Kocaeli Med J. 2023; 12(3): 402-405 | DOI: 10.5505/ktd.2023.05902

Neutrophil-to-Lymphocyte Ratio: A Biomarker for Severity of Acute Appendicitis

Taygun Gülþen¹, Muhammer Ergenç^2
1Department of General Surgery, Istanbul Sultanbeyli State Hospital, Istanbul, Turkey
²Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey

INTRODUCTION: Acute appendicitis is one of the common causes of acute abdominal pain and is the most common cause of emergency abdominal surgery worldwide. The neutrophil-to-lymphocyte ratio (NLR) is a systemic inflammatory variable that provides information about two different immune and inflammatory pathways. In this study, according to histopathology results, we aimed to evaluate the predictive value of NLR in the differential diagnosis of complicated and uncomplicated appendicitis.
METHODS: We included patients who underwent appendectomy surgery in our clinic between September 2016 and September 2022. The white blood cell (WBC), neutrophil, and lymphocyte count of the patients before the surgery were analyzed and the neutrophil-lymphocyte ratios were calculated. Patients with perforation and gangrenous appendicitis on pathology were considered complicated. Patients were divided into complicated and uncomplicated appendicitis groups and were compared.
RESULTS: 171 patients with complicated appendicitis and 1309 patients with uncomplicated appendicitis were compared. In the complicated appendicitis group, preoperative WBC, neutrophil count and NLR values were found to be statistically significantly higher, while the lymphocyte count was lower. There was a significant difference between complicated and uncomplicated appendicitis in terms of NLR values, 8.78 ± 5.87 and 6.33 ± 4.34, respectively, p<0.001.
DISCUSSION AND CONCLUSION: To predict a complication such as perforation or gangrene in acute appendicitis, the surgeon can benefit from personal experience, radiological imaging methods, and laboratory parameters. NLR, neutrophil, and lymphocyte counts seem to be very helpful in this regard.

Keywords: appendicitis, neutrophil lymphocyte ratio, perforated appendicitis

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Nötrofil-Lenfosit Oraný: Akut Apandisitin Ciddiyeti için Bir Biyobelirteç

Taygun Gülþen¹, Muhammer Ergenç^2
1Ýstanbul Sultanbeyli Devlet Hastanesi, Genel Cerrahi Kliniði, Ýstanbul, Türkiye
²Marmara Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Akut apandisit, akut karýn aðrýsýnýn yaygýn nedenlerinden biridir ve dünya çapýnda acil karýn cerrahisinin en yaygýn nedenidir. Nötrofil-lenfosit oraný (NLR), iki farklý immün ve inflamatuar yolak hakkýnda bilgi veren sistemik bir inflamatuar deðiþkendir. Bu çalýþmada, histopatoloji sonuçlarýna göre, komplike ve komplike olmayan apandisitin ayýrýcý tanýsýnda NLR'nin prediktif deðerini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Eylül 2016 ve Eylül 2022 tarihleri arasýnda kliniðimizde apendektomi ameliyatý geçiren hastalar çalýþmaya dahil edildi. Hastalarýn ameliyat öncesi beyaz kan hücresi (WBC), nötrofil ve lenfosit sayýlarý analiz edildi ve nötrofil-lenfosit oranlarý hesaplandý. Patolojisinde perforasyon ve gangrenöz apandisit olan hastalar komplike olarak kabul edildi. Hastalar komplike ve komplike olmayan apandisit gruplarýna ayrýldý ve karþýlaþtýrýldý.
BULGULAR: 171 komplike apandisit hastasý ile 1309 komplike olmayan apandisit hastasý karþýlaþtýrýldý. Komplike apandisit grubunda ameliyat öncesi WBC, nötrofil sayýsý ve NLR deðerleri istatistiksel olarak anlamlý derecede yüksek bulunurken, lenfosit sayýsý daha düþük bulundu. NLR deðerleri açýsýndan komplike ve komplike olmayan apandisitler arasýnda anlamlý fark saptandý, sýrasýyla 8.78 ± 5.87 ve 6.33 ± 4.34, p<0.001.
TARTIÞMA ve SONUÇ: Akut apandisitte perforasyon veya gangren gibi bir komplikasyonu öngörmek için cerrah kiþisel deneyiminden, radyolojik görüntüleme yöntemlerinden ve laboratuvar parametrelerinden yararlanabilir. NLR, nötrofil ve lenfosit sayýlarý bu konuda oldukça yararlý görünmektedir.

Anahtar Kelimeler: apandisit, nötrofil lenfosit oraný, perfore apandisit

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