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Helicobacter Pylori Eradikasyon Tedavisi Sonrasi HastaTakibinde Nöltrofil Lenfosit Oranının Duyarlılık ve Özgüllüğü

Yıl 2022, Cilt: 9 Sayı: 2, 202 - 207, 30.06.2022
https://doi.org/10.34087/cbusbed.1015436

Öz

Giriş ve Amaç: Endoskopik olarak H. Pilory pozitifliği tespit edilen ve eradikasyon tedavisi uygulanan hastaların takibinde tedavinin başarısını gözlemlemek için NRL oranının sensitivite ve spesifitesini ortaya koymayı amaçladık.
Gereç ve Yöntem: İstanbul Medipol Üniversitesi Pendik Hastanesi, Endoskopi Ünitesi’nde, üst gastrointestinal sistem endoskopisi yapılan 386 hasta değerlendirildi. HP pozitif ve negatif olan hastaların nötrofil, lenfosit sayıları, nötrofil lenfosit oranları (NLO) karşılaştırıldı. HP pozitif olan 205 hastaya 2 haftalık üçlü tedavi ile H. pylori eradikasyonu uygulandı. Tedavi bitiminden 4 hafta sonra gaitada H. Pilori antijen testi yapıldı ve negatif sonuç eradikasyon olarak tanımlandı. Eş zamanlı olarak tüm hastalara tam kan sayımı yapılarak. NLO hesaplandı ve değerler eradike edilen ve edilemeyen gruplar arasında karşılaştırıldı.
Bulgular: H. Pilory eradikasyonu 100 (%48,7) hastada sağlanabilmişken 105 (%51,3) hastanın gaitada antijen testi pozitif olarak geldi. Bu iki grup arasında nötrofil sayıları (P<0,0001), lenfosit sayıları(P<0,0001), ile nötrofil lenfosit oranı (P<0,0001) arasında istatistiksel olarak anlamlı fark mevcuttu. Nötrofil /Lenfosit oranının cutoff değeri 2,058 alındığında Helikobakter pilori eradikasyonunu tespit etmedeki duyarlılık ve özgüllüğü sırasıyla %90,5 ve %85 olarak tespit edildi
Sonuç: Çalışmamızda, tam kan sayımında bulunan parametrelerden elde edilen nötrofil/lenfosit oranı HP (+) olgularda daha yüksek bulunmuştur. Bu belirtecin tedavi süresince ve tedaviden sonra hastaları takip etmek için yararlı olabileceğini ancak başarılı HP eradikasyonu tedavisinden sonra, takip belirteci olarak nötrofil/ lenfosit oranındaki değişiklikleri değerlendirmek için daha geniş örneklem grubu ile yapılacak daha çok sayıda çalışmaya ihtiyaç olduğunu düşünmekteyiz.

Kaynakça

  • Narayanan, M, Reddy, K.M, Marsicano, E. Peptic Ulcer Disease And Helicobacter Pylori İnfection, Missouri Medicine, 2018, 115(3), 219-24.
  • Malfertheiner, P, Selgrad, M, Bornschein, J, Helicobacter Pylori: Clinical Management. Current Opinion İn Gastroenterology, 2012, 28(6), 608-14.
  • Prell, C, Osterrieder, S, Lottspeich, C et al., Improved Performance Of A Rapid Office-Based Stool Test For Detection Of Helicobacter Pylori İn Children Before And After Therapy, Journal of Clinical Microbiology, 2009, 47(16), 3980-84.
  • Ataseven, H, Demir, A, Keçeci, M, Peptik Ülsere Bağlı Üst Gastrointestinal Kanamalı Olgularda Helicobacter Pylori Eradikasyonunun Fekal Antijen Testi İle Tespiti, Fırat Üniversitesi Tıp Fakültesi Dergisi, 2004, 18(3), 199-204.
  • P, Chey, W.D, Murthy, U, Toskes, P, Carpenter, S et al., The 13c-Urea Blood Test Accurately Detecs H.Pylori İnfection: A United States, Multicenter Trial American Journal of Gastroenterology, 1999, 94(6), 1522-5.
  • Evansdg, Evans, D.J, Lampert, H.C, Graham, D.Y, Restriction Fragment Length Polymorphism İn The Adhesin Gene Hpa A Of H.Pylori, American Journal Of Gastroenterology, 1995, 90(12), 1282-8.
  • Suppiah, A, Malde, D, Arab, T, Hamed, M, Allgar, V, Smith, A.M, et al., The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR, Journal of Gastrointestinal Surgery, 2013, 17(4), 675-681.
  • Akalın, Ç, The Evaluation Of Neutrophil To Lymphocyte Ratio And Platelet To Lymphocyte Ratio İn Anorectal Abscess, Ulus Travma Acil Cerrahi Derg, 2020, 26(6), 887-892.
  • Ferhatoğlu, M, Şenol, K, Kartal, A, Kıvılcım, T, Filiz, A, Helicobacter Pylori Eradikasyonu Takibinde Nötrofil/Lenfosit Oranının Önemi, Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 2019, 52(1), 38-42.
  • Dixon, M.F, Genta, R.M, Yardley, J.H, Correa, P, Classification and grading of gastritis, Theupdated Sydney System, International Workshop on the Histopathology of Gastritis, American Journal of Surgical Pathology, 1996, 20(10), 1161-1181.
  • Makola, D, Peura, D.A, Crowe, S.E, Helicobacter pylori infection and related gastrointestinal diseases, Journal of Clinical Gastroenterology, 2007, 41(6), 548-558.
  • Jackson, L, Britton, J, Lewis, S.A, Mckeever, T.M, Atherton, J, Fullerton, D, Fogarty, A.W, A Population-Based Epidemiologic Study of Helicobacter Pylori İnfection and its Association with Systemic İnflammation, Helicobacter, 2009, 14(5), 108-113.
  • Destek, S, Yabacı, A, Abik, Y.N, Gül, V.O, Değer, K.C, Predictive and prognostic value of L-lactate, D-dimer, leukocyte, C-reactive protein andneutrophil/lymphocyteratio in patients with acute mesenteric ischemia, Ulus Travma Acil Cerrahi Dergisi, 2020, 26(1), 86-94.
  • Bener, A, Uduman, S.A, Ameen, A, Alwash, R, Pahsa, M.A, Usmani, M.A, Al-Naili, S.R, Amiri, K.M, Prevalance of Helicobacter pylori infection among low socioeconomic workers, Journal of Communicable Diseases, 2002, 34(3), 179-184.
  • Ben Ammar, A, Cheikh, I, Kchaou, M, Chouaib, Querghi, H, Chaabo, A, Prevalance of Helicobacter pylori infection in normal or asymptomatic patients, La Tunisie Medicale, 2003, 81(3), 200-204.
  • Alim, A, Ataş, A, Güneş, T, Ataş, M, Yıldırım, M, Öztekin, A, Yıldızbaş, H, Sivas İl Merkezinde Semptomatik ve Asemptomatik Yetişkin Bireylerde Helicobacter Pylori Seroprevalansı, Cumhuriyet Medical Journal, 2004, 26(2), 75-80.
  • Turfaner, N, Süt, N, Kapmaz, A, Sipahioğlu, F, Cerrahpaşa Tıp Fakültesi Aile Hekimliği Anabilim Dalı Check-Up Polikliniği’ne Başvuran Hastalarda Helicobacter Pylori Sıklığı ve Bunu Etkileyen Faktörler, Cerrahpaşa Tıp Dergisi, 2006, 37(1), 1 – 4.
  • Farah, R, Khamisy-Farah, R, Journal of Clinical Laboratory Analysis, 2014, 28(3), 219 23.
  • Aktepe, O.C, Ciftci, I.H, Safak, B, Uslan, I, Dilek, F.H, Five methods for detection of Helicobacter pylori in theTurkish population, World Journal of Gastroenterology, 2011, 17(47), 5172-6.
  • Kalem, F, Ozdemir, M, Baysal, B, Investigation of the Presence of Helicobacter Pylori by Different Methods in Patients with Dyspeptic Complaints, Mikrobiyoloji Bulteni, 2010, 44(1), 29-34.
  • Chotivitayatarakorn, P, Mahachai, V, Vilaichone, R.K, Effectiveness of 7-day and 14-day Moxifloxacin- Dexlansoprazole based triple therapy and probiotic supplement for Helicobacter pylori eradication in Thai patients with non-ulcer dyspepsia: A double- blind randomized placebo-controlled study, Asian Pacific Journal of Cancer Prevention, 2017, 18(10), 2839-43.
  • Mahachai, V, Sirimontaporn, N, Tumwasorn, S, et al., Sequential therapy in clarithromycin- sensitive and -resistant Helicobacter pylori based on polymerase chain reaction molecular test, Journal of Gastroenterology and Hepatology, 2011, 26(5), 825-8.
  • Demir, M, Ataseven, H. The effects of sequential treatment as a first-line therapy for Helicobacter pylori eradication, Turkish Journal of Medical Sciences, 2011, 41(3), 427-433.
  • Kadayıfçı, A, Büyükhatipoğlu, Savaş, C, Şimşek, İ, Eradication of Helicobacter Pylori With Triple Therapy: An Epidemiologic Analysis Of Trends İn Turkey Over 10 Years, Clinical Therapeutics, 2006, 28(11), 1960-6.
  • Çekin, A.H, Şahintürk, Y, Akbay Harmandar, F, Uyar, S, Yolcular B.O, Çekin, Y, Turkish Journal of Gastroenterology, 2017, 28(1), 3-11.
  • Poonyam, P, Chotivitayatarakorn, P, Vilaichone, R.K, High Effective of 14-Day High-Dose PPI- Bismuth-Containing Quadruple Therapy with Probiotics Supplement for Helicobacter Pylori Eradication: A Double Blinded-Randomized Placebo-Controlled Study, Asian Pacific Journal of Cancer Prevention, 2019, 1, 20(9), 2859-64.

Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment

Yıl 2022, Cilt: 9 Sayı: 2, 202 - 207, 30.06.2022
https://doi.org/10.34087/cbusbed.1015436

Öz

Objective: The aim of this study is to determine the sensitivity and specificity of the NLR ratio in order to assess treatment effectiveness in the follow-up of patients who are endoscopic H. pylori-positive and administered eradication therapy.
Materials and Methods: The Endoscopy Unit at Istanbul Medipol University Pendik Hospital evaluated 386 individuals who underwent upper gastrointestinal endoscopy. Neutrophil and lymphocyte counts, as well as neutrophil-to-lymphocyte ratios (NLR), were compared in HP positive and negative patients. H. pylori eradication was performed on 205 HP-positive patients using a 2-week triple therapy. All patients had a complete blood count done at the same time, and NLR was computed and compared between the eradicated and non-eradicated groups.
Results: H. pylori eradication was accomplished in 100 (48.7%) of the patients, whereas the stool antigen test was positive in 105 (51.3%) of the patients. There was a statistically significant difference in neutrophil counts (P<0.0001), lymphocyte counts (P<0.0001), and neutrophil-to-lymphocyte ratio (P<0.0001). The sensitivity and specificity in identifying Helicobacter pylori eradication were determined to be 90.5% and 85%, respectively when the cutoff value for the Neutrophil-to-Lymphocyte ratio was set at 2.058.
Conclusion: The neutrophil-to-lymphocyte ratio was shown to be greater in HP (+) cases based on the parameters discovered in the complete blood count in our study. We believe that this measure might be used to monitor patients during and after therapy, but additional research with larger sample sizes is needed to assess changes in neutrophil-to-lymphocyte ratio as a follow-up indicator following successful HP eradication therapy.

Kaynakça

  • Narayanan, M, Reddy, K.M, Marsicano, E. Peptic Ulcer Disease And Helicobacter Pylori İnfection, Missouri Medicine, 2018, 115(3), 219-24.
  • Malfertheiner, P, Selgrad, M, Bornschein, J, Helicobacter Pylori: Clinical Management. Current Opinion İn Gastroenterology, 2012, 28(6), 608-14.
  • Prell, C, Osterrieder, S, Lottspeich, C et al., Improved Performance Of A Rapid Office-Based Stool Test For Detection Of Helicobacter Pylori İn Children Before And After Therapy, Journal of Clinical Microbiology, 2009, 47(16), 3980-84.
  • Ataseven, H, Demir, A, Keçeci, M, Peptik Ülsere Bağlı Üst Gastrointestinal Kanamalı Olgularda Helicobacter Pylori Eradikasyonunun Fekal Antijen Testi İle Tespiti, Fırat Üniversitesi Tıp Fakültesi Dergisi, 2004, 18(3), 199-204.
  • P, Chey, W.D, Murthy, U, Toskes, P, Carpenter, S et al., The 13c-Urea Blood Test Accurately Detecs H.Pylori İnfection: A United States, Multicenter Trial American Journal of Gastroenterology, 1999, 94(6), 1522-5.
  • Evansdg, Evans, D.J, Lampert, H.C, Graham, D.Y, Restriction Fragment Length Polymorphism İn The Adhesin Gene Hpa A Of H.Pylori, American Journal Of Gastroenterology, 1995, 90(12), 1282-8.
  • Suppiah, A, Malde, D, Arab, T, Hamed, M, Allgar, V, Smith, A.M, et al., The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR, Journal of Gastrointestinal Surgery, 2013, 17(4), 675-681.
  • Akalın, Ç, The Evaluation Of Neutrophil To Lymphocyte Ratio And Platelet To Lymphocyte Ratio İn Anorectal Abscess, Ulus Travma Acil Cerrahi Derg, 2020, 26(6), 887-892.
  • Ferhatoğlu, M, Şenol, K, Kartal, A, Kıvılcım, T, Filiz, A, Helicobacter Pylori Eradikasyonu Takibinde Nötrofil/Lenfosit Oranının Önemi, Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 2019, 52(1), 38-42.
  • Dixon, M.F, Genta, R.M, Yardley, J.H, Correa, P, Classification and grading of gastritis, Theupdated Sydney System, International Workshop on the Histopathology of Gastritis, American Journal of Surgical Pathology, 1996, 20(10), 1161-1181.
  • Makola, D, Peura, D.A, Crowe, S.E, Helicobacter pylori infection and related gastrointestinal diseases, Journal of Clinical Gastroenterology, 2007, 41(6), 548-558.
  • Jackson, L, Britton, J, Lewis, S.A, Mckeever, T.M, Atherton, J, Fullerton, D, Fogarty, A.W, A Population-Based Epidemiologic Study of Helicobacter Pylori İnfection and its Association with Systemic İnflammation, Helicobacter, 2009, 14(5), 108-113.
  • Destek, S, Yabacı, A, Abik, Y.N, Gül, V.O, Değer, K.C, Predictive and prognostic value of L-lactate, D-dimer, leukocyte, C-reactive protein andneutrophil/lymphocyteratio in patients with acute mesenteric ischemia, Ulus Travma Acil Cerrahi Dergisi, 2020, 26(1), 86-94.
  • Bener, A, Uduman, S.A, Ameen, A, Alwash, R, Pahsa, M.A, Usmani, M.A, Al-Naili, S.R, Amiri, K.M, Prevalance of Helicobacter pylori infection among low socioeconomic workers, Journal of Communicable Diseases, 2002, 34(3), 179-184.
  • Ben Ammar, A, Cheikh, I, Kchaou, M, Chouaib, Querghi, H, Chaabo, A, Prevalance of Helicobacter pylori infection in normal or asymptomatic patients, La Tunisie Medicale, 2003, 81(3), 200-204.
  • Alim, A, Ataş, A, Güneş, T, Ataş, M, Yıldırım, M, Öztekin, A, Yıldızbaş, H, Sivas İl Merkezinde Semptomatik ve Asemptomatik Yetişkin Bireylerde Helicobacter Pylori Seroprevalansı, Cumhuriyet Medical Journal, 2004, 26(2), 75-80.
  • Turfaner, N, Süt, N, Kapmaz, A, Sipahioğlu, F, Cerrahpaşa Tıp Fakültesi Aile Hekimliği Anabilim Dalı Check-Up Polikliniği’ne Başvuran Hastalarda Helicobacter Pylori Sıklığı ve Bunu Etkileyen Faktörler, Cerrahpaşa Tıp Dergisi, 2006, 37(1), 1 – 4.
  • Farah, R, Khamisy-Farah, R, Journal of Clinical Laboratory Analysis, 2014, 28(3), 219 23.
  • Aktepe, O.C, Ciftci, I.H, Safak, B, Uslan, I, Dilek, F.H, Five methods for detection of Helicobacter pylori in theTurkish population, World Journal of Gastroenterology, 2011, 17(47), 5172-6.
  • Kalem, F, Ozdemir, M, Baysal, B, Investigation of the Presence of Helicobacter Pylori by Different Methods in Patients with Dyspeptic Complaints, Mikrobiyoloji Bulteni, 2010, 44(1), 29-34.
  • Chotivitayatarakorn, P, Mahachai, V, Vilaichone, R.K, Effectiveness of 7-day and 14-day Moxifloxacin- Dexlansoprazole based triple therapy and probiotic supplement for Helicobacter pylori eradication in Thai patients with non-ulcer dyspepsia: A double- blind randomized placebo-controlled study, Asian Pacific Journal of Cancer Prevention, 2017, 18(10), 2839-43.
  • Mahachai, V, Sirimontaporn, N, Tumwasorn, S, et al., Sequential therapy in clarithromycin- sensitive and -resistant Helicobacter pylori based on polymerase chain reaction molecular test, Journal of Gastroenterology and Hepatology, 2011, 26(5), 825-8.
  • Demir, M, Ataseven, H. The effects of sequential treatment as a first-line therapy for Helicobacter pylori eradication, Turkish Journal of Medical Sciences, 2011, 41(3), 427-433.
  • Kadayıfçı, A, Büyükhatipoğlu, Savaş, C, Şimşek, İ, Eradication of Helicobacter Pylori With Triple Therapy: An Epidemiologic Analysis Of Trends İn Turkey Over 10 Years, Clinical Therapeutics, 2006, 28(11), 1960-6.
  • Çekin, A.H, Şahintürk, Y, Akbay Harmandar, F, Uyar, S, Yolcular B.O, Çekin, Y, Turkish Journal of Gastroenterology, 2017, 28(1), 3-11.
  • Poonyam, P, Chotivitayatarakorn, P, Vilaichone, R.K, High Effective of 14-Day High-Dose PPI- Bismuth-Containing Quadruple Therapy with Probiotics Supplement for Helicobacter Pylori Eradication: A Double Blinded-Randomized Placebo-Controlled Study, Asian Pacific Journal of Cancer Prevention, 2019, 1, 20(9), 2859-64.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Gökhan Yılmaz 0000-0003-0889-9586

Ece Yiğit 0000-0002-8293-3554

Yayımlanma Tarihi 30 Haziran 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 9 Sayı: 2

Kaynak Göster

APA Yılmaz, G., & Yiğit, E. (2022). Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 9(2), 202-207. https://doi.org/10.34087/cbusbed.1015436
AMA Yılmaz G, Yiğit E. Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment. CBU-SBED. Haziran 2022;9(2):202-207. doi:10.34087/cbusbed.1015436
Chicago Yılmaz, Gökhan, ve Ece Yiğit. “Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9, sy. 2 (Haziran 2022): 202-7. https://doi.org/10.34087/cbusbed.1015436.
EndNote Yılmaz G, Yiğit E (01 Haziran 2022) Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9 2 202–207.
IEEE G. Yılmaz ve E. Yiğit, “Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment”, CBU-SBED, c. 9, sy. 2, ss. 202–207, 2022, doi: 10.34087/cbusbed.1015436.
ISNAD Yılmaz, Gökhan - Yiğit, Ece. “Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9/2 (Haziran 2022), 202-207. https://doi.org/10.34087/cbusbed.1015436.
JAMA Yılmaz G, Yiğit E. Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment. CBU-SBED. 2022;9:202–207.
MLA Yılmaz, Gökhan ve Ece Yiğit. “Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 9, sy. 2, 2022, ss. 202-7, doi:10.34087/cbusbed.1015436.
Vancouver Yılmaz G, Yiğit E. Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment. CBU-SBED. 2022;9(2):202-7.