Choi Euno, Yoo Youngeun, Kim Ji Min, Sung Sun Hee, Lee Dakeun, Park Sanghui
Department of Pathology, Ewha Womans University College of Medicine, Seoul 07985, Korea.
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
J Clin Med. 2021 Sep 6;10(17):4030. doi: 10.3390/jcm10174030.
The aim of the study was to investigate the clinical significance of various histomorphologic findings related to mucosal inflammation in negative appendectomy. We reviewed histopathologic findings of 118 negative appendectomies and correlated them with the appendicitis inflammatory response (AIR) score and appendiceal diameter. Among 118 patients with negative appendectomy, 94 (80%), 73 (78%) and 89 (75%) patients displayed mucosal inflammation, high neutrophil score (neutrophil count ≥10/5 high power field and surface epithelial flattening, respectively. Out of 118 patients with negative appendectomy, mucosal inflammation, high neutrophil score and surface epithelial flattening were associated with higher risk group according to the appendicitis inflammatory response (AIR) score ( < 0.05, respectively). In addition, mucosal inflammation, high neutrophil score and surface epithelial flattening were frequently detected in 118 negative appendectomies, compared with 24 incidental appendectomies ( < 0.05, respectively). In an analysis of 77 negative appendectomy patients with appendiceal diameter data available, increased appendiceal diameter was positively correlated with luminal inflammation, high neutrophil score and surface epithelial flattening ( < 0.05, respectively). In conclusion, mucosal inflammation, high neutrophil score and surface epithelial flattening in negative appendectomy may be relevant to patients' signs and symptoms, especially in cases with no other cause of the abdominal pain.
本研究的目的是探讨阴性阑尾切除术中与黏膜炎症相关的各种组织形态学表现的临床意义。我们回顾了118例阴性阑尾切除术的组织病理学结果，并将其与阑尾炎炎症反应（AIR）评分及阑尾直径进行关联分析。在118例阴性阑尾切除术患者中，分别有94例（80%）、73例（78%）和89例（75%）患者出现黏膜炎症、高中性粒细胞评分（中性粒细胞计数≥10/5高倍视野）及表面上皮扁平。在118例阴性阑尾切除术患者中，根据阑尾炎炎症反应（AIR）评分，黏膜炎症、高中性粒细胞评分及表面上皮扁平与较高风险组相关（P均<0.05）。此外，与24例偶然阑尾切除术相比，黏膜炎症、高中性粒细胞评分及表面上皮扁平在118例阴性阑尾切除术中更常被检测到（P均<0.05）。在对77例有阑尾直径数据的阴性阑尾切除术患者的分析中，阑尾直径增加与管腔炎症、高中性粒细胞评分及表面上皮扁平呈正相关（P均<0.05）。总之，阴性阑尾切除术中的黏膜炎症、高中性粒细胞评分及表面上皮扁平可能与患者的体征和症状相关，尤其是在无其他腹痛原因的病例中。
