grades determined by scrotal Doppler USG and it was checked whether there was a difference between the groups. Results: Mean age of the patients was 27.6±7.1 years. While 44 of 348 patients had varicocele was right-sided, the remaining 304 patients had left-sided varicocele. Varicocele was Grade 3 in 71 (20.5%) patients, Grade 2 in 239 (68.7%) and Grade 1 in the remaining 38 (10.9%). The mean VVD (mm) value for all groups was 4.2±1.2. There was no significant difference between the groups in terms of age and TS (p=0.056 and p=0.071, respectively). There was a statistically significant difference between three groups in terms of PDW and MPV values (p=0.025 and p=0.018, respectively). Group 3 was significantly higher for both parameters than Group 1. According to the spearman correlation coefficient calculated by using VVD and PC, PDW, and MPV parameters, it was found that the VVD showed a significant positive correlation with PDW and MPV (r=0.190, p=0.002 and r=0.201, p=0.001 respectively). Conclusion: Based on the importance of the vascular component in the pathophysiology of varicocele, it should be emphasized that it supports the hypothesis that varicocele may be a component of systemic venous anomalies.
Keywords: Mean platelet volume; varicocele
Objective: The relationship between the increase in the mean platelet volume, which is the determinant of platelet activation, and vascular pathologies is known. Therefore, in order to elucidate varicocele etiopathogenesis, we aimed to examine whether there is an any connection among MPV and varicocele. Material and Methods: 348 patients who underwent unilateral varicocelectomy in our clinic between 2013 and 2019 were prospectively comprised in the study. Patient's age, MPV in complete blood count, platelet distribution width (PDW), platelet count (PC) and mean varicose vein diameters were recorded. These parameters were compared between patient groups (Group 1 is level 1 varicocele patients; Group 2 is level 2 varicocele patients and Group 3 is level 3 varicocele patients), which were divided according to the varicocele grades determined by scrotal Doppler USG and it was checked whether there was a difference between the groups. Results: Mean age of the patients was 27.6±7.1 years. While 44 of 348 patients had varicocele was right-sided, the remaining 304 patients had left-sided varicocele. Varicocele was Grade 3 in 71 (20.5%) patients, Grade 2 in 239 (68.7%) and Grade 1 in the remaining 38 (10.9%). The mean VVD (mm) value for all groups was 4.2±1.2. There was no significant difference between the groups in terms of age and TS (p=0.056 and p=0.071, respectively). There was a statistically significant difference between three groups in terms of PDW and MPV values (p=0.025 and p=0.018, respectively). Group 3 was significantly higher for both parameters than Group 1. According to the spearman correlation coefficient calculated by using VVD and PC, PDW, and MPV parameters, it was found that the VVD showed a significant positive correlation with PDW and MPV (r=0.190, p=0.002 and r=0.201, p=0.001 respectively). Conclusion: Based on the importance of the vascular component in the pathophysiology of varicocele, it should be emphasized that it supports the hypothesis that varicocele may be a component of systemic venous anomalies.
Keywords: Mean platelet volume; varicocele
ÖZET
Amaç: Trombosit aktivasyonunun belirleyicisi olan ortalama trombosit hacmindeki (OTH) artışın vasküler patolojilerle olan ilişkisi bilinmektedir. Bu nedenle de varikoselin etiyopatogenezini aydınlatmak için OTH ve varikosel arasında bir ilişki olup olmadığını incelemeyi amaçladık. Gereç ve Yöntemler: 2013-2019 Ocak ayları arasında kliniğimizde tek taraflı varikoselektomi operasyonu yapılan 348 hasta prospektif olarak çalışmaya dâhil edildi. Hastaların yaşı, tam kan sayımındaki OTH, trombosit dağılım genişliği (TDG), trombosit sayısı (TS) ve ortalama varikoz ven çapları (VVÇ) kayıt edildi. Bu parametreler, skrotal Doppler ultrasonografi (USG) ile belirlenen varikosel derecelerine göre ayrılan hasta grupları (Grup 1, derece 1 varikosel; Grup 2, derece 2 varikoseli ve Grup 3, derece 3 varikosel) arasında karşılaştırıldı ve gruplar arasında bir fark olup olmadığına bakıldı. Bulgular: Ortalama hasta yaşı 27,6±7,1 yıl idi. 348 hastanın 44'ünde varikosel sağ taraflı iken kalan 304 hastada varikosel sol taraflı idi. Hastaların 71'inde (%20,5) varikosel derece 3 iken, 239'unda (%68,7) derece 2 ve kalan 38'inde (%10,9) derece 1 idi. Tüm gruplar için VVÇ (mm) ortalama değeri 4,2±1,2 idi. Gruplar arasında yaş ve TS açısından anlamlı bir fark yoktu (sırasıyla; p=0,056 ve p=0,071). Gruplar arasında TDG ve OTH değerleri açısından yapılan incelemede istatistiksel anlamlı farklılık saptandı (sırasıyla, p=0,025 ve p=0,018). Her iki parametre için de Grup 3, Grup 1'e göre anlamlı olarak yüksek izlendi. VVÇ ile TS, TDG ve OTH arasında yapılan spearman korelasyon katsayısına göre VVÇ'nin TDG ve OTH ile anlamlı düzeyde pozitif korelasyon gösterdiği saptandı (sırasıyla r=0,190, p=0,002 ve r=0,201, p=0,001). Sonuç: Varikoselin patofizyolojisinde vasküler bileşenin önemine dayanarak vurgulanmalıdır ki çıkan sonuç; varikoselin sistemik venöz anomalilerin bir bileşeni olabileceği hipotezini desteklemektedir.
Anahtar Kelimeler: Ortalama trombosit hacmi; varikosel
Amaç: Trombosit aktivasyonunun belirleyicisi olan ortalama trombosit hacmindeki (OTH) artışın vasküler patolojilerle olan ilişkisi bilinmektedir. Bu nedenle de varikoselin etiyopatogenezini aydınlatmak için OTH ve varikosel arasında bir ilişki olup olmadığını incelemeyi amaçladık. Gereç ve Yöntemler: 2013-2019 Ocak ayları arasında kliniğimizde tek taraflı varikoselektomi operasyonu yapılan 348 hasta prospektif olarak çalışmaya dâhil edildi. Hastaların yaşı, tam kan sayımındaki OTH, trombosit dağılım genişliği (TDG), trombosit sayısı (TS) ve ortalama varikoz ven çapları (VVÇ) kayıt edildi. Bu parametreler, skrotal Doppler ultrasonografi (USG) ile belirlenen varikosel derecelerine göre ayrılan hasta grupları (Grup 1, derece 1 varikosel; Grup 2, derece 2 varikoseli ve Grup 3, derece 3 varikosel) arasında karşılaştırıldı ve gruplar arasında bir fark olup olmadığına bakıldı. Bulgular: Ortalama hasta yaşı 27,6±7,1 yıl idi. 348 hastanın 44'ünde varikosel sağ taraflı iken kalan 304 hastada varikosel sol taraflı idi. Hastaların 71'inde (%20,5) varikosel derece 3 iken, 239'unda (%68,7) derece 2 ve kalan 38'inde (%10,9) derece 1 idi. Tüm gruplar için VVÇ (mm) ortalama değeri 4,2±1,2 idi. Gruplar arasında yaş ve TS açısından anlamlı bir fark yoktu (sırasıyla; p=0,056 ve p=0,071). Gruplar arasında TDG ve OTH değerleri açısından yapılan incelemede istatistiksel anlamlı farklılık saptandı (sırasıyla, p=0,025 ve p=0,018). Her iki parametre için de Grup 3, Grup 1'e göre anlamlı olarak yüksek izlendi. VVÇ ile TS, TDG ve OTH arasında yapılan spearman korelasyon katsayısına göre VVÇ'nin TDG ve OTH ile anlamlı düzeyde pozitif korelasyon gösterdiği saptandı (sırasıyla r=0,190, p=0,002 ve r=0,201, p=0,001). Sonuç: Varikoselin patofizyolojisinde vasküler bileşenin önemine dayanarak vurgulanmalıdır ki çıkan sonuç; varikoselin sistemik venöz anomalilerin bir bileşeni olabileceği hipotezini desteklemektedir.
Anahtar Kelimeler: Ortalama trombosit hacmi; varikosel
REFERANSLAR:
- Kocakoc E, Serhatlioglu S, Kiris A, Bozgeyik Z, Ozdemir H, Bodakci MN. Color Doppler sonographic evaluation of inter-relations between diameter, reflux and flow volume of testicular veins in varicocele. Eur J Radiol. 2003;47(3):251-6.[Crossref] [PubMed]
- Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AMA. WHO manual for the standardized investigation, diagnosis and management of the infertile male. Cambridge, UK: Cambridge University Press; 2000. p.54.
- The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. World Health Organization. Fertil Steril. 1992;57(6):1289-93.[Crossref] [PubMed]
- Kiliç S, Aksoy Y, Sincer I, Oğuz F, Erdil N, Yetkin E. Cardiovascular evaluation of young patients with varicocele. Fertil Steril. 2007;88(2):369-73. doi: 10.1016/j.fertnstert. 2006.11.119.[Crossref] [PubMed]
- Yetkin E, Kilic S, Acikgoz N, Ergin H, Aksoy Y, Sincer I, et al. Increased prevalence of varicocele in patients with coronary artery ectasia. Coron Artery Dis. 2005;16(5):261-4.[Crossref] [PubMed]
- Mangalpally KK, Siqueiros-Garcia A, Vaduganathan M, Dong JF, Kleiman NS, Guthikonda S. Platelet activation patterns in platelet size sub-populations: differential responses to aspirin in vitro. J Thromb Thrombolysis. 2010;30(3):251-62.[Crossref] [PubMed]
- Honisch S, Gu S, Vom Hagen JM, Alkahtani S, Al Kahtane AA, Tsapara A, et al. Chorein Sensitive Arrangement of Cytoskeletal Architecture. Cell Physiol Biochem. 2015;37(1):399-408.[Crossref] [PubMed]
- Kai H, Kitadai Y, Kodama M, Cho S, Kuroda T, Ito M, et al. Involvement of proinflammatory cytokines IL-1beta and IL-6 in progression of human gastric carcinoma. Anticancer Res. 2005;25(2A):709-13.[PubMed]
- Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58.[Crossref] [PubMed]
- Mutlu H, Artis TA, Erden A, Akca Z. Alteration in mean platelet volume and platicrit values in patients with cancer that developed thrombosis. Clin Appl Thromb Hemost. 2013;19(3): 331-3.[Crossref] [PubMed]
- Saatcı Yaşar A, Yüksel Ö, Arslantaş U, Karakaş F, Kırbaş Ö. Association between admission mean platelet volume and coronary patency after thrombolytic therapy for acute myocardial infarction. Turk Kardiyol Dern Ars. 2010;38:85-9.
- Pikija S, Cvetko D, Hajduk M, Trkulja V. Higher mean platelet volume determined shortly after the symptom onset in acute ischemic stroke patients is associated with a larger infarct volume on CT brain scans and with worse clinical outcome. Clin Neurol Neurosurg. 2009;111(7):568-73.[Crossref] [PubMed]
- Bath P, Algert C, Chapman N, Neal B; Progress Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke. 2004;35(3):622-6.[Crossref] [PubMed]
- Mihmanli I, Kurugoglu S, Cantasdemir M, Zulfikar Z, Halit Yilmaz M, Numan F. Color Doppler ultrasound in subclinical varicocele: an attempt to determine new criteria. Eur J Ultrasound. 2000;12(1):43-8.[Crossref] [PubMed]
- Bostwick D.G, Cheng L. Urologic surgical pathology. Chapter 6. Mosby Elsevier, China: Mosby/Elsevier; 2nd ed. 2008. p.216-27, 274-5, 287-96.
- Beyan C, Beyan E. Mean platelet volume may not be related to the physiopathology of varicocele. Andrologia. 2015;47(4):367.[Crossref] [PubMed]
- Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. J Thromb Thrombolysis. 2006; 22(3):161-4.[Crossref] [PubMed]
- Coppinger J.A, Cagney G, Toomey S, Kislinger T, Belton O, McRedmond J.P, et al. Characterization of the proteins released from activated platelets leads to localization of novel platelet proteins in human atherosclerotic lesions. Blood. 2004;103(6):2096-104.[Crossref] [PubMed]
- Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest. 2005;115(12):3378-84.[Crossref] [PubMed] [PMC]
- Karpatkin S. Heterogeneity of human platelets. II. Functional evidence suggestive of young and old platelets. J Clin Invest. 1969;48(6):1083-7.[Crossref] [PubMed] [PMC]
- Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J. 2001;22(17):1561-71.[Crossref] [PubMed]
- Pyo JS, Cho WJ. Mean platelet volume, platelet distribution width, and platelet count in varicocele: a systematic review and meta-analysis. Cell Physiol Biochem. 2016;38(6): 2239-46.[Crossref] [PubMed]
- Bozkurt Y, Soylemez H, Sancaktutar AA, Islamoglu Y, Kar A, Penbegul N, et al. Relationship between mean platelet volume and varicocele: a preliminary study. Urology. 2012;79(5):1048-51.[Crossref] [PubMed]
- Coban S, Keles I, Biyik İ, Guzelsoy M, Turkoglu A.R, Ocak N. Does varicocele correction lead to normalization of preoperatively elevated mean platelet volume levels? Can Urol Assoc J. 2015;9(1-2):E5-9.[Crossref] [PubMed] [PMC]
- Stokes KY, Granger DN. Platelets: a critical link between inflammation and microvascular dysfunction. J Physiol. 2012;590(5):1023-34.[Crossref] [PubMed] [PMC]
.: İşlem Listesi