Nötrofil/lenfosit oranı kronik Hepatit C hastalarında fibrozis belirteci olarak kullanılabilir mi?

Abstract

Background: It is reported that about 170-200 million people are chronically infected with Hepatitis C virus (HCV) in the world. In developed countries, about 25% of cirrhosis cases, one third of hepatocellular cancers, and 40% of all chronic hepatitis cases are caused by HCV. In this study, we want to determine the utility of neutrophil/lymphocyte ratio (NLR) to predict the fibrosis in patients with chronic hepatitis C. Methods: In our study NLR was prospectively investigated whether it can predict, or not the fibrosis on patients who diagnosed Chronic hepatitis C (CHC) and underwent liver biopsy in July 2011 - January 2013 by Kayseri Training and Research Hospital, Department of Gastroenterology. Results: 81 patients diagnosed with CHC and underwent liver biopsy were included in the study. Fibrosis and necroinflammatory activity in liver biopsy specimens was determined in accordance to Ishak fibrosis scoring system. All Ishak scores were re-scored according to France METAVIR Cooperative Study Group as Score 0, 1, 2, 3, 4. In such re-scored METAVIR scores, Score 0, 1, 2 were defined as low fibrosis and Score 3, 4 were defined as high fibrosis. 46 of 81 patients (% 57) were in low fibrosis group and 35 of them (43%) were in high fibrosis group. When Comparing the NLRs; it is seen that in low fibrosis group NLR was 2.09 and in high fibrosis group NLR was 1.72 (p=0.038). It is seen that AST predicts fibrosis because of AST/ALT ratio was higher due to increase in favor of AST especially in patients with cirrhosis. Furthermore, NLR predicts fibrosis with 60% sensitivity and 65.2 % specificity if cutt off value is taken as 1.77. Conclusion: According to our results, NLR can predicts the degree of liver fibrosis in chronic liver disease, despite it’s lower sensitivity and specificity.