ORIGINAL RESEARCH
The Value of Inflammatory Parameters in the Differantial Diagnosis of “Benign” and “Malignant” Lesions in Parotid Gland Tumors
Parotis Bezi Tümörlerinde “Benign” ve “Malign” Ayırıcı Tanısında İnflamatuar Parametrelerin Değeri
Received Date : 02 Oct 2019
Accepted Date : 12 Nov 2019
Available Online : 19 Dec 2019
Doğukan ÖZDEMİRa, Mehmet BİRİNCİb, Ahmet BEDİRc, Samet AYDEMİRc, Dursun Mehmet MEHELa, Mustafa BAKIRTAŞd, Abdulkadir ÖZGÜRa
aKulak Burun Boğaz Hastalıkları ABD, Sağlık Bilimleri Üniversitesi, Samsun Eğitim ve Araştırma Hastanesi, Samsun, TÜRKİYE
bKulak Burun Boğaz Hastalıkları Kliniği, Of Devlet Hastanesi, Trabzon, TÜRKİYE
cKulak Burun Boğaz Hastalıkları Kliniği, dPatoloji Kliniği, Samsun Eğitim ve Araştırma Hastanesi, Samsun, TÜRKİYE
Doi: 10.24179/kbbbbc.2019-71711 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(3):131-6
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The diagnosis of benign or malignant parotid gland masses is based on physical
examination, radiological examination or interventional methods. In our study, it was calculated
from the parameters measured in routine blood tests; neutrophil/lymphocyte ratio (NLO),
platelet/lymphocyte ratio (PLO), neutrophil count, lymphocyte count, platelet count, erythrocyte
distribution width, and mean corpuscular volume and was found that they had importance in the differential
diagnosis of benign-malignant masses. Material and Methods: Between November 2016 and
May 2019, 95 patients operated for parotid gland tumors were included in the study. The data of the
patients were analyzed retrospectively; age, sex, postoperative histopathological results and hematological
parameters were recorded. Histopathological results were divided into two groups as benign
and malignant. Data recorded between the two groups were compared. Results: The mean neutrophils
and lymphocytes were significantly higher in malignant tumors compared to benign tumors (p=0.011
and p=0.040, respectively). The mean NLR value was 2.68±0.99 in malignant tumors and 1.84±0.95 in
benign tumors, and was statistically significant (p<0,000). The mean PLO value was 153.44±81.21 in
malignant tumors and 114.26±59.27 in benign tumors, and a statistically significant difference was
found (p=0.016). Conclusion: NLR and PLO values can be used to differentiate benign and malignant
parotid gland tumors. These parameters can be easily calculated from routine routine hemogram
analysis, and cheap and fast results can be obtained with this method.
Keywords: Parotid tumor marker; neutrophil lymphocyte ratio; platelet lymphocyte ratio
ÖZET
Amaç: Parotis bezi kitlelerinde benign veya malign ön tanısının konulması; fizik muayene, radyolojik
tetkik veya girişimsel yöntemlerle olmaktadır. Çalışmamızda, hastaların rutin kan tetkiklerinde
bakılan parametrelerden hesaplanan; nötrofil/lenfosit oranı (NLO), platelet/lenfosit oranı (PLO), nötrofil
sayısı, lenfosit sayısı, platelet sayısı, eritrosit dağılım genişliği ve ortalama korpuskuler volüm ile
parotis kitlelerinin benign-malign ayırıcı tanısında önemini değerlendirmeyi amaçladık. Gereç ve Yöntemler:
Çalışmaya, Kasım 2016-Mayıs 2019 tarihleri arasında parotis bezinde tümör nedeni ile opere
edilmiş 95 hasta dâhil edildi. Hastaların verileri retrospektif olarak incelenerek; yaş, cinsiyet, postoperatif,
histopatolojik sonuçlar ve hematolojik parametreler kaydedildi. Histopatolojik sonuçlar benign ve
malign olarak 2 gruba ayrıldı. Her 2 grup arasında kaydedilen veriler karşılaştırıldı. Bulgular: Malign
tümörlerde NLO ortalamaları benign tümörlere göre anlamlı olarak yüksek bulundu (sırasıyla p=0,011;
p=0,040). Malign tümörlerde NLO ortalama değeri 2,68±0,99, benign tümörlerde 1,84±0,95 olarak hesaplandı
ve istatistiksel olarak anlamlı derecede yüksekdi (p<0,000). PLO ortalama değeri malign tümörlerde
153,44±81,21, benign tümörlerde 114,26±59,27 olarak hesaplandı ve istatistiksel olarak anlamlı
farklılık bulundu (p=0,016). Sonuç: Parotis bezi tümörlerinin benign-malign ayrımında NLO ve PLO
değerleri kullanılabilir. Bu parametreler rutin bakılan hemogram tahlilinden kolayca hesaplanabilen,
ucuz, hızlı sonuç veren bir yöntemdir.
Anahtar Kelimeler: Parotis tümörü belirteç; nötrofil lenfosit oranı; platelet lenfosit oranı
KAYNAKLAR
- Damar M, Dinç AE, Erdem D, Aydil U, Kizil Y, Eravcı FC, et al. Pretreatment neutrophil-lymphocyte ratio in salivary gland tumors is associated with malignancy. Otolaryngol Head Neck Surg. 2016;155(6):988-96. [Crossref] [PubMed]
- Garrett SL, Trott K, Sebastiano C, Wolf MJ, Rao NK, Curry JM, et al. Sensitivity of fine-needle aspiration and imaging modalities in the diagnosis of low-grade mucoepidermoid carcinoma of the parotid gland. Ann Otol Rhinol Laryngol. 2019;128(8):755-9. [Crossref] [PubMed]
- Berge T, Söderström N. Fine‐needle cytologic biopsy in diseases of the salivary glands. Acta Pathologica Microbiologica Scandinavica. 1963;58(1):1-9. [Crossref] [PubMed]
- Oka K, Chikamatsu K, Eura M, Katsura F, Yumoto E, Tokunaga H. [Clinical significance of fine-needle aspiration biopsy in major salivary gland tumors]. Nippon Jibiinkoka Gakkai Kaiho. 2002;105(11):1109-15. [Crossref] [PubMed]
- Sismanis A, Merriam JM, Kline TS, Davis RK, Shapshy SM, Strong MS. Diagnosis of salivary gland tumors by fine needle aspiration biopsy. Head Neck Surg. 1981;3(6):482-9. [Crossref] [PubMed]
- Deveci İ, Sürmeli M. Correlation of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio with histopathological findings in patients with tongue cancer. The Medical Journal of Haydarpaşa Numune Training and Research Hospital. 2018;58(3):122-7. [Crossref]
- Quer M, Vander Poorten V, Takes RP, Silver CE, Boedeker CC, de Bree R, et al. Surgical options in benign parotid tumors: a proposal for classification. Eur Arch Otorhinolaryngol. 2017;274(11):3825-36. [Crossref] [PubMed]
- Chen L, Zhang G, Zhang Z, Wang Y, Hu L, Wu J. Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of idiopathic sudden sensorineural hearing loss: a systematic review and meta-analysis. Medicine (Baltimore). 2018;97(38):e12492. [Crossref] [PubMed] [PMC]
- Takenaka Y, Oya R, Kitamiura T, Ashida N, Shimizu K, Takemura K, et al. Prognostic role of neutrophil‐to‐lymphocyte ratio in head and neck cancer: a meta‐analysis. Head Neck. 2018;40(3):647-55. [Crossref] [PubMed]
- Mascarella MA, Mannard E, Silva SD, Zeitoni A. Neutrophil‐to‐lymphocyte ratio in head and neck cancer prognosis: a systematic review and meta‐analysis. Head Neck. 2018;40(5):1091-100. [Crossref] [PubMed]
- Wang Y, Wang P, Andrukhov O, Wang T, Song S, Yan C, et al. Meta‐analysis of the prognostic value of the neutrophil‐to‐lymphocyte ratio in oral squamous cell carcinoma. J Oral Pathol Med. 2018;47(4):353-8. [Crossref] [PubMed]
- Yu Y, Wang H, Yan A, Wang H, Li X, Liu J, et al. Pretreatment neutrophil to lymphocyte ratio in determining the prognosis of head and neck cancer: a meta-analysis. BMC Cancer. 2018;18(1):383. [Crossref] [PubMed] [PMC]
- Kano S, Homma A, Hatakeyama H, Mizumachi T, Sakashita T, Kakizaki T, et al. Pretreatment lymphocyte‐to‐monocyte ratio as an independent prognostic factor for head and neck cancer. Head Neck. 2017;39(2):247-53. [Crossref] [PubMed]
- Kum RO, Ozcan M, Baklaci D, Kum NY, Yilmaz YF, Gungor V, et al. Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions. Asian Pac J Cancer Prev. 2014;15(17):7351-5. [Crossref] [PubMed]
- Kawakita D, Tada Y, Imanishi Y, Beppu S, Tsukahara K, Kano S, et al. Impact of hematological inflammatory markers on clinical outcome in patients with salivary duct carcinoma: a multi-institutional study in Japan. Oncotarget. 2017;8(1):1083-91. [Crossref]
- Eskiizmir G, Uz U, Onur E, Ozyurt B, Karaca Cikrikci G, Sahin N, et al. The evaluation of pretreatment neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio in patients with laryngeal neoplasms. Braz J Otorhinolaryngol. 2019;85(5):578-87. [Crossref] [PubMed]
- Cheng G, Liu F, Niu X, Fang Q. Role of the pretreatment neutrophil-to-lymphocyte ratio in the survival of primary parotid cancer patients. Cancer Manag Res. 2019;11:2281-6. [Crossref] [PubMed] [PMC]
- Seng D, Fang Q, Li P, Liu F, Liu S. Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in pediatric parotid cancer. Front Pediatr. 2019;7:207. [Crossref] [PubMed] [PMC]
- Kuzucu İ, Güler İ, Kum RO, Baklacı D, Özcan M. Increased neutrophil lymphocyte ratio and platelet lymphocyte ratio in malignant parotid tumors. Braz J Otorhinolaryngol. 2019. Apr 23. Doi: 10.1016/j.bjorl.2019.02.009. [Epub ahead of print]. [Crossref] [PubMed]
- Freling NJ, Molenaar WM, Vermey A, Mooyaart EL, Panders AK, Annyas AA, et al. Malignant parotid tumors: clinical use of MR imaging and histologic correlation. Radiology. 1992;185(3):691-6. [Crossref] [PubMed]
- Zbären P, Triantafyllou A, Devaney KO, Poorten VV, Hellquist H, Rinaldo A, et al. Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy? Eur Arch Otorhinolaryngol. 2018;275(11):2609-13. [Crossref] [PubMed]
- Schmidt RL, Hall BJ, Wilson AR, Layfield LJ. A systematic review and meta-analysis of the diagnostic accuracy of fine-needle aspiration cytology for parotid gland lesions. Am J Clin Pathol. 2011;136(1):45-9. [Crossref] [PubMed]
- Liu CC, Jethwa AR, Khariwala SS, Johnson J, Shin JJ. Sensitivity, specificity, and posttest probability of parotid fine-needle aspiration: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2016;154(1):9-23. [Crossref] [PubMed] [PMC]
- Feinstein AJ, Alonso J, Yang SE, St John M. Diagnostic accuracy of fine-needle aspiration for parotid and submandibular gland lesions. Otolaryngol Head Neck Surg. 2016;155(3):431-6. [Crossref] [PubMed]
- Eytan DF, Yin LX, Maleki Z, Koch WM, Tufano RP, Eisele DW, et al. Utility of preoperative fine needle aspiration in parotid lesions. Laryngoscope. 2018;128(2):398-402. [Crossref] [PubMed]
- Kim HJ, Kim JS. Ultrasound-guided core needle biopsy in salivary glands: a meta‐analysis. Laryngoscope. 2018.;128(1):118-25. [Crossref] [PubMed]
- Witt BL, Schmidt RL. Ultrasound‐guided core needle biopsy of salivary gland lesions: a systematic review and meta‐analysis. Laryngoscope. 2014;124(3):695-700. [Crossref] [PubMed]
