Zorrilla-Alfaro Sidere M, Lechuga-Garcia Nestor A, Araujo-Conejo Arturo, Ramirez-Hernandez Leticia A, Garza-Veloz Idalia, Mauricio-Gonzalez Alejandro, Delgado-Enciso Ivan, Rodriguez-Sanchez Iram P, Martinez-Fierro Margarita L
Molecular Medicine Laboratory, Unidad Académica de Medicina Humana y C.S, Universidad Autónoma de Zacatecas, Zacatecas 98160, Mexico.
Hospital General Zacatecas "Luz González Cosío", Servicios Públicos de Salud IMSS-BIENESTAR, Zacatecas 98160, Mexico.
J Clin Med. 2025 Jul 25;14(15):5281. doi: 10.3390/jcm14155281.
: Acute appendicitis is a common emergency requiring abdominal surgery. Despite its prevalence, there are no specific biomarkers for its diagnosis and prognosis. The aim of this study was to assess the basic laboratory tests of patients with acute appendicitis and to evaluate and integrate biochemical variables into the diagnosis of appendicitis. : This was a retrospective, cross-sectional cohort study that included data from patients who underwent an appendectomy. Two groups of patients were considered based on their surgical (non-complicated/complicated appendicitis) or pathological diagnosis (non-perforated/perforated appendicitis). Factor analysis was carried out to identify communalities to put forward classificatory indices. Receiver operating characteristic (ROC) analysis was used to assess the accuracy of the predictions. : The cohort included 246 patients (51.6% male, mean age: 24.79 ± 19.32 years). By using their biochemical data, we generated 6 new indices whose areas under the ROC curve (AUC) ranged between 0.632 and 0.762 for complicated appendicitis and from 0.597 to 0.742 for perforated appendicitis. Inflammatory Metabolic Index (IMI) at the fixed cutoffs was a promising biomarker for both histopathological and surgical diagnoses with odds ratios (OR) of 10.45 and 5.21, respectively. The Metabolic-Inflammatory Stress Index (MISI) showed high specificity (over 72%) and significant AUC values for both diagnoses (0.742 and 0.676). These findings were reinforced by significant -values and Youden indices. : IMI and MISI were demonstrated to be effective biomarkers for complicated and perforated appendicitis. IMI provides predictive capability, while MISI offers specificity and significant AUC values for both histopathological and surgical diagnoses. Incorporating these biomarkers could enhance the accuracy of appendicitis diagnosis and potentially guide clinical decision-making.
急性阑尾炎是一种常见的需要进行腹部手术的急症。尽管其发病率很高，但目前尚无用于诊断和预后评估的特异性生物标志物。本研究旨在评估急性阑尾炎患者的基础实验室检查，并评估生化变量并将其整合到阑尾炎的诊断中。
这是一项回顾性横断面队列研究，纳入了接受阑尾切除术患者的数据。根据手术情况（非复杂性/复杂性阑尾炎）或病理诊断（非穿孔性/穿孔性阑尾炎）将患者分为两组。进行因子分析以确定共性，从而提出分类指标。采用受试者工作特征（ROC）分析来评估预测的准确性。
该队列包括246例患者（男性占51.6%，平均年龄：24.79±19.32岁）。通过使用他们的生化数据，我们生成了6个新指标，对于复杂性阑尾炎，其ROC曲线下面积（AUC）在0.632至0.762之间，对于穿孔性阑尾炎，AUC在0.597至0.742之间。固定临界值下的炎症代谢指数（IMI）是组织病理学和手术诊断的一个有前景的生物标志物，其比值比（OR）分别为10.45和5.21。代谢 - 炎症应激指数（MISI）在两种诊断中均显示出高特异性（超过72%）和显著的AUC值（0.742和0.676）。这些发现通过显著的P值和约登指数得到了加强。
IMI和MISI被证明是复杂性和穿孔性阑尾炎的有效生物标志物。IMI提供预测能力，而MISI为组织病理学和手术诊断提供特异性和显著的AUC值。纳入这些生物标志物可以提高阑尾炎诊断的准确性，并可能指导临床决策。
