Research Article
Hematologic Inflammatory Markers in the Retrospective Evaluation of Cases with A Pathologic Diagnosis of Uterine Fibroid
Abstract
Objective: The patients with a postoperative pathologic diagnosis of uterine leiomyoma were evaluated in terms of surgical procedure, fibroid features and accompanying pathologies. We also wanted to reveal the relationship of inflammatory markers with the number, size and localization of fibroids.
Material and Methods: The data of 102 patients with a postoperative pathologic diagnosis of uterine leiomyoma were assessed retrospectively. Age, gravida, parity, preoperative and postoperative hemogram results of patients were obtained from the patients’ files. Fibroid size, number, location and other gyneco-pathologies accompanying myoma were obtained from the pathology reports.
Results: When the fibroid localization was examined, it was determined that 44.1%of the fibroids showed intramural location, and at least 2 fibroids were detected 61%of the patients. Retrospective review of the surgical procedures performed showed that total abdominal hysterectomy was performed in 46%of the patients. For the relationship between inflammatory parameters and fibroid size; neutrophil/lymphocyte ratio and lymphocyte/monocyte ratio values were found to be statistically different (p= 0.023; 0.038 respectively), however, platelet/lymphocyte ratio values were statistically insignificant (p˃0.05). There was no statistically significant difference between the preoperative and postoperative hemoglobin values of the cases examined in terms of both fibroid size and number (p˃0.05).
Conclusion: While a decrease in lymphocyte/monocyte ratio is observed with increased number of fibroids, there is an increase in neutrophil/lymphocyte ratio and a decrease in lymphocyte/monocyte ratio with an increase in myoma size.
References
- 1. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-7.
- 2. Karakaya BK, Çelik HK, Keçecioğlu M, Evliyaoğlu Ö, Sarıkaya E, Erkaya S. Submuköz myom boyutu ve serum hemoglobin seviyesi arasındaki ilişki. Jinekoloji Obstetrik ve Neonatoloji Tıp Dergisi. 2017;14(2):45-7.
- 3. Schwartz LB, Rutkowski N, Horan C, Nachtigall LE, Snyder J, Goldstein SR. Use of transvaginal ultrasonography to monitor the effects of tamoxifen on uterine leiomyoma size and ovarian cyst formation. J Ultrasound Med. 1998;17(11):699-703.
- 4. Rock AJ, Jones WH. Te Linde’s Operative Gynecology. 10th ed. Philadelphia. Wiliams & Wilkins Lippincott, 2012.
- 5. Guarnaccia MM, Rein MS. Traditional surgical approaches to uterine fibroids: abdominal myomectomy and hysterectomy. Clin Obstet Gynecol. 2001;44(2):385-400.
- 6. Wamsteker K, Emanuel MH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstetrics and Gynecology. 1993;82(5):736-40.
- 7. Santulli P, Borghese B, Lemaréchal H, Leconte M, Millischer A-E, Batteux F et al. Increased serum oxidative stress markers in women with uterine leiomyoma. PloS one. 2013;8(8):e72069.
- 8. Protic O, Toti P, Islam MS, Occhini R, Giannubilo SR, Catherino WH et al. Possible involvement of inflammatory/reparative processes in the development of uterine fibroids. Cell Tissue Res. 2016;364(2):415-27.
- 9. Kececioglu M, Tokmak A, Sarikaya E, Kececioglu TS, Akselim B, Koseoglu SB et al. Role of neutrophil lymphocyte ratio at preoperative adenomyosis diagnosis. Medicine Sci. 2016;5(2):426-31.
- 10. Ilhan G, Atmaca FFV, Altan E, Zebitay AG, Sözen H, Akyol H et al. Evaluation of neutrofil-lymphocyte ratio, platelet-lymphocyte ratio, red cell distribution width-platelet ratio for the diagnosis of premature ovarian insufficiency. J Family Reprod Health. 2016;10(4):211-6.
- 11. Gambone JC, Reiter RC. Nonsurgical management of chronic pelvic pain: a multidisciplinary approach. Clin Obstet Gynecol. 1990;33(1):205-11.
- 12. Coskun B, Guzel AI, Coskun B, Kokanali D, Simşir C, Doganay M. The evaluation of association between body mass index and clinical parameters in women underwent myomectomy. Journal of Health Sciences and Medicine. 2020;3(1):47-50.
- 13. Sei K, Masui K, Sasa H, Furuya K. Size of uterine leiomyoma is a predictor for massive haemorrhage during caesarean delivery. Eur J Obstet Gynecol Reprod Biol. 2018;223(4):60-3.
- 14. Bademkıran C. Myom nedenli uygulanan cerrahi tedavi olgularının retrospektif değerlendirilmesi (tez). Eskişehir. Eskişehir Osmangazi Üniversitesi Tıp Fakültesi; 2013.
- 15. Ahsen A, Ulu MS, Yuksel S, Demir K, Uysal M, Erdogan M et al. As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation. 2013;36(6):1357-62.
- 16. Yayla Ç, Akboğa MK, Gayretli YK, Ertem AG, Efe TH, Şen F et al. A novel marker of inflammation in patients with slow coronary flow: lymphocyte-to-monocyte ratio. Biomark Med. 2016;10(5):485-93.
- 17. Lalosevic MS, Markovic AP, Stankovic S, Stojkovic M, Dimitrijevic I, Vujacic IR et al. Combined diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers of systemic inflammation in the diagnosis of colorectal cancer. Disease Markers. 2019;2019: 6036979.
- 18. Çaltekin İ, Gökçen E. Strok alt gruplarinda lenfosit monosit orani ve inflamatuar belirteçlerdeki değişimin değerlendirilmesi. Bozok Tıp Dergisi. 2020;10(1):190-5.
- 19. Zakynthinos E, Pappa N. Inflammatory biomarkers in coronary artery disease. J Cardiol. 2009;53(3):317-33.
- 20. Demirtaş E, Demirtaş E. Diagnostic value of neutrophil to lymphocyte ratio to rule out chronic obstructive pulmonary disease exacerbation from acute heart failure in the emergency department. Disaster and Emergency Medicine Journal. 2019;4(3):102-8.
- 21. Cho Hy, Kim K, Kim YB, No JH. Differential diagnosis between uterine sarcoma and leiomyoma using preoperative clinical characteristics. J Obstet Gynaecol Res. 2016;42(3):313-8.
- 22. Çınar M, Aksoy RT, Güzel Aİ, Tokmak A, Yenicesu O, Sarıkaya E et al. The association between clinical parameters and uterine fibroid size in patients who underwent abdominal myomectomy. J Exp Ther Oncol. 2016;11:195-8.
- 23. Taşkıran Ç, Kurdoğlu M, Bozkurt N, Polat M, Kurdoğlu Z, Yıldırım M. Uterin myomların hematolojik parametreler üzerine olan etkisinin incelenmesi. Türk Fertilite Dergisi. 2006;14:195-9.
- 24. Madendag Y, Sahin E, Aydin E, Madendag IC, Acmaz G, Karaman H. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can be useful markers for distinguishing uterine adenomyosis and leiomyoma. Gynecology Obstetrics & Reproductive Medicine. 2018;24(3):147-50.
- 25. Erdoğan F, Sayan CD, Yeral Mİ, Özkan ZS, Sağsöz N. Histerektomi sonrası adenomyozis ve leiomyoma tanıları alan hastaların pre-operatif inflamasyon parametrelerinin karşılaştırılması. Ortadoğu Tıp Dergisi. 2019;11(4):555-60.
- 26. Korczyński J, Sobkiewicz S. Adenomyosis. Diagnostic technique and treatment. Ginekologia polska. 2001;72(5):317-21.
- 27. Keskin S, Keskin D, Özdemir Ö. Histerektomi endikasyonları ve histopatolojik tanıların dağılımı. Cumhuriyet Tıp Dergisi. 2013;35(3):357-62.
- 28. Özkan ZS, Kumbak B, Cilgin H, Simsek M, Turk BA. Coexistence of adenomyosis in women operated for benign gynecological diseases. Gynecol Endocrinol. 2012;28(3):212-5.
- 29. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18(6):535-58.
- 30. Guntupalli SR, Ramirez PT, Anderson ML, Milam MR, Bodurka DC, Malpica A. Uterine smooth muscle tumor of uncertain malignant potential: a retrospective analysis. Gynecol Oncol. 2009;113(3):324-6.
PATOLOJİ SONUCU UTERİN LEİOMYOM OLARAK SONUÇLANAN OLGULARIN HEMATOLOJİK İNFLAMATUAR BELİRTEÇLER İLE RETROSPEKTİF DEĞERLENDİRİLMESİ
Abstract
Amaç: Patoloji sonucu uterin leiomyom olarak sonuçlanan vakaların, yapılan cerrahi işlem, myom özellikleri ve eşlik eden patolojiler açısından değerlendirilmesi hedeflenmiştir. Ayrıca; myom sayısı, büyüklüğü ve lokalizasyonuna göre inflamatuar belirteçlerin de değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Cerrahi sonrası patoloji sonucu uterin leiomyom olarak değerlendirilen 102 hastanın verileri retrospektif olarak değerlendirildi. Olguların yaş, gravida, parite, preoperatif ve postoperatif hemogram sonuçlarına hasta dosyalarından ulaşıldı. Myoma eşlik eden diğer jineko-patolojiler, myom boyutu, sayısı ve yerleşimi bilgilerine patoloji raporlarından ulaşıldı.
Bulgular: Myom yerleşimi incelendiğinde olguların %44.1’inin intramural yerleşim gösterdiği, myom sayısına bakıldığında ise hastaların %61’ inde en az iki adet myom olduğu saptandı. Hastalara yapılan cerrahi işlemler retrospektif değerlendirildiğinde olguların %46’sına total abdominal histerektomi yapıldığı görüldü. İnflamatuar parametrelerle myom büyüklüğü arasındaki ilişki incelendiğinde; ≤5 cm ile ˃5 cm myomu olan olgular karşılaştırıldığında nötrofil/lenfosit oranı ve lenfosit/monosit oranı değerleri istatistiksel olarak anlamlı farklı bulundu (sırasıyla, p=0.023; 0.038), ancak platelet/lenfosit oranı değerleri istatistiksel olarak anlamsız bulundu (p˃0.05). Hem myom boyutu hem de sayısı açısından incelenen olguların preoperatif ve postoperatif hemoglobin değerleri arasında istatistiksel olarak bir farklılık saptanmadı (p˃0.05).
Sonuç: Artmış myom sayısı ile lenfosit/monosit oranında azalma gözlenirken, myom boyutu artışıyla nötrofil/lenfosit oranında artış ve lenfosit/monosit oranında da azalma olmaktadır.
References
- 1. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-7.
- 2. Karakaya BK, Çelik HK, Keçecioğlu M, Evliyaoğlu Ö, Sarıkaya E, Erkaya S. Submuköz myom boyutu ve serum hemoglobin seviyesi arasındaki ilişki. Jinekoloji Obstetrik ve Neonatoloji Tıp Dergisi. 2017;14(2):45-7.
- 3. Schwartz LB, Rutkowski N, Horan C, Nachtigall LE, Snyder J, Goldstein SR. Use of transvaginal ultrasonography to monitor the effects of tamoxifen on uterine leiomyoma size and ovarian cyst formation. J Ultrasound Med. 1998;17(11):699-703.
- 4. Rock AJ, Jones WH. Te Linde’s Operative Gynecology. 10th ed. Philadelphia. Wiliams & Wilkins Lippincott, 2012.
- 5. Guarnaccia MM, Rein MS. Traditional surgical approaches to uterine fibroids: abdominal myomectomy and hysterectomy. Clin Obstet Gynecol. 2001;44(2):385-400.
- 6. Wamsteker K, Emanuel MH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstetrics and Gynecology. 1993;82(5):736-40.
- 7. Santulli P, Borghese B, Lemaréchal H, Leconte M, Millischer A-E, Batteux F et al. Increased serum oxidative stress markers in women with uterine leiomyoma. PloS one. 2013;8(8):e72069.
- 8. Protic O, Toti P, Islam MS, Occhini R, Giannubilo SR, Catherino WH et al. Possible involvement of inflammatory/reparative processes in the development of uterine fibroids. Cell Tissue Res. 2016;364(2):415-27.
- 9. Kececioglu M, Tokmak A, Sarikaya E, Kececioglu TS, Akselim B, Koseoglu SB et al. Role of neutrophil lymphocyte ratio at preoperative adenomyosis diagnosis. Medicine Sci. 2016;5(2):426-31.
- 10. Ilhan G, Atmaca FFV, Altan E, Zebitay AG, Sözen H, Akyol H et al. Evaluation of neutrofil-lymphocyte ratio, platelet-lymphocyte ratio, red cell distribution width-platelet ratio for the diagnosis of premature ovarian insufficiency. J Family Reprod Health. 2016;10(4):211-6.
- 11. Gambone JC, Reiter RC. Nonsurgical management of chronic pelvic pain: a multidisciplinary approach. Clin Obstet Gynecol. 1990;33(1):205-11.
- 12. Coskun B, Guzel AI, Coskun B, Kokanali D, Simşir C, Doganay M. The evaluation of association between body mass index and clinical parameters in women underwent myomectomy. Journal of Health Sciences and Medicine. 2020;3(1):47-50.
- 13. Sei K, Masui K, Sasa H, Furuya K. Size of uterine leiomyoma is a predictor for massive haemorrhage during caesarean delivery. Eur J Obstet Gynecol Reprod Biol. 2018;223(4):60-3.
- 14. Bademkıran C. Myom nedenli uygulanan cerrahi tedavi olgularının retrospektif değerlendirilmesi (tez). Eskişehir. Eskişehir Osmangazi Üniversitesi Tıp Fakültesi; 2013.
- 15. Ahsen A, Ulu MS, Yuksel S, Demir K, Uysal M, Erdogan M et al. As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation. 2013;36(6):1357-62.
- 16. Yayla Ç, Akboğa MK, Gayretli YK, Ertem AG, Efe TH, Şen F et al. A novel marker of inflammation in patients with slow coronary flow: lymphocyte-to-monocyte ratio. Biomark Med. 2016;10(5):485-93.
- 17. Lalosevic MS, Markovic AP, Stankovic S, Stojkovic M, Dimitrijevic I, Vujacic IR et al. Combined diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers of systemic inflammation in the diagnosis of colorectal cancer. Disease Markers. 2019;2019: 6036979.
- 18. Çaltekin İ, Gökçen E. Strok alt gruplarinda lenfosit monosit orani ve inflamatuar belirteçlerdeki değişimin değerlendirilmesi. Bozok Tıp Dergisi. 2020;10(1):190-5.
- 19. Zakynthinos E, Pappa N. Inflammatory biomarkers in coronary artery disease. J Cardiol. 2009;53(3):317-33.
- 20. Demirtaş E, Demirtaş E. Diagnostic value of neutrophil to lymphocyte ratio to rule out chronic obstructive pulmonary disease exacerbation from acute heart failure in the emergency department. Disaster and Emergency Medicine Journal. 2019;4(3):102-8.
- 21. Cho Hy, Kim K, Kim YB, No JH. Differential diagnosis between uterine sarcoma and leiomyoma using preoperative clinical characteristics. J Obstet Gynaecol Res. 2016;42(3):313-8.
- 22. Çınar M, Aksoy RT, Güzel Aİ, Tokmak A, Yenicesu O, Sarıkaya E et al. The association between clinical parameters and uterine fibroid size in patients who underwent abdominal myomectomy. J Exp Ther Oncol. 2016;11:195-8.
- 23. Taşkıran Ç, Kurdoğlu M, Bozkurt N, Polat M, Kurdoğlu Z, Yıldırım M. Uterin myomların hematolojik parametreler üzerine olan etkisinin incelenmesi. Türk Fertilite Dergisi. 2006;14:195-9.
- 24. Madendag Y, Sahin E, Aydin E, Madendag IC, Acmaz G, Karaman H. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can be useful markers for distinguishing uterine adenomyosis and leiomyoma. Gynecology Obstetrics & Reproductive Medicine. 2018;24(3):147-50.
- 25. Erdoğan F, Sayan CD, Yeral Mİ, Özkan ZS, Sağsöz N. Histerektomi sonrası adenomyozis ve leiomyoma tanıları alan hastaların pre-operatif inflamasyon parametrelerinin karşılaştırılması. Ortadoğu Tıp Dergisi. 2019;11(4):555-60.
- 26. Korczyński J, Sobkiewicz S. Adenomyosis. Diagnostic technique and treatment. Ginekologia polska. 2001;72(5):317-21.
- 27. Keskin S, Keskin D, Özdemir Ö. Histerektomi endikasyonları ve histopatolojik tanıların dağılımı. Cumhuriyet Tıp Dergisi. 2013;35(3):357-62.
- 28. Özkan ZS, Kumbak B, Cilgin H, Simsek M, Turk BA. Coexistence of adenomyosis in women operated for benign gynecological diseases. Gynecol Endocrinol. 2012;28(3):212-5.
- 29. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18(6):535-58.
- 30. Guntupalli SR, Ramirez PT, Anderson ML, Milam MR, Bodurka DC, Malpica A. Uterine smooth muscle tumor of uncertain malignant potential: a retrospective analysis. Gynecol Oncol. 2009;113(3):324-6.
There are 30 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | April 30, 2021 |
| Submission Date | July 13, 2020 |
| Published in Issue | Year 2021 Volume: 23 Issue: 1 |
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Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.