Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
The Prognostic Value of the Red Cell Distribution Width to Platelet Count Ratio in Patients with Breast Cancer
Meme Kanserli Hastalarda Kırmızı Küre Dağılım Genişliğinin Trombosit Sayısına Oranının Prognostik Değeri
Hayriye ŞAHİNLİa, Esra ZEYNELGİLa, Sema TÜRKERa
aAnkara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Clinic of Medical Oncology, Ankara, TURKEY
Turkiye Klinikleri J Med Sci.2020;40(2):188-95
doi: 10.5336/medsci.2019-71722
Article Language: EN
Full Text
ABSTRACT
 Objective: The prognostic value of red cell distribution width to platelet count ratio (RPR) in patients with breast cancer is not clear. This study aims to evaluate the prognostic significance of red cell distribution width to platelet count ratio in breast cancer patients. Material and Methods: A retrospective analysis was performed on 150 patients with non-metastatic breast cancer between January 2014-December 2018. The optimal cut off value of RPR was 0.54 for diseasefree survival (DFS). The chi-square test or Fisher's exact test was used to evaluate relationships between the RPR and other clinicopathological variables. Kaplan-Meier log-rank test was used to determine the effect of variables on DFS. Cox's proportional hazards model was used for multivariate analysis. Results: Median follow-up period was 39±1.174 (13-66) months and 5-year survival was 96.60%. There was no relationships between the RPR and clinicopathological variables. Kaplan-Meier analysis showed significant correlation between elevated RPR level (p=0.001) and high MPV(mean platelet volume)/Platelet(P) ratio (p=0.006) and DFS. DFS was found to be short in patients with high RPR and high MPV/P ratio. When multivariate analysis was performed with cox regression analysis, RPR level (p=0.025) and tumor size (p=0.047) were found to be independent prognostic factors . RPR was found to be a more valuable prognostic marker than mean platelet volume to platelet ratio (MPV/P). Conclusion: We found that high RPR levels before adjuvant treatment were associated with poor DFS in patients with curative resected breast cancer. Accordingly, the RPR level can be used as a prognostic marker in non-metastatic breast cancer. However, further studies conducted with a larger number of patients are needed.

Keywords: Breast cancer; red cell distribution width; platelet; prognosis
ÖZET
 Amaç: Meme kanserli hastalarda kırmızı küre dağılım genişliğinin trombosit sayısına oranı (RPR)'nın prognostik değeri net olarak bilinmemektedir. Bu çalışmada amacımız kırmızı küre dağılım genişliğinin trombosit sayısına oranının meme kanserli hastalarda prognostik önemini değerlendirmektir. Gereç ve Yöntemler: Bu retrospektif çalışmaya Ocak 2014-Aralık 2018 tarihleri arasında opere olmuş 150 metastatik olmayan meme kanserli hasta dahil edildi. RPR düzeyinin hastalıksız sağkalım (HSK) için optimum cutoff değeri 0,54 olarak alındı. RPR ve klinikopatolojik değişkenler arasındaki ilişkiyi değerlendirmek için ki kare ve Fisher exact testleri kullanıldı. Değişkenlerin HSK etkisini saptamak için Kaplan-Meier log-rank testi kullanıldı. Multivariate analiz için Cox oransal hazards modeli kullanıldı. Bulgular: Hastaların median takip süresi 39±1,174 (13-66) ay idi. 5 yıllık sağkalım %96,60 idi. RPR ile klinikopatalojik değişkenler arasında ilişki saptanmadı. Kaplan-Meier analizinde yüksek RPR düzeyi (p<0,001) ve yüksek ortalama trombosit hacminin trombositlere oranı (MPV/P) (p=0,006) ile HSK arasında anlamlı ilişki saptandı. Yüksek RPR düzeyi ve yüksek MPV/P oranı olan hastalarda HSK kısa saptandı. Cox regresyon analizi ile multivariate analiz yapıldığında RPR (p=0,025) ve tümör çapı (p=0,047) bağımsız prognostik faktörler olarak tespit edildi. RPR'nin, MPV/P oranına göre daha değerli bir prognostik belirteç olduğu saptandı. Sonuç: Bu çalışmada, küratif rezeksiyon yapılmış meme kanserli hastalarda adjuvan tedavi öncesi yüksek RPR düzeylerinin kötü HSK ile ilişkili olduğu saptanmıştır. Metastatik olmayan meme kanserli hastalarda , RPR düzeyi prognostik bir marker olarak kullanılabilir, ancak daha fazla hasta sayısı ile yapılacak çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Meme kanseri; kırmızı küre dağılım genişliği; trombosit; prognoz
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