Epitelyal Over Kanserinde İmmün-İnflamatuar İndekslerin Prediktif Önemi

Özet

Amaç: Bu çalışmada epitelyal over kanseri (EOC) hastalarında sistemik immün-inflamasyon indeksi (SII), nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR) gibi sistemik immün-inflamatuar indekslerin prognostik öneminin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Akdeniz Üniversitesi Hastanesi'nde 2005-2019 yılları arasında tanı konulan EOC hastaları üzerinde retrospektif bir analiz yapıldı. Hematolojik maligniteleri, otoimmün hastalıkları, kronik inflamatuar hastalıkları olan veya başka kanser öyküsü bulunan hastalar çalışmadan dışlandı. Ameliyat öncesi ve sonrası hematolojik parametreler toplandı. İmmün-inflamatuar indekslerin prognostik değeri Kaplan-Meier sağkalım analizi, Cox regresyonu ve alıcı işletim karakteristiği (ROC) analizi kullanılarak değerlendirildi. Bulgular: Toplam 264 EOC hastası çalışmaya dahil edildi. Ameliyat sonrası SII ve NLR değerleri ameliyat öncesine göre anlamlı derecede yüksekti (p<0.001). Ameliyat sonrası yüksek SII ve NLR değerleri seröz histoloji, malign sitoloji ve ileri evre hastalık ile ilişkiliydi. ROC analizi postoperatif SII'nin omental metastazı (AUC=0.654, p<0.001), ileri evre hastalığı (AUC=0.641, p<0.001) ve 3 yıllık sağ kalımı (AUC=0.663, p<0.001) öngördüğünü göstermiştir. Kaplan-Meier analizi, ameliyat sonrası SII ve NLR değeri yüksek olan hastalarda genel sağ kalımın daha az olduğunu göstermiştir (p<0.001). Çok değişkenli Cox regresyonu, yüksek postoperatif SII (HR=2.45, p<0.001) ve NLR'nin (HR=1.89, p=0.001) bağımsız prognostik faktörler olduğunu doğruladı. Sonuç: Ameliyat sonrası immün-inflamatuar indeksler, özellikle SII ve NLR, EOC'de önemli prognostik belirteçlerdir. İlerlemiş hastalık ve kötü sağ kalım ile olan ilişkileri, potansiyel klinik faydalarını vurgulamaktadır. Bu bulguları doğrulamak için daha ileri çalışmalara ihtiyaç vardır.

Abstract

Objective: This study aimed to evaluate the prognostic significance of systemic immune-inflammatory indices, including the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), in patients with epithelial ovarian cancer (EOC). Material and Methods: A retrospective analysis was conducted in patients with EOC diagnosed at Akdeniz University Hospital between 2005 and 2019. Patients with hematologic malignancies, autoimmune disorders, chronic inflammatory diseases, or a history of other cancers were excluded. Preoperative and postoperative hematologic parameters were recorded. The prognostic value of immune-inflammatory indices was assessed using nn-Meier survival analysis, Cox regression, and receiver operating characteristic (ROC) analysis. Results: A total of 264 EOC patients were included. Postoperative SII and NLR values were significantly higher than the preoperative levels (p<0.001). Higher postoperative SII and NLR were associated with serous histology, malignant cytology, and advanced-stage disease. ROC analysis showed that postoperative SII predicted omental metastasis (AUC=0.654, p<0.001), advanced-stage disease (AUC=0.641, p<0.001), and 3-year survival (AUC=0.663, p<0.001). Kaplan-Meier analysis revealed shorter overall survival in patients with high postoperative SII and NLR (p<0.001). Multivariate Cox regression confirmed that high postoperative SII (HR=2.45, p<0.001) and NLR (HR=1.89, p=0.001) as independent prognostic factors. Conclusion: Postoperative immune-inflammatory indices, particularly SII and NLR, are significant prognostic markers in EOC. Their association with advanced disease and poor survival highlights their potential clinical utility. Further studies are needed to confirm these findings.

Anahtar kelimeler

Epitelyal over kanseri sistemik immün-inflamasyon indeksi nötrofil-lenfosit oranı trombosit-lenfosit oranı prognoz sağkalım Epithelial ovarian cancer systemic immune-inflammation index neutrophil-to-lymphocyte ratio platelet-to-lymphocyte ratio prognosis survival

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Bu Makaleye Atıf Yap

Güner, F. C., Iltar, E., Güney, M. C., Cantürk, R. S., Dogan, S., Doğan, N. U., Tuncer, A., Şimşek, T. (2026). Epitelyal Over Kanserinde İmmün-İnflamatuar İndekslerin Prediktif Önemi. Akdeniz Tıp Dergisi, Cilt: 12 Sayı: 1. https://doi.org/10.53394/akd.1666986

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