Relationship Between Apnea Hypopnea Index, Neutrophil Lymphocyte Ratio And Platelet Lymphocyte Ratio in Patients With Obstructive Sleep Apnea Syndrome

Aim:The aim of this study was to assess the association between apnea-hypopnea index (AHI) with neutrophil lymphocyte ratio (NLO) and platelet lymphocyte ratio (PLO) according to gender in patients with obstructive sleep apnea syndrome (OSAS) and to investigate whether PLO and NLO can be a predictor of disease severity before polysomnography.Material and Method:This study was designed as retrospective and cross-sectional, between March 2018 and April 2018, The patients who underwent PSG who were admitted to the Otorhinolaryngology outpatient clinic of Adana City Training and Research Hospital with the complaint of snoring and sleep apnea were evaluated. The study population was divided in to four groups: (i) first group described as; AHI 0-4.9 (ii) second group described as; 5-14.9 (iii) third group described as; AHI 15-29.9 and (iv) fourth group decribed as AHI ≥30 according to polyspmnography (PSG). Neutrophil, lymphocyte and platelet results were evaluated routinely from the blood count results.Results:Of the patients included in the study, 106 were male and 32 were female. The mean age was 45.3 (43,3 for males and 50,4 for females), the mean body mass index (BMI) was 30.1 (min: 19 - max: 51), the mean AHI was 23.7 (min: 0,3 max: 103), the mean PLO was 113,1 (male:111.2 , female: 119.5) and the mean NLO was 1,93 (male:1.99, female:1.72 ) . In our study, the highest PLO value was found in group 2 and the highest NLO value was found in group 3. The lowest NLO and PLO values were found in group 4, unlike the results from other studies. However, no statistically significant difference was found between the groups.Conclusıons:In OSAS, there is a need for more comprehensive prospective and multi-centered study to better understand AHI and NLO, PLO relationship

Macroscopic Portal Vein Thrombosis in HCC Patients

Macroscopic portal vein invasion (PVT) by hepatocellular carcinoma (HCC) in the liver is one of the most important negative prognostic factors for HCC patients. The characteristics of a large cohort of such patients were examined. We found that the percent of patients with PVT significantly increased with increasing maximum tumor diameter (MTD), from 13.7% with tumors of MTD 10cm. There were similar numbers of HCC patients with very large tumors with and without PVT. Thus, MTD alone was insufficient to explain the presence of PVT, as were high AFP levels, since less than 50% of high AFP patients had PVT. However, the percent of patients with PVT was also found to significantly increase with increasing blood alpha-fetoprotein (AFP) levels and tumormultifocality. A logistic regressionmodel that included these 3 factors together showed an odds ratio of 17.9 for the combination of MTD >5.0cm plus tumor multifocality plus elevated AFP, compared to low levels of these 3 parameters. The presence or absence of macroscopic PVT may therefore represent different HCC aggressiveness phenotypes, as judged by a significant increase in tumor multifocality and AFP levels in the PVT positive patients. Factors in addition to MTD and AFP must also contribute to PVT development