Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age
Yıl: 2020 Cilt: 30 Sayı: 3 Sayfa Aralığı: 157 - 163 Metin Dili: İngilizce DOI: 10.4274/tjcd.galenos2020.2020-2-4 İndeks Tarihi: 31-05-2021
Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age
Öz: Aim: Acute appendicitis (AA) is one of the most common emergency surgical pathologies. The tests used in the differential diagnosis of these patientsneed to be quick, easy to access and cheap. Discussions continue about the value of laboratory tests in the diagnosis of AA. In this study, we aimed todetermine the diagnostic value of platelet/lymphocyte ratio (PLR) in the diagnosis of AA and to determine its diagnostic value in different age groups.Method: Patients who underwent appendectomy after a preliminary diagnosis of AA between January 2015 and January 2020 were enrolled. Patientswere divided into two groups, according to the postoperative pathology finding: group 1 (negative appendectomy) and group 2 (AA). In addition,groups were divided into subgroups based on age: 18-39 years, 40-59 years and 60 years and older. Platelet and lymphocyte counts and PLR werecompared between groups and subgroups. In diagnostic accuracy evaluation ROC curve analysis was used; p<0.05 value was considered statisticallysignificant.Results: A total of 875 patients were included in the study. There were 152 patients in group 1 (negative appendectomy) and 723 patients in group2 (AA). Mean age was similar between the groups (33.43 vs 35.33, p=0.152). In univariate analysis, lymphocyte count (p=0.033) and platelet count(p=0.002) were found to be significant. In multivariate analysis, lymphocyte count (p=0.000), platelet count (p=0.012) and PLR (odds ratio: 0.632;95% confidence interval (minimum-maximum) 0.440-0.908; p=0.013) were found to be significant. When the ROC curve analysis was performed,the sensitivity of PLR regardless of age was 70.82% and the specificity was 40.13% (p=0.093). The highest specificity was in the 40-59 years age group(85.71%), the highest sensitivity was in the age group 60 and older (78.79%) (p=0.002).Conclusion: PLR cannot be used alone in the diagnosis of AA. Normal PLR values cannot exclude AA alone. In addition, the PLR diagnostic valuevaries according to age groups. The surgeon’s clinical evaluation should continue to be a priority in the diagnosis of AA.
Anahtar Kelime: Akut Appendisit Tanısında Platelet/Lenfosit Oranının Tanısal Değeri ve Yaş ile İlişkisi
Öz: Amaç: Akut appendisit (AA) en sık karşılaşılan acil cerrahi patolojilerden biridir. Bu hastaların ayırıcı tanısında kullanılan testlerin hızlı, kolay ulaşılabilir ve ucuz olması gerekmektedir. AA tanısının konmasında laboratuvar testlerinin değeri etrafında tartışmalar devam etmektedir. Bu çalışmada AA tanısında platelet/lenfosit oranının (PLO) tanısal değerini saptamayı ve yaş gruplarında tanısal değerinin nasıl değiştiğini saptamayı amaçladık . Yöntem: Ocak 2015 ile Ocak 2020 tarihleri arasında AA ön tanısı ile opere edilen hastalar çalışmaya dahil edildi. Postoperatif patoloji bulgusuna göre hastalar grup 1 negatif appendektomi; grup 2 akut apandisit olmak üzere iki gruba ayrıldı. Ayrıca 18-39,40-59,60 yaş ve üstü olmak üzere subgruplara ayrıldı. Platelet, lenfosit sayısı ve PLO gruplarda ve subgruplarda karşılaştırıldı. Tanısal doğruluk değerlendirmede (ROC) eğrisi analizi kullanıldı; p<0,05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Toplam 875 hasta çalışmaya katıldı grup 1: 152, grup 2: 723 hastadan oluşuyordu (yaş 33,43 vs 35,33 p=0,152). Univaryant analizde lenfosit sayısı (p=0,033) ve trombosit sayısı (p=0,002) istatistiksel olarak anlamlı bulundu. Multivaryant analizde AA tanısında PLO bağımsız risk faktörüydü [olasılık oranı 0,632 %95 güven aralığı (minimum-maksimum) 0,440 -0,908 p=0,013]. ROC eğrisi analizi yapıldığında yaştan bağımsız sensivitesi %70,82, spesivitesi %40,13 p=0,093 idi. Yaş gruplarında en yüksek spesivite 40-59 yaş arasında %85,71, en yüksek sensivite 60 yaş ve üstü grupta %78,79 p=0,002 bulundu. Sonuç: PLO AA tanısında tek başına kullanılamaz. Normal PLO değerleri akut apandisiti tek başına dışlayamaz. Ayrıca PLR tanısal değeri yaş gruplarına göre değişmektedir. Cerrahın klinik değerlendirmesi akut apandisit tanısında öncelikli olmaya devam etmelidir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Pehlivanlı F, Aydin O. Role of platelet to lymphocyte ratio as a biomedical marker for the pre-operative diagnosis of acute appendicitis. Surg Infect (Larchmt) 2019;20:631-636.
- 2. Kahramanca S, Ozgehan G, Seker D, Gökce EI, Seker G, Tunç G, Küçükpınar T, Kargıcı H. Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2014;20:19-22.
- 3. Küçük E. The change of neutrophil lymphocyte ratio in acute appendicitis. Med-Science 2015;4:2379-2387.
- 4. Spangler R, Van Pham T, Khoujah D. Abdominal emergencies in the geriatric patient. Int J Emerg Med 2014;7:1-7.
- 5. Güller U, Rosella L, McCall J, Brügger LE, Candinas D. Negative appendicectomy and perforation rates in patients undergoing laparoscopic surgery for suspected appendicitis. Br J Surg 2011;98:589-595.
- 6. Ünal Y. A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes. Ulus Travma Acil Cerrahi Derg 2018;24:434-439.
- 7. Sevinç MM, Kınacı E, Çakar E, Bayrak S, Özakay A, Aren A, Sarı S. Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis: an analysis of 3392 cases. Ulus Travma Acil Cerrahi Derg 2016;22:155-162.
- 8. McGoran DR, Sims HM, Zia K, Uheba M, Shaikh IA. The value of biochemical markers in predicting a perforation in acute appendicitis. ANZ J Surg 2013;83:79-83.
- 9. Yıldırım AC, Anuk T, Günal E, İrem B, Gülkan S. Clinical Value of the Platelet-to-Lymphocyte Ratio for Diagnosing Complicated Acute Appendicitis. Turk J Colorectal Dis 2017;27:1-5.
- 10. Yazar FM, Bakacak M, Emre A, Urfalıoglu A, Serin S, Cengiz E, Bülbüloglu E. Predictive role of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for diagnosis of acute appendicitis during pregnancy. Kaohsiung J Med Sci 2015;31:591-596.
- 11. Uncer AA, Cavus S, Balcioglu A, Silay S, Demiralp I, Calkan E, Altin MA, Eryilmaz E, Karaisaoglu AO, Bukulmez A, Dogan I, Embleton DB, Cetinkursun S. Can mean platelet volume, Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, Platelet-to-Lymphocyte ratios be favourable predictors for the differential diagnosis of appendicitis? J Park Med Assoc 2019;69:647-654.
- 12. Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg 2004;91:28-37.
- 13. Boshnak N, Boshnaq M, Elgohary H. Evaluation of platelet indices and red cell distribution width as new biomarkers for the diagnosis of acute appendicitis. J Invest Surg 2018;31:121-129.
- 14. Duran İ, Avcı V, Nazik S, Altun E. Neutrophile Lymphocyte Ratio and Platelets Lymphocyte Ratio in the Diagnosis of Childhood Appendicitis. Turk J Biochem 2017;15:1-7.
- 15. Kahramanca Ş, Özgehan G, Kaya O, Küçükpınar TH, Kargıcı H, Avşar MF. Platelet to lymphocyte ratio and acute appendicitis. Kafkas J Med Sci 2017;7:153-157.
| APA | topal u, Akyuz M, Sözüer E, İsaoğulları Ş, DAL F, Talih T (2020). Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. , 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| Chicago | topal uğur,Akyuz Muhammet,Sözüer Erdoğan Mütevelli,İsaoğulları Şadi Yenel,DAL Fatih,Talih Tutkun Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. (2020): 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| MLA | topal uğur,Akyuz Muhammet,Sözüer Erdoğan Mütevelli,İsaoğulları Şadi Yenel,DAL Fatih,Talih Tutkun Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. , 2020, ss.157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| AMA | topal u,Akyuz M,Sözüer E,İsaoğulları Ş,DAL F,Talih T Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. . 2020; 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| Vancouver | topal u,Akyuz M,Sözüer E,İsaoğulları Ş,DAL F,Talih T Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. . 2020; 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| IEEE | topal u,Akyuz M,Sözüer E,İsaoğulları Ş,DAL F,Talih T "Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age." , ss.157 - 163, 2020. 10.4274/tjcd.galenos2020.2020-2-4 |
| ISNAD | topal, uğur vd. "Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age". (2020), 157-163. https://doi.org/10.4274/tjcd.galenos2020.2020-2-4 |
| APA | topal u, Akyuz M, Sözüer E, İsaoğulları Ş, DAL F, Talih T (2020). Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. Türk Kolon ve Rektum Hastalıkları Dergisi, 30(3), 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| Chicago | topal uğur,Akyuz Muhammet,Sözüer Erdoğan Mütevelli,İsaoğulları Şadi Yenel,DAL Fatih,Talih Tutkun Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. Türk Kolon ve Rektum Hastalıkları Dergisi 30, no.3 (2020): 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| MLA | topal uğur,Akyuz Muhammet,Sözüer Erdoğan Mütevelli,İsaoğulları Şadi Yenel,DAL Fatih,Talih Tutkun Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. Türk Kolon ve Rektum Hastalıkları Dergisi, vol.30, no.3, 2020, ss.157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| AMA | topal u,Akyuz M,Sözüer E,İsaoğulları Ş,DAL F,Talih T Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. Türk Kolon ve Rektum Hastalıkları Dergisi. 2020; 30(3): 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| Vancouver | topal u,Akyuz M,Sözüer E,İsaoğulları Ş,DAL F,Talih T Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age. Türk Kolon ve Rektum Hastalıkları Dergisi. 2020; 30(3): 157 - 163. 10.4274/tjcd.galenos2020.2020-2-4 |
| IEEE | topal u,Akyuz M,Sözüer E,İsaoğulları Ş,DAL F,Talih T "Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age." Türk Kolon ve Rektum Hastalıkları Dergisi, 30, ss.157 - 163, 2020. 10.4274/tjcd.galenos2020.2020-2-4 |
| ISNAD | topal, uğur vd. "Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age". Türk Kolon ve Rektum Hastalıkları Dergisi 30/3 (2020), 157-163. https://doi.org/10.4274/tjcd.galenos2020.2020-2-4 |
