Narváez González Hugo Fernando, De Alba Cruz Israel, Carbajal Cabrera Pabel Ruben, Morales Tercero Yunuen Ailyn, Luna León Luis Gerardo, Vargas Ávila Arcenio Luis
Surgery, Hospital Regional "General Ignacio Zaragoza" ISSSTE, Mexico City, MEX.
Colorectal Surgery, Hospital Regional "Lic. Adolfo López Mateos" ISSSTE, Mexico City, MEX.
Cureus. 2024 Mar 21;16(3):e56656. doi: 10.7759/cureus.56656. eCollection 2024 Mar.
Diverticulitis is a prevalent gastrointestinal disease that may require surgical intervention. The aim of the study was to investigate the involvement of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as biomarkers of severity in complicated diverticular disease (CDD) in Mexican patients and their correlation with the need for surgical intervention, the length of hospital stay, and mortality.
An observational, longitudinal, and retrospective study performed from 2017 to 2021 was considered in patients over 18 years of age, with a diagnosis of CDD by using computed tomography and with a hemogram taken in the first 24 hours upon admission to the emergency department to describe the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) of NLR and PLR in the CDD. Results: A total of 102 Mexican patients suffering from CDD, 54% women and 46% men with a mean of 59 years, were analyzed. According to Hinchey's classification, 79 (77.5%) patients showed type I, 12 (12.8%) type II, 5 (4.9%) type III, and 6 (5.9%) type IV. The mean hospital stay was 8.8 days, with a mortality rate of 3.9%. The cut-off value was established at 5.1 for NLR according to the results of the receiver operating characteristic (ROC) curve with an area under the curve (AUC) of 0.633, a sensitivity of 90%, a specificity of 43%, PPV of 21.8%, and NPV of 96% for the prediction of CDD. A cut-off value for PLR at 72 was established according to the results of the ROC curve with an AUC of 0.482, a sensitivity of 78%, a specificity of 40%, PPV of 96%, and NPV of 9% for the prediction of CDD.
The NLR and PLR are easily calculable and accessible biomarkers that can be part of the decision-making for the diagnosis and treatment of CDD in Mexican people as has been observed in other populations. However, more prospective, multicenter comparative studies are needed to assess the efficacy and safety of these biomarkers in relation to those already described.
憩室炎是一种常见的胃肠道疾病，可能需要手术干预。本研究的目的是调查中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）作为墨西哥患者复杂性憩室病（CDD）严重程度生物标志物的情况，以及它们与手术干预需求、住院时间和死亡率的相关性。
对2017年至2021年进行的一项观察性、纵向和回顾性研究进行分析，研究对象为18岁以上患者，通过计算机断层扫描诊断为CDD，并在急诊科入院后的前24小时内进行血常规检查，以描述NLR和PLR在CDD中的敏感性、特异性以及阳性和阴性预测值（分别为PPV和NPV）。结果：共分析了102例患有CDD的墨西哥患者，其中女性占54%，男性占46%，平均年龄为59岁。根据欣奇分类法，79例（77.5%）患者为I型，12例（12.8%）为II型，5例（4.9%）为III型，6例（5.9%）为IV型。平均住院时间为8.8天，死亡率为3.9%。根据受试者工作特征（ROC）曲线结果，NLR的截断值确定为5.1，曲线下面积（AUC）为0.633，预测CDD的敏感性为90%，特异性为43%，PPV为21.8%，NPV为96%。根据ROC曲线结果，PLR的截断值确定为72，AUC为0.482，预测CDD的敏感性为78%，特异性为40%，PPV为96%，NPV为9%。
正如在其他人群中所观察到的那样，NLR和PLR是易于计算和获取的生物标志物，可作为墨西哥人群CDD诊断和治疗决策的一部分。然而，需要更多前瞻性、多中心的比较研究来评估这些生物标志物相对于已描述的生物标志物的有效性和安全性。
