.: ORİJİNAL ARAŞTIRMA
Granülomatöz Mastit Tedavisi Sonrası Nükslerin Öngörülmesinde Tedavi Öncesi Nötrofil-Lenfosit Oranının Rolü
Role of Pre-treatment Neutrophil-Lymphocyte Ratio in the Prediction of Recurrences After Granulomatous Mastitis Treatment
Turkiye Klinikleri J Med Sci. 2020;40(1):46-51
doi: 10.5336/medsci.2019-66835
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Granülomatöz mastit, hem tanısı zor hem de ideal tedavi yöntemi olmayan kronik inflamatuar bir hastalıktır. Nadir görülen bir antite olması nedeni ile prognostik faktörler ve tedavi kalsifikasyonu üzerine araştırmalar kısıtlıdır. Son zamanlarda sistemik inflamasyonun biyobelirteci olarak kullanılan nötrofil-lenfosit oranı (NLO) nın popülerliği giderek artmaktadır. Bu çalışmada, kronik inflamatuar hastalık olması nedeni ile granülomatöz mastitte tedavi sonrası nükslerin öngörülmesinde tedavi öncesi NLO'nun rolünün araştırılması amaçlanmıştır. Gereç ve Yöntemler: Biyopsi sonuçlarına göre granülomatöz mastit hastalığı tespit edilen ve tedavi edilen 62 hastanın verileri retrospektif olarak incelendi. Hastalar, medikal tedavi ve cerrahi tedavi olmak üzere 2 gruba ayrıldı. Demografik verilerinin yanında tedavi öncesi NLO'ları hesaplandı. Her iki grupta da tam kür sağlanmış olan hastalar çalışmaya dâhil edildi. Tedavilerin tamamlanmasından en az 6 ay sonra hastalar telefon yoluyla aranarak nüks durumları, tekrar tedavi alıp almadıkları sorgulandı. Bulgular: Toplam 59 hasta çalışmaya dâhil edildi. Hastalar tedavi sonrası en az 6 ay takip edilmiş olup, ortalama takip süresi 52,44±27,29 (6-103) ay idi. Steroid tedavisi alan hastaların 4 (%20)'ünde nüks gelişirken, cerrahi tedavi alan hastaların 3 (%7,9)'ünde nüks gözlendi. Cerrahi ve medikal takip edilen hasta grupları arasında, tedavi öncesi NLO ile nüks açısından anlamlı farklılık izlenmedi (p>0,05). Ancak yapılan tedaviye bakılmaksızın incelendiğinde, nüks olan hastaların NLO'ları nüks olmayanlara göre daha yüksekti (p=0,00). Sonuç: Granülomatöz mastit hastalarında tedavi öncesi NLO değeri uzun dönemde nüksü öngörmede fikir verici olabilir.
Anahtar Kelimeler: Granülomatöz mastit; nötrofil infiltrasyonu; nüks; prognoz
Amaç: Granülomatöz mastit, hem tanısı zor hem de ideal tedavi yöntemi olmayan kronik inflamatuar bir hastalıktır. Nadir görülen bir antite olması nedeni ile prognostik faktörler ve tedavi kalsifikasyonu üzerine araştırmalar kısıtlıdır. Son zamanlarda sistemik inflamasyonun biyobelirteci olarak kullanılan nötrofil-lenfosit oranı (NLO) nın popülerliği giderek artmaktadır. Bu çalışmada, kronik inflamatuar hastalık olması nedeni ile granülomatöz mastitte tedavi sonrası nükslerin öngörülmesinde tedavi öncesi NLO'nun rolünün araştırılması amaçlanmıştır. Gereç ve Yöntemler: Biyopsi sonuçlarına göre granülomatöz mastit hastalığı tespit edilen ve tedavi edilen 62 hastanın verileri retrospektif olarak incelendi. Hastalar, medikal tedavi ve cerrahi tedavi olmak üzere 2 gruba ayrıldı. Demografik verilerinin yanında tedavi öncesi NLO'ları hesaplandı. Her iki grupta da tam kür sağlanmış olan hastalar çalışmaya dâhil edildi. Tedavilerin tamamlanmasından en az 6 ay sonra hastalar telefon yoluyla aranarak nüks durumları, tekrar tedavi alıp almadıkları sorgulandı. Bulgular: Toplam 59 hasta çalışmaya dâhil edildi. Hastalar tedavi sonrası en az 6 ay takip edilmiş olup, ortalama takip süresi 52,44±27,29 (6-103) ay idi. Steroid tedavisi alan hastaların 4 (%20)'ünde nüks gelişirken, cerrahi tedavi alan hastaların 3 (%7,9)'ünde nüks gözlendi. Cerrahi ve medikal takip edilen hasta grupları arasında, tedavi öncesi NLO ile nüks açısından anlamlı farklılık izlenmedi (p>0,05). Ancak yapılan tedaviye bakılmaksızın incelendiğinde, nüks olan hastaların NLO'ları nüks olmayanlara göre daha yüksekti (p=0,00). Sonuç: Granülomatöz mastit hastalarında tedavi öncesi NLO değeri uzun dönemde nüksü öngörmede fikir verici olabilir.
Anahtar Kelimeler: Granülomatöz mastit; nötrofil infiltrasyonu; nüks; prognoz
ABSTRACT
Objective: Granulomatous mastitis is a chronic inflammatory disease that is both difficult to diagnose and not the ideal treatment method. It is due to a rare entity studies on prognostic factors and treatment calcification are limited. Recently, neutrophil-lymphocyte ratio (NLR), which is used as biomarker of systemic inflammation, is increasing in popularity. In this study, we aimed to investigate the role of pre-treatment NLR in the prediction of recurrences after granulomatous mastitis treatment due to chronic inflammatory disease. Material and Methods: According to biopsy results detected and treated that 62 patients with granulomatous mastitis disease were viewed retrospectively. The patients were divided into two groups as medical treatment and surgical treatment. In addition to demographic data, pretreatment NLR were calculated. Patients who obtained complete cure were included in the study in both group too. At least 6 months after the completion of the treatments, the patients were searched by telephone and they were asked whether they had relapses and need any treatment or not. Results: A total of 59 patients were included in the study. The patients were followed up for at least 6 months after the treatment and the mean follow-up period was 52.44±27.29 (6-103) months. Recurrence was observed in 4 (20%) of the patients who received steroid treatment and 3 (7.9%) of the patients who received surgical treatment had recurrence. There was no significant difference between groups with pre-treatment NLR to recurrence rates (p>0.05). Regardless of the treatment option, NLR was higher patients with relaps than patients without relapse (p=0.00). Conclusion: Pre-treatment NLR may be an idea for predicting long-term recurrence after treatment in patients with granulomatosis mastitis.
Keywords: Granulomatous mastitis; neutrophil infiltration; recurrence; prognosis
Objective: Granulomatous mastitis is a chronic inflammatory disease that is both difficult to diagnose and not the ideal treatment method. It is due to a rare entity studies on prognostic factors and treatment calcification are limited. Recently, neutrophil-lymphocyte ratio (NLR), which is used as biomarker of systemic inflammation, is increasing in popularity. In this study, we aimed to investigate the role of pre-treatment NLR in the prediction of recurrences after granulomatous mastitis treatment due to chronic inflammatory disease. Material and Methods: According to biopsy results detected and treated that 62 patients with granulomatous mastitis disease were viewed retrospectively. The patients were divided into two groups as medical treatment and surgical treatment. In addition to demographic data, pretreatment NLR were calculated. Patients who obtained complete cure were included in the study in both group too. At least 6 months after the completion of the treatments, the patients were searched by telephone and they were asked whether they had relapses and need any treatment or not. Results: A total of 59 patients were included in the study. The patients were followed up for at least 6 months after the treatment and the mean follow-up period was 52.44±27.29 (6-103) months. Recurrence was observed in 4 (20%) of the patients who received steroid treatment and 3 (7.9%) of the patients who received surgical treatment had recurrence. There was no significant difference between groups with pre-treatment NLR to recurrence rates (p>0.05). Regardless of the treatment option, NLR was higher patients with relaps than patients without relapse (p=0.00). Conclusion: Pre-treatment NLR may be an idea for predicting long-term recurrence after treatment in patients with granulomatosis mastitis.
Keywords: Granulomatous mastitis; neutrophil infiltration; recurrence; prognosis
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