Department, of Surgical Oncology, Sakarya University Faculty of Medicine, Sakarya-Turkey.
Department of Gastroenterological Surgery, Sakarya University Faculty of Medicine, Sakarya-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 Apr;28(4):434-439. doi: 10.14744/tjtes.2020.69027.
One of the most misdiagnosed appendicular pathologies is lymphoid hyperplasia (LH) that can be managed con-servatively when identified early and is self-limiting. The aim of this retrospective study was to compare acute appendicitis (AA) with LH in terms of hematological parameters to determine whether there is a hematological predictor to distinguish the two diseases.
Complete blood cell counts of patients with AA were compared with those having LH.
One-hundred-ninety-five patients (118 male/77 female) underwent appendectomy. Histopathological examination re-vealed acute AA in 161 patients (82.6%), and negative appendectomy (NA) in 19 patients (9.7%). Of the NA specimens, 16 were LH (8.2%). Thirteen patients (6.7%) had AA with simultaneous LH. White blood cell count (p=0.030, neutrophil (p=0.009), neutrophil per-centage (p=0.009), and neutrophil/lymphocyte ratio (p=0.007) were significantly higher in AA whereas lymphocyte count (p=0.027), lymphocyte percentage (p=0.006) were significantly higher in LH. Multi logistic regression analysis revealed white blood cell count as the only independent predictor in distinguishing AA from LH with a 69.1% sensitivity, 80.0% specificity, 77.5% positive predictive value, and 72.1% negative predictive value. The cut-off value for white blood cell count was 11.3 Ku/L, and every one unit (1000/mm3) increase in white blood cell count raises the risk of AA by 1.24 times, while values below this value will increase the likelihood of LH.
The most predictive complete blood count parameter in distinguishing LH from AA appears to be as white blood cell count.
最容易误诊的阑尾疾病之一是淋巴组织增生（LH），如果能早期发现并进行保守治疗，它是自限性的。本回顾性研究的目的是比较急性阑尾炎（AA）和 LH 在血液学参数方面的差异，以确定是否存在血液学预测因子来区分这两种疾病。
比较 AA 患者和 LH 患者的全血细胞计数。
195 名患者（男 118 例，女 77 例）接受了阑尾切除术。组织病理学检查显示 161 例（82.6%）为急性 AA，19 例（9.7%）为阴性阑尾切除术（NA）。在 19 例 NA 标本中，有 16 例为 LH（8.2%）。13 例（6.7%）患者同时患有 AA 和 LH。白细胞计数（p=0.030，中性粒细胞（p=0.009），中性粒细胞百分比（p=0.009）和中性粒细胞/淋巴细胞比值（p=0.007）在 AA 中显著升高，而淋巴细胞计数（p=0.027），淋巴细胞百分比（p=0.006）在 LH 中显著升高。多变量逻辑回归分析显示，白细胞计数是区分 AA 和 LH 的唯一独立预测因子，其敏感性为 69.1%，特异性为 80.0%，阳性预测值为 77.5%，阴性预测值为 72.1%。白细胞计数的临界值为 11.3 Ku/L，白细胞计数每增加 1 个单位（1000/mm3），AA 的风险增加 1.24 倍，而低于该值会增加 LH 的可能性。
区分 LH 和 AA 最具预测性的全血细胞计数参数似乎是白细胞计数。
