Yıl: 2013 Cilt: 12 Sayı: 2 Sayfa Aralığı: 66 - 68 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients

Öz:
Giriş ve Amaç: Son yıllarda ilgi odağı haline gelen, değişik inflamatu -var ve neoplastik hastalıklar ile ilişkilendirilen basit, ucuz ve efektif birmarker olan nötrofil-lenfosit oranı öne çıkmakta olup kronik hepatit Bhastalarında çalışılmamıştır. Biz çalışmamızda hepatit B tanısı ile has-talık düzeyini belirleme, tedavi kararı alma gibi nedenlerle HBV DNAbakılan ve karaciğer biyopsisi uygulanan hastaların fibrozis düzeyi ilenötrofil-lenfosit oranı arasındaki ilişkiyi araştırdık. Materyal ve Metod:2005-2010 yılları arasında biyopsi alınmış 486 hepatit B hastasının dos-yası retrospektif tarandı ve bu hastalardan çalışma kriterlerine uyan268 naiv hasta bulundu Naiv hastalar çalışmaya alınırken, daha ön -ceden antiviral tedavi almış olan hastalar ve anti-Delta pozitif olanlarçalışma dışı bırakıldılar. Bulgular: Biyopsi alınmış olan çalışma popülas-yonu 163 (%60,8) erkek (yaş: 38±13), 105 (%39,2) kadın (yaş: 37±14)olmak üzere 268 (yaş: 38±13) kişiden oluşmaktaydı. Hastaların fibro -zis skoruna göre dağılımlarına bakıldığında 0/6=122 hasta (%45,5),1/6=50 hasta (%18,7), 2/6=37 hasta (%13,8), 3/6=25 hasta (%9,3),4/6=5 hasta (%1,9), 5/6=6 hasta (%2,2), 6/6=23 hasta (%8,6) şeklin -de dağılmaktaydı. Fibrozis skoru ile nötrofil-lenfosit oranı (r: +0,510 p:0,000), histolojik aktivite indeksi (r: +0,478 p: 0,000) arasında anlamlıkorelasyon saptanırken, HBV DNA düzeyi arasında anlamlı bir korelas-yon izlenmedi (r: +0,035 p: 0,556). Fibrozis skoru 0-1 olan hastalarınnötrofil-lenfosit oranı değeri 1,6±0,5 iken fibrozis skoru 2-6 olanlarda2,4±0,8 saptandı (p=0,000). Tartışma: Kronik hepatit B hastasını polik-linikte ilk kez gördüğümüzde hastalığın evresi ve histopatolojik olarakkaraciğerin durumu hakkında klinisyen olarak bir öngörüde bulunmakiçin nötrofil-lenfosit oranının yararlı olacağını düşünmekteyiz.
Anahtar Kelime:

Konular: Gastroenteroloji ve Hepatoloji

Hepatit B hastalarında nötrofil/lenfosit oranı ile fibrosis arasındaki ilişki

Öz:
Background and Aims:In recent years, the neutrophil to lymphocyteratio has been popular as a simple, inexpensive and effective markerassociated with various inflammatory and neoplastic diseases. Thismarker has not yet been investigated in chronic hepatitis B patients. Inour study with hepatitis B patients, we aimed to investigate the relati- onship between fibrosis levels and the neutrophil to lymphocyte ratiofor determining the disease severity and making treatment decisionsusing HBV-DNA and liver biopsy results. Materials and Methods: 486hepatitis B patients subjected to liver biopsy between 2005 and 2010were screened retrospectively from patient charts. Only 268 naive pa- tients fit the criteria for this study. Naive patients were included whi- e patients treated with antiviral drugs and with a positive anti-Deltaresult were excluded from the study. Results: The study consisted of268 (age: 38±13 years) patients with liver biopsies [163 (60.8%) males(age: 38±13), 105 (39.2%) females (age: 37±14)]. Fibrosis score distri- bution of the patients was as follows: 0/6: 122 patients (45.5%), 1/6:50 patients (18.7%), 2/6: 37 patients (13.8%), 3/6: 25 patients (9.3%),4/6: 5 patients (1.9%), 5/6: 6 patients (2.2%), and 6/6: 23 patients(8.6%). There was a significant correlation between fibrosis score andhistological activity index (r: +0.478 p: 0.000), while HBV-DNA levelsshowed no significant correlation (r: +0.035, p: 0.556). Conclusions: The neutrophil to lymphocyte ratio is predicted to be useful in decidingthe disease severity and histopathological grade of liver disease in ch- ronic hepatitis B patients who are first seen in the outpatient clinic.
Anahtar Kelime:

Konular: Gastroenteroloji ve Hepatoloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Liaw YF. Natural history of chronic hepatitis B virus infection and long-term outcome under treatment. Liver Int 2009; 29 (Suppl 1): 100-7.
  • 2. Ceylan B, Fincanci M, Yardimci C, et al. Can mean platelet volume determine the severity of liver fibrosis or inflammation in patients with chronic hepatitis B? Eur J Gastroenterol Hepatol 2013; 25: 606-12.
  • 3. Ahn SH, Chan HL, Chen PJ, APPROACH Working Group. Chronic hepatitis B: whom to treat and for how long? Propositions, chal - lenges, and future directions. Hepatol Int 2010; 4: 386-95.
  • 4. European Association for the Study of the Liver. EASL clinical prac- tice guidelines: management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167-85.
  • 5. Lee IC, Huang YH, Chan CC. Impact of body mass index and viral load on liver histology in hepatitis B e antigen-negative chronic hepatitis B. Clin Nutr 2011; 30: 647-52.
  • 6. Poynard T, Morra R, Ingiliz P, et al. Assessment of liver fibrosis: noninvasive means. Saudi J Gastroenterol 2008; 14: 163-73.
  • 7. Ucar F, Sezer S, Ginis Z, Ozturk G. APRI, the FIB-4 score, and Forn’s index have noninvasive diagnostic value for liver fibrosis in patients with chronic hepatitis B. Eur J Gastroenterol Hepatol 2013 Mar 18 [Epub ahead of print].
  • 8. Liang B, Li Y, Zhao A, et al. Clinical utility of serum matrix metal - loproteinase-2 and tissue inhibitor of metalloproteinase-2 concen- trations in the assessment of liver fibrosis due to chronic hepatitis B. J Int Med Res 2012; 40: 631-9.
  • 9. Martínez SM, Crespo G, Navasa M, Forns X. Noninvasive assess- ment of liver fibrosis. Hepatology 2011; 53: 325-35.
  • 10. Zhou K, Gao CF, Zhao YP, et al. Simpler score of routine labora - tory tests predicts liver fibrosis in patients with chronic hepatitis B. J Gastroenterol Hepatol 2010; 25: 1569-77.
  • 11. Wang D, Wang Q, Shan F, et al. Identification of the risk for liver fibrosis on CHB patients using an artificial neural network based on routine and serum markers. BMC Infect Dis 2010; 10: 251.
  • 12. Guthrie GJ, Charles KA, Roxburgh CS, et al. The systemic inflam - mation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol 2013 Apr 16 [Epub ahead of print].
  • 13. Celikbilek M, Dogan S, Ozbakır O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013; 27: 72-6.
  • 14. Alkhouri N, Morris-Stiff G, Campbell C, et al. Neutrophil to lym - phocyte ratio: a new marker for predicting steatohepatitis and fibrosis in patients with nonalcoholic fatty liver disease. Liver Int 2012; 32: 297-302.
  • 15. Ozturk ZA, Kuyumcu ME, Yesil Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest 2013 Mar [Epub ahead of print].
  • 16. Dogan S, Celikbilek M, Yagbasan A, Yücesoy M. Noninvasive as- sessment of the effect of treatment in nonalcoholic fatty liver dis- ease: neutrophil to lymphocyte ratio. Liver Int 2012; 32: 1189.
  • 17. Celikbilek M, Dogan S, Yurci A, Ozbakir O. Neutrophil to lym - phocyte ratio: a hopeful marker predicting the disease severity in patients with nonalcoholic fatty liver disease. Liver Int 2012; 32: 1188.
APA Yeşil A, Coşgun s, ERDEM E, KOÇHAN K, Dilber F, GÖNEN C (2013). The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. , 66 - 68.
Chicago Yeşil Atakan,Coşgun süleyman,ERDEM Emrullah,KOÇHAN Koray,Dilber Feyza,GÖNEN Can The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. (2013): 66 - 68.
MLA Yeşil Atakan,Coşgun süleyman,ERDEM Emrullah,KOÇHAN Koray,Dilber Feyza,GÖNEN Can The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. , 2013, ss.66 - 68.
AMA Yeşil A,Coşgun s,ERDEM E,KOÇHAN K,Dilber F,GÖNEN C The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. . 2013; 66 - 68.
Vancouver Yeşil A,Coşgun s,ERDEM E,KOÇHAN K,Dilber F,GÖNEN C The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. . 2013; 66 - 68.
IEEE Yeşil A,Coşgun s,ERDEM E,KOÇHAN K,Dilber F,GÖNEN C "The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients." , ss.66 - 68, 2013.
ISNAD Yeşil, Atakan vd. "The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients". (2013), 66-68.
APA Yeşil A, Coşgun s, ERDEM E, KOÇHAN K, Dilber F, GÖNEN C (2013). The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. Akademik Gastroenteroloji Dergisi, 12(2), 66 - 68.
Chicago Yeşil Atakan,Coşgun süleyman,ERDEM Emrullah,KOÇHAN Koray,Dilber Feyza,GÖNEN Can The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. Akademik Gastroenteroloji Dergisi 12, no.2 (2013): 66 - 68.
MLA Yeşil Atakan,Coşgun süleyman,ERDEM Emrullah,KOÇHAN Koray,Dilber Feyza,GÖNEN Can The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. Akademik Gastroenteroloji Dergisi, vol.12, no.2, 2013, ss.66 - 68.
AMA Yeşil A,Coşgun s,ERDEM E,KOÇHAN K,Dilber F,GÖNEN C The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. Akademik Gastroenteroloji Dergisi. 2013; 12(2): 66 - 68.
Vancouver Yeşil A,Coşgun s,ERDEM E,KOÇHAN K,Dilber F,GÖNEN C The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients. Akademik Gastroenteroloji Dergisi. 2013; 12(2): 66 - 68.
IEEE Yeşil A,Coşgun s,ERDEM E,KOÇHAN K,Dilber F,GÖNEN C "The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients." Akademik Gastroenteroloji Dergisi, 12, ss.66 - 68, 2013.
ISNAD Yeşil, Atakan vd. "The relationship between fibrosis level and blood neutrophil tolymphocyte ratio in chronic HBV patients". Akademik Gastroenteroloji Dergisi 12/2 (2013), 66-68.