Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei, 220, Taiwan; Department of Chemical Engineering and Materials Science, Yuan Ze University, Chung-Li, Taoyuan 320, Taiwan.
Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei, 220, Taiwan; Graduate Institute of Medicine, Yuan Ze University, Chung-Li, Taoyuan, 320, Taiwan.
J Formos Med Assoc. 2024 Oct;123(10):1093-1098. doi: 10.1016/j.jfma.2024.01.023. Epub 2024 Feb 9.
BACKGROUND/PURPOSE: Acute appendicitis (AA) stands as the most prevalent cause of acute abdominal pain among children. The potential for morbidity escalates significantly when uncomplicated appendicitis (UA) progresses to complicated appendicitis (CA), which can encompass gangrenous, necrotic, or perforated appendicitis. Consequently, establishing an early and accurate diagnosis of AA, and effectively differentiating CA from UA, becomes paramount. This study explores the diagnostic utility of various blood biomarkers for distinguishing CA from UA in pediatric patients.
We conducted a retrospective review of medical records pertaining to pediatric patients who underwent surgery for AA. Patients were categorized as either having UA or CA based on histopathological examination of the appendix. The data collected and analyzed included demographic information, white blood cell (WBC) count, neutrophil proportion, lymphocyte proportion, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) levels upon admission.
Among the 192 pediatric patients who underwent surgery for AA, 150 were diagnosed with UA, while 42 were diagnosed with CA. The CA group exhibited significantly higher neutrophil proportions, NLRs, PLRs, and CRP levels, alongside lower lymphocyte proportions (all p < 0.01) compared to the UA group. Receiver operating characteristic (ROC) curve analysis disclosed that CRP exhibited the highest specificity, sensitivity, and positive and negative predictive values for predicting CA.
CRP emerges as a valuable biomarker for differentiating complicated appendicitis from uncomplicated appendicitis.
背景/目的：急性阑尾炎（AA）是儿童急性腹痛最常见的原因。当单纯性阑尾炎（UA）发展为复杂性阑尾炎（CA）时，其发病率显著增加，CA 可能包括坏疽性、坏死性或穿孔性阑尾炎。因此，早期准确诊断 AA，并有效区分 CA 与 UA，至关重要。本研究探讨了各种血液生物标志物在鉴别儿科患者 CA 与 UA 中的诊断价值。
我们对接受手术治疗的 AA 儿科患者的病历进行了回顾性分析。根据阑尾的组织病理学检查，患者被分为 UA 或 CA。收集和分析的数据包括人口统计学信息、白细胞（WBC）计数、中性粒细胞比例、淋巴细胞比例、中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）以及入院时的 C 反应蛋白（CRP）水平。
在 192 名接受手术治疗的 AA 儿科患者中，150 名被诊断为 UA，42 名被诊断为 CA。与 UA 组相比，CA 组的中性粒细胞比例、NLR、PLR 和 CRP 水平显著升高，而淋巴细胞比例显著降低（均 p<0.01）。受试者工作特征（ROC）曲线分析显示，CRP 预测 CA 的特异性、敏感性、阳性和阴性预测值最高。
CRP 是鉴别复杂性阑尾炎与单纯性阑尾炎的有价值的生物标志物。
