Eritrosit Dağılım Genişliği (RDW ve Nötrofil Lenfosit Oranının (NLR) Rezeksiyon Uygulanan Küçük Hücreli Dışı Akciğer Kanserli Hastalarda Mortalite ve Morbiditeye Etkisi

Abstract

Lung cancer is the most frequently diagnosed cancer type and it is a leading cause of cancer death in worldwide. Treatment of early-stage non-small cell lung cancer is surgery.15-25% of all cases are operable. Treatment model of lung resection and mediastinal lymph node dissection can be made for cure. It is well-known that the importance of inflammation in response to tumors. Researches indicates that the quantitative measure of the variability of circulating red blood cells, which is the size of the red cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) may be the markers of chronic inflammation. There is strong correlation between RDW elevation and pulmonary hypertension, coronary arter disease and myocardial infarction thus, RDW is considered as an independent risk factor for cardiac disease. NLR is an important prognostic indicator for some types of malignancies as colorectal, gastric and pancreatic. RDW and NLR are evaluated by routine complete blood count. Our work is planned to determine the impact of RDW and NLR on mortality and morbidity in patients who have been operated because of non-small cell lung cancer (NSCLC). The patients who are treated by surgery due to NSCLC were analyzed retrospectively between January 2002 and December 2012, in the Department of Thoracic Surgery, Hacettepe University Faculty of Medicine. The demographic data, laboratory parameters, the characteristics of the tumor pathology, surgical procedures, preoperative preparation, postoperative complications, survival and disease-free survival data were recorded from patient charts and the population register system. Correlation between RDW level elevation and survival rate is negative and statistically significant (p:0,019). Influence of RDW level elevation on disease-free survival rate is negative (p:0,057). As blood neutrophil level elevated survival (p:0,007) and disease-free survival (p:0,009) rates are decreased, but if lymphosit level elevated survival (p<0,001) and disease-free survival (p<0,001) rates are increased as well. Correlation between NLR level and survival and disease-free survival rates are negative and statistically significant (p<0,001). Because findings about the correlation between survival and disease-free survival rates and RDW and NLR levels, these can be used as prognostic markers for predicting survival and disease-free survival rates as an easy, cheap and reproducible method. The correlation between RDW and postoperative length of stay and mechanical ventilation support was identified. If supported with bigger series and prospective studies, these can be used as a routine prosedures.