Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Preoperatif Sistemik İnflamasyon Belirteçlerinin Nefrektomi Patolojisini Öngörmedeki Rolü: Retrospektif Kohort Çalışması
Predictive Role of Preoperative Systemic Inflammatory Markers in Nephrectomy Pathology: Retrospective Cohort Study
Abdullah GÜLa , Özgür EKİCİb , Salim ZENGİNa , Çağlar BOYACIa
aSağlık Bilimleri Üniversitesi Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Bursa, Türkiye
bNusaybin Devlet Hastanesi, Üroloji Kliniği, Mardin, Türkiye
J Reconstr Urol. 2023;13(2):53-9
doi: 10.5336/urology.2023-96926
Article Language: TR
Full Text
ÖZET
 Amaç: Böbrek kitlesi tespit edilen hastalarda, preoperatif kan bazlı belirteçlerin kitle patolojisi tahmininde kullanılabilirliğini araştırmaktır. Gereç ve Yöntemler: Kliniğimizde Haziran 2016-Ocak 2023 tarihleri arasında böbrek kitlesi nedeniyle radikal ya da parsiyel nefrektomi yapılmış hastalar geriye dönük tarandı. Preoperatif kan grubu, hemogram parametreleri, aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), üre/kreatinin, glomerüler filtrasyon hızı değerleri, nötrofil lenfosit oranı, platelet lenfosit oranı, lenfosit monosit oranı [lymphocyte monocyte ratio (LMR)], De Ritis oranı (AST/ALT), bilgisayarlı tomografi ve manyetik rezonans görüntüleme bulguları, nefrektomi histopatoloji bulguları kaydedildi. Hastalar nefrektomi patolojisine göre malign (Grup 1) ve benign (Grup 2) olmak üzere iki gruba ayrıldı. Gruplar arasında başlangıçta kaydedilen veriler karşılaştırıldı. Bulgular: Çalışmaya 216 hasta dâhil edildi. Ortalama yaş 59,60±11,62 yıl, erkek/kadın oranı 131/85 idi. Nefrektomi patolojilerinin 194'ü (%89,8) malign, 22'si (%10,2) ise benign olarak raporlandı. Her iki grup arasında cinsiyet, tümör tarafı, cerrahi sınır pozitifliği ve kan grubu açısından istatistiksel anlamlı farklılık izlenmezken, iki grup arasında preoperatif verilerden tümör boyutu ve LMR (p değerleri sırasıyla 0,010 ve 0,003) istatistiksel anlamlı farklı bulundu. Subgrup analizinde, kitle boyutu ≤4 cm ve ≤7 cm alt gruplarında, tüm parametreler benzerdi. Sonuç: Özellikle T1 evre böbrek tümörlerinde önem arz eden malign/benign ayırımında, preoperatif kitle patolojisini öngörebilen herhangi bir parametre bulunamamıştır.

Anahtar Kelimeler: Alanin transaminaz; aspartat aminotransferazlar; böbrek neoplazileri; lenfositler; nötrofiller
ABSTRACT
 Objective: To investigate the usefullness of preoperative blood-based parameters in the prediction of histopathology reports of the kidney masses. Material and Methods: Patients who underwent radical or partial nephrectomy due to kidney mass in our clinic between June 2016 and January 2023 were retrospectively reviewed. Preoperative hemogram parameters, aspartate aminotransferases (AST), alanine transaminase (ALT), urea/creatinine, glomerular filtration rate values, neutrophil lymphocyte ratio, platelet lymphocyte ratio, lymphocyte monocyte ratio (LMR), De Ritis ratio (AST/ALT), blood groups, computed tomography and magnetic resonance imaging findings, nephrectomy histopathology reports were recorded. The patients were divided into two groups as malignant (Group 1) and benign (Group 2) according to nephrectomy pathology. Initial data were compared between the groups. Results: Two hundred sixteen patients were included in the study. The mean age was 59.60±11.62 years and the male/female ratio was 131/85. The number of the malignant and benign pathology was 194 (89.8%) and 22 (10.2%), respectively. While no statistically significant difference was observed between the two groups in terms of gender, tumor side, surgical margin positivity and blood group, tumor size and LMR (p values 0.010 and 0.003, respectively) were found to be statistically different between the two groups. In the subgroup analysis, all parameters were comparable in patients with mass size ≤4 cm and ≤7 cm. Conclusion: We did not find any parameter that could predict the mass pathology for the differentiation of malignant and benign, which is especially essential for T1 stage renal tumors in our study.

Keywords: Alanine transaminase; aspartate aminotransferases; kidney neoplasms; lymphocytes; neutrophils
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