LÖKOSİT TROMBOSİT AGREGATLARININ İLERİ EVRE KANSER HASTALARINDA TROMBOZ GELİŞİMİNE KATKISI
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Tarih
2017
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Namık Kemal Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızın amacı inflamasyon ve tromboza yatkınlıkla giden solid organ tümörü hastalarinda lökosit trombosit agregatlari ve tromboz ilişkisini tespit etmektir. Materyal ve Metot: Çalışmada Namık Kemal Üniversitesi Onkoloji Bilim Dalı’ nda 2013 -2014 tarihleri arasında izlenen 28 metastatik GİS tümörü, 33 metastatik akciğer tümörü, 29 opere tümör olgusu olmak üzere toplam 90 hastaya ilişkin labaratuar ve klinik verileri 12 sağlıklı gönüllüden oluşan kontrol grubu ile karşılaştırmayı amaçladık. Bu amaç doğrultusunda trombosit aktivasyonunun iyi bir göstergesi olduğu gösterilmiş olan monosit trombosit agregatları, granülosit trombosit agregatları; kanda trombin ortaya çıkışını gösteren trombin- antitrombin III kompleks ve inflamasyon belirteci olarak yüksek duyarlıklı C reaktif protein düzeyleri çalışıldı. Mevcut verilerden nötrofil lökosit oranı hesap edildi. Hastalarda venöz tromboz tespiti için ise derin ven trombozu prospektif olarak değerlendirildi. Bulgular: Çalışmamızda monosit trombosit agregatları düzeyi metastatik GİS tümörlerinde ve opere tümörlerde kontrol gruba göre anlamlı düzeyde yüksek tespit edildi (p: 0,05 ; 0,029 sırasıyla). Granülosit trombosit agregatları düzeyi ise metastatik GİS, metastatik akciğer ve opere tümörlerin tümünde kontrol gruba göre anlamlı düzeyde yüksek saptandı (p: 0,015; 0,0,012 ; 0,01 sırasıyla). Yüksek duyarlıklı C reaktif protein düzeyi de metastatik GİS ve metastatik akciğer tümörlerinde kontrol gruba göre anlamlı yüksek saptandı (p: 0,014 ; 0,000 sırasıyla). Yüksek duyarlıklı C reaktif protein düzeyi ayrıca metastatik akciğer tümörlerinde opere tümörlere göre de anlamlı yüksek saptandı (p: 0,000). Trombin- antitrombin III kompleksve nötrofil lökosit oranı düzeylerinde ise gruplar arasında anlamlı farklılık gözlenmedi. Hiperkoagülopatinin değerlendirilmesine yönelik tüm gruplar analiz edildiğinde derin ven trombozu geçirme sıklığı %22 (18 hasta) olarak tespit edildi.Gruplar derin ven trombozu sıklığı açısından tek tek incelendiğinde ise kontrol grupta hiç derin ven trombozu izlenmedi. Opere tümör hastalarında oran % 17 iken, metastatik akciğer tümörlerinde %21 idi. Metastatik GİS tümörlerinde derin ven trombozu sıklığı ise %35 olarak tespit edildi.Derin ven trombozu olanlar ile olmayanlar arasında yaş, monosit trombosit agregatları, granülosit trombosit agregatları, trombin- antitrombin III kompleksve yüksek duyarlıklı C reaktif protein değerleri arasında fark saptanmadı. Bununla birlikte gruplar arasında nötrofil lökosit oranı anlamlı farklı idi (p: 0,034). Sonuç: Sonuçta, bildiğimiz kadarıyla ilk kez farklı evre ve farklı dokulardan kaynaklı kanser hastalarında lökosit trombosit agregatı değerlerinin yükseldiğini tespit ettik. Elde ettiğimiz sonuçları doğrulamak ve bu bilgilerin kanser hastalarında trombotik olayların tahmininde potansiyel etkisini ortaya koymak için daha büyük hasta grupları ile yapılan çalışmalara ihtiyaç vardır.
Aim: The aim of our study was to determine the relations between leukocyte platelet aggregates and thrombosis in patients with solid tumors who are susceptible to inflammation and thrombosis. Materials and Methods: In this study, we compared laboratory and clinical data of 28 metastatic gastrointestinal tumors, 33 metastatic lung tumors, 29 operated tumor patients, for a total of 90 patients with a control group consisting of 12 healthy volunteers followed at Namik Kemal University Oncology clinic in between 2013 -2014. For this purpose, monocyte platelet aggregates which have shown to be good indicators of platelet activation, granulocyte platelet aggregates; thrombin-antithrombin III complex which represents the output of blood thrombin and high-sensitivity C-reactive protein levels were studied. Neutrophil lymphocyte ratio was calculated from the available data. Deep vein thrombosis for detection of venous thrombosis were prospectively evaluated in patients. Results: According to the results, monocyte platelet aggregates level of metastatic gastrointestinal tumors and operated tumors were found to be significantly higher compared to the control group (p: 0.05, 0.029, respectively). Granulocyte platelet aggregates level in all of the tumors of metastatic gastrointestinal, metastatic lung and operated tumors were found to be significantly higher compared with the control group (p = 0.015; 0,0,012; 0.01, respectively). high-sensitivity C-reactive protein levels were also found to be significantly higher compared with the control group in metastatic gastrointestinal and metastatic lung tumors (p: 0.014, 0.000, respectively). high-sensitivity C-reactive protein levels were also determined to be significantly higher in metastatic tumors compared with operated tumors (p = 0.000). No significant difference was observed between the groups in the levels of thrombin-antithrombin III complex and neutrophil lymphocyte ratio. When all groups were analyzed to assess the hypercoagulopathy, deep vein thrombosis frequency were identified as 22% (18 patients). When groups were analyzed individually, deep vein thrombosis was not observed in the control group. The rate was 17% in operated tumors, and was 21% in metastatic lung tumors. The incidence of deep vein thrombosis in metastatic gastrointestinal tumors was found to be 35%. There was no significant difference between patients with and without deep vein thrombosis about age, monocyte platelet aggregates, granulocyte platelet aggregates, thrombin-antithrombin III complex and high-sensitivity C-reactive protein levels. However, neutrophil lymphocyte ratio was significantly different between groups (p = 0.034). Conclusion: In conclusion, to the best of our knowledge for the first time we found leukocyte platelet aggregate values increases in cancer patients of different stages and different tissue origin. To confirm the results we have achieved, and to demonstrate the potential impact of this information in estimation of thrombotic events in cancer patients more studies conducted in larger groups of patients are needed.
Aim: The aim of our study was to determine the relations between leukocyte platelet aggregates and thrombosis in patients with solid tumors who are susceptible to inflammation and thrombosis. Materials and Methods: In this study, we compared laboratory and clinical data of 28 metastatic gastrointestinal tumors, 33 metastatic lung tumors, 29 operated tumor patients, for a total of 90 patients with a control group consisting of 12 healthy volunteers followed at Namik Kemal University Oncology clinic in between 2013 -2014. For this purpose, monocyte platelet aggregates which have shown to be good indicators of platelet activation, granulocyte platelet aggregates; thrombin-antithrombin III complex which represents the output of blood thrombin and high-sensitivity C-reactive protein levels were studied. Neutrophil lymphocyte ratio was calculated from the available data. Deep vein thrombosis for detection of venous thrombosis were prospectively evaluated in patients. Results: According to the results, monocyte platelet aggregates level of metastatic gastrointestinal tumors and operated tumors were found to be significantly higher compared to the control group (p: 0.05, 0.029, respectively). Granulocyte platelet aggregates level in all of the tumors of metastatic gastrointestinal, metastatic lung and operated tumors were found to be significantly higher compared with the control group (p = 0.015; 0,0,012; 0.01, respectively). high-sensitivity C-reactive protein levels were also found to be significantly higher compared with the control group in metastatic gastrointestinal and metastatic lung tumors (p: 0.014, 0.000, respectively). high-sensitivity C-reactive protein levels were also determined to be significantly higher in metastatic tumors compared with operated tumors (p = 0.000). No significant difference was observed between the groups in the levels of thrombin-antithrombin III complex and neutrophil lymphocyte ratio. When all groups were analyzed to assess the hypercoagulopathy, deep vein thrombosis frequency were identified as 22% (18 patients). When groups were analyzed individually, deep vein thrombosis was not observed in the control group. The rate was 17% in operated tumors, and was 21% in metastatic lung tumors. The incidence of deep vein thrombosis in metastatic gastrointestinal tumors was found to be 35%. There was no significant difference between patients with and without deep vein thrombosis about age, monocyte platelet aggregates, granulocyte platelet aggregates, thrombin-antithrombin III complex and high-sensitivity C-reactive protein levels. However, neutrophil lymphocyte ratio was significantly different between groups (p = 0.034). Conclusion: In conclusion, to the best of our knowledge for the first time we found leukocyte platelet aggregate values increases in cancer patients of different stages and different tissue origin. To confirm the results we have achieved, and to demonstrate the potential impact of this information in estimation of thrombotic events in cancer patients more studies conducted in larger groups of patients are needed.
Açıklama
Anahtar Kelimeler
Lökosit trombosit agregatı, tromboz, kanser, Trauma, pediatric patient, gender difference, emergency depar
Kaynak
Namık Kemal Tıp Dergisi (International Journal of Basic and Clinical Medicine)
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
1
