Ahmad Khairol Ashraf, Ideris Noorharisman, Aziz Syed Hassan Syed Abd
Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Department of Surgery, Hospital Melaka, Jalan Mufti Haji Khalil, Melaka, Malaysia.
Malays J Med Sci. 2019 Nov;26(6):55-66. doi: 10.21315/mjms2019.26.6.6. Epub 2019 Dec 30.
Acute appendicitis is one of the most common surgical emergencies. However, its proper diagnosis is complicated. This study aims to evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to diagnose acute appendicitis in pre-operative state.
Histopathological examination of appendicectomies conducted between 2016 and 2017 in Melaka Hospital, Malaysia were traced and categorised into three groups: i) G1 (normal appendix), ii) G2 (acute appendicitis) and iii) G3 (perforated appendicitis). The reports were randomised and a total of 338 samples were collected. NLR values were compared between the three different groups and analysed.
The median values of NLR for G1, G2 and G3 were 2.37, 5.25 and 9.27, respectively. We found a statistically significant difference in NLR between G1 and G2 ( < 0.001), and G2 and G3 ( < 0.001). The diagnostic values of NLR for acute appendicitis and perforated appendicitis were 3.11 (sensitivity: 75.23%, specificity: 68.70%) and 6.17 (sensitivity: 76.32%, specificity: 58.72%), respectively. There was a substantial correlation between NLR and disease severity, and a moderate correlation between NLR and duration of admission.
NLR, with a sensitivity of 75.23% and specificity of 68.70%, is a useful and reliable adjunct in diagnosing acute appendicitis. Hence, it will help in reducing the rate of negative appendicectomies.
急性阑尾炎是最常见的外科急症之一。然而，其准确诊断较为复杂。本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）在术前诊断急性阑尾炎的能力。
追踪并整理了2016年至2017年在马来西亚马六甲医院进行的阑尾切除术的组织病理学检查结果，并将其分为三组：i）G1组（正常阑尾），ii）G2组（急性阑尾炎）和iii）G3组（穿孔性阑尾炎）。报告随机抽取，共收集了338个样本。比较并分析了三组之间的NLR值。
G1组、G2组和G3组的NLR中位数分别为2.37、5.25和9.27。我们发现G1组和G2组之间（<0.001）以及G2组和G3组之间（<0.001）的NLR存在统计学显著差异。NLR对急性阑尾炎和穿孔性阑尾炎的诊断值分别为3.11（敏感性：75.23%，特异性：68.70%）和6.17（敏感性：76.32%，特异性：58.72%）。NLR与疾病严重程度之间存在显著相关性，与住院时间之间存在中度相关性。
NLR敏感性为75.23%，特异性为68.70%，是诊断急性阑尾炎有用且可靠的辅助指标。因此，它将有助于降低阴性阑尾切除术的发生率。
