Kocaeli Med J. 2019; 8(3): 22-27 | DOI: 10.5505/ktd.2019.28482

Neutrophil-Lymphocyte Ratio is Valuable in Predicting the Pathology Result in the Patients with Renal Mass > 4 cm Prior to the Partial Nephrectomy

Volkan Çaðlayan, Efe Önen, Sinan Avcý, Murat Þambel, Metin Kýlýç, Erdem Toprak, Sedat Öner
University of Health Sciences Bursa Training and Research Hospital, Department of Urology, Bursa, Turkey

INTRODUCTION: To assess the efficacy of neutrophil-lymphocyte ratio (NLR) in predicting the pathology results of renal masses prior to partial nephrectomy (PN).
METHODS: The data of 76 patients who underwent PN between March 2012 and March 2018 was evaluated. Patients were grouped according to pathology results (malign group-benign group), tumor stage (T1a-T1b) and tumor grade (Grade1-Grade2-Grade3) and mass size (≤4 cm->4 cm).
RESULTS: Benign group was consisted of 17 patients and malign group was of 59 patients. No statistically significant difference was found when preoperative NLR of benign and malign groups were compared (p=0.113). When malign group was divided into 2 groups according to tumor stage (T1a-T1b), NLR of T1b group was significantly higher than benign group and T1a group (p=0.007 and p<0.001, respectively). In grade3 tumor group, NLR was significantly higher when compared with grade1 and grade2 groups (p<0.001 and p=0.02, respectively). Thirty-four patients had renal masses >4 cm. NLR was significantly higher in the patients with >4 cm malign renal masses (p=0.035). The cut-off value to predict malignancy was 2.31 with 65% specificity and 50% sensitivity.
DISCUSSION AND CONCLUSION: NLR is a valuable parameter at predicting pathology result in patients with renal masses >4 cm. Higher NLR value was associated high grade tumors. Further studies must be performed to certify the efficacy of NLR.

Keywords: Partial nephrectomy, Neutrophil-lymphocyte ratio, Renal cell carcinoma

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Nötrofil-Lenfosit Oraný, Parsiyel Nefrektomi Öncesinde 4 cm'den büyük Renal Kitlesi Olan Hastalarýn Patoloji Sonucunu Tahmin Etmekte Faydalýdýr

Volkan Çaðlayan, Efe Önen, Sinan Avcý, Murat Þambel, Metin Kýlýç, Erdem Toprak, Sedat Öner
Saðlýk Bilimleri Üniversitesi Bursa Yüksek Ýhtisas Eðitim ve Araþtýrma Hastanesi, Üroloji Kliniði, Bursa, Türkiye

GÝRÝÞ ve AMAÇ: Nötrofil-lenfosit oranýnýn (NLR) parsiyel nefrektomi (PN) öncesi renal kitlelerin patoloji sonuçlarýnýn öngörülmesindeki etkinliðini deðerlendirmek.


YÖNTEM ve GEREÇLER: Mart 2012 ve Mart 2018 tarihleri arasýnda PN yapýlan 76 hastanýn verileri deðerlendirildi. Hastalar patoloji sonuçlarýna (malign grup benign grup), tümör evresine (T1a-T1b) ve tümör derecesine (Grade 1-Grade2-Grade3) ve kitle boyutuna (<4 cm-> 4 cm) göre gruplandý.
BULGULAR: Benign grup 17 hastadan, malign grup 59 hastadan oluþmaktaydý. Benign ve malign gruplarýn preoperatif NLR'leri karþýlaþtýrýldýðýnda istatistiksel olarak anlamlý bir fark bulunmadý (p = 0.113). Malign grup tümör evresine göre (T1a-T1b) 2 gruba ayrýldýðýnda, T1b grubunun NLR deðeri benign grup ve T1a grubundan anlamlý olarak yüksekti (sýrasýyla p= 0.007 ve p<0.001). Grade 3 tümör grubunda NLR, grade1 ve grade2 gruplarýna göre anlamlý olarak daha yüksekti (sýrasýyla, p<0.001 ve p = 0.02). Otuz dört hastada, 4 cm'den büyük böbrek kitleleri vardý. NLR 4 cm'den büyük malign böbrek kitlesi olan hastalarda anlamlý olarak yüksekti (p = 0,035). Maligniteyi tahmin etmek için cut-off deðeri 2,31 idi ve % 65 özgüllük ve % 50 duyarlýlýða sahipti.

TARTIÞMA ve SONUÇ: NLR, böbrek kitleleri 4 cm'den büyük olan hastalarda patoloji sonucunu öngörmede deðerli bir parametredir. Daha yüksek NLR deðeri yüksek dereceli tümörler ile iliþkilidir. NLR'nin etkinliðini doðrulamak için ileri çalýþmalar yapýlmalýdýr.

Anahtar Kelimeler: Parsiyel nefrektomi, Nötrofil-lenfosit oraný, Renal hücreli karsinom

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