Importance of neutrophil-lymphocyte ratio in the management of children with cervical lymphadenopathy

INTRODUCTION: Cervical lymphadenopathy is a common presenting symptom in pediatric patients. The differentiation of malignant from benign causes and increasing the armamentarium of additional predictive factors is critically important. In this study, we aimed to assess the clinical importance of neutrophil-lymphocyte ratio in the evaluation of children with cervical lymphadenopathy.
METHODS: Eighty-six (n: 86) children (<18 years of age) were the subjects of this study. Three groups were assigned and group 1 as a control patients (n: 30) who underwent circumcision or inguinal hernia repair in our hospital. Group 2 (n=30) as a study group composed of patients who were examined in the otorhinolaryngology and/or pediatric hematology-oncology outpatient clinics due to chronic enlarged cervical lymph nodes. Group 3 (n=26) was composed of patients who were diagnosed with Hodgkin lymphoma. The neutrophil-lymphocyte ratio in the groups were analyzed.
RESULTS: There was significant differences between the mean neutrophil-lymphocyte ratios of group 1 and 3 (p <0.05) and group 2 and 3 (p <0.05) whereas no significant difference was found between group 1 and 2 (p >0.05). A receiver operating characteristic (ROC) curve analysis was performed based on the neutrophil-lymphocyte ratio value of 1.2 corresponded to the maximum combined sensitivity and specificity on the ROC curve and 40% sensitivity and 33% specificity were determined.
DISCUSSION AND CONCLUSION: Present study reveals higher neutrophil-lymphocyte ratio in lymphoma group than the others. However low specificity and sensitivity values restricts the use of a reliable parameter to detect malignancy.

Servikal lenfadenopatili çocuklarýn yönetiminde nötrofil-lenfosit oranýnýn önemi

GÝRÝÞ ve AMAÇ: Servikal lenfadenopati, pediatrik hastalarda sýk görülen bir semptomdur. Ek prediktif faktörlerin arttýrýlmasý, malign nedenleri iyi huylu nedenlerden ayýrmak için kritik öneme sahiptir. Bu çalýþmada, servikal lenfadenopatili çocuklarýn deðerlendirilmesinde nötrofil lenfosit oranýnýn klinik önemini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya 18 yaþ altý 86 çocuk hasta dahil edildi. Üç grup oluþturuldu ve kontrol grubu olan grup 1 (30 çocuk) hastanemizde sünnet veya inguinal herni nedeniyle opere edilen hastalardan oluþmaktadýr. Grup 2 çalýþma grubu (30 çocuk) olup kulak burun boðaz ve/veya pediatric hematoloji-onkoloji polikliniklerinde kronik servikal lenfadenopati nedeniyle deðerlendirilen hastalardan oluþmaktadýr. Grup 3 (26 çocuk) ise Hodgkin lenfoma tanýlý hastalardan oluþmaktadýr. Tüm gruplarýn nötrofil-lenfosit oranlarý analiz edilmiþtir.
BULGULAR: Ortalama nötrofil-lenfosit oranlarý açýsýndan grup 1 ve grup 3 (p <0.05) ile grup 2 ve grup3 (p <0.05) arasýnda anlamlý farklýlýk saptanmýþken grup1 ve grup 2 arasýnda anlamlý farklýlýk saptanmamýþtýr (p >0.05). ROC eðrisinde maksimum kombine hassasiyete ve özgüllüðe karþýlýk gelen 1.2 nötrofil-lenfosit oraný deðerine dayanarak bir alýcý ROC analizi yapýldý ve % 40 hassasiyet ve % 33 özgüllük belirlendi.
TARTIÞMA ve SONUÇ: Bu çalýþmada lenfomalý grupta diðer gruplara göre yüksek nötrofil-lenfosit oranlarý ortaya koymaktadýr. Ancak düþük özgüllük ve hassasiyet deðerleri, maligniteyi tespit etmek için parametrenin güvenilir olarak kullanýmýný kýsýtlar.