Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
Hematology Institute, Galilee Medical Center, Nahariya, Israel.
Int J Lab Hematol. 2024 Feb;46(1):58-62. doi: 10.1111/ijlh.14163. Epub 2023 Aug 29.
Acute appendicitis (AA) requires a prompt diagnosis. According to postoperative pathological results, a significant number of appendectomies are performed on a normal appendix (NA). The aim of this study is to evaluate the role of preoperative inflammatory markers in supporting and improving the clinical diagnosis of AA, extracting more information from CBC parameters.
The study is a retrospective one. The histopathological results of operated appendix from 102 patients, who underwent appendectomy for clinically suspected AA, were extracted from the Galilee Medical Center systems. Two patient groups (NA and true AA) were compared for neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR) and mean platelet volume (MPV). The obtained data were statistically analyzed, using the independent sample t test and Mann-Whitney test. Category data have been compared among groups with the chi-squared test. The primary endpoint of our research was to assess the predictive power of blood biomarkers.
Patients with suspected AA, based on clinical picture and contrast enhanced computed tomography (CECT), and with MLR-value ≥0.3357 were 5.25 times more likely than normal to have AA. Patients with NLR-value ≥3.2223 were 7 times more likely than normal to have AA. The differences in PLR and MPV values were not statistically significant.
The NLR and MLR biomarkers can assist in diagnosis of AA. This can be particularly helpful in cases where CECT is contraindicated, as in pregnant women or children.
急性阑尾炎（AA）需要及时诊断。根据术后病理结果，相当一部分阑尾切除术是针对正常阑尾（NA）进行的。本研究旨在评估术前炎症标志物在支持和改善 AA 临床诊断中的作用，从 CBC 参数中提取更多信息。
这是一项回顾性研究。从加利利医疗中心系统中提取了 102 例因临床疑似 AA 而行阑尾切除术患者的手术阑尾组织病理学结果。将两组患者（NA 和真正的 AA）进行比较，比较中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）和平均血小板体积（MPV）。使用独立样本 t 检验和曼-惠特尼检验对获得的数据进行统计学分析。使用卡方检验比较组间的分类数据。我们研究的主要终点是评估血液生物标志物的预测能力。
基于临床症状和增强 CT（CECT）检查，且 MLR 值≥0.3357 的疑似 AA 患者发生 AA 的可能性是正常患者的 5.25 倍。NLR 值≥3.2223 的患者发生 AA 的可能性是正常患者的 7 倍。PLR 和 MPV 值的差异无统计学意义。
NLR 和 MLR 生物标志物可辅助诊断 AA。在 CECT 禁忌的情况下，如孕妇或儿童，这可能特别有帮助。
