The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia

Aziret, Mehmet; Ercan, Metin; KAYA, Ahmet; Karaman, Kerem; KÖSE, Elif; Kahraman, Yavuz Selim; Karacaer, Cengiz

doi:10.14744/tjtes.2020.69027

The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia

Ahmet KAYA, (Sakarya Üniversitesi, Tıp Fakültesi, Cerrahi Onkoloji Anabilim Dalı, Sakarya, Türkiye)

Kerem KARAMAN, (Sakarya Üniversitesi, Tıp Fakültesi, Gastroenterolojik Cerrahi Anabilim Dalı, Sakarya, Türkiye)

Mehmet AZİRET, (Sakarya Üniversitesi, Tıp Fakültesi, Gastroenterolojik Cerrahi Anabilim Dalı, Sakarya, Türkiye)

Metin ERCAN, (Sakarya Üniversitesi, Tıp Fakültesi, Gastroenterolojik Cerrahi Anabilim Dalı, Sakarya, Türkiye)

Elif KÖSE, (Sakarya Üniversitesi, Tıp Fakültesi, Halk Sağlığı Anabilim Dalı, Sakarya, Türkiye)

Yavuz Selim KAHRAMAN, (Sakarya Üniversitesi, Tıp Fakültesi, Cerrahi Onkoloji Anabilim Dalı, Sakarya, Türkiye)

Cengiz KARACAER (Sakarya Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Sakarya, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

5 3

Yıl: 2022 Cilt: 28 Sayı: 4 Sayfa Aralığı: 434 - 439 Metin Dili: İngilizce DOI: 10.14744/tjtes.2020.69027 İndeks Tarihi: 10-05-2023

The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia

Öz:

BACKGROUND: One of the most misdiagnosed appendicular pathologies is lymphoid hyperplasia (LH) that can be managed conservatively when identified early and is self-limiting. The aim of this retrospective study was to compare acute appendicitis (AA) with LH in terms of hematological parameters to determine whether there is a hematological predictor to distinguish the two diseases. METHODS: Complete blood cell counts of patients with AA were compared with those having LH. RESULTS: One-hundred-ninety-five patients (118 male/77 female) underwent appendectomy. Histopathological examination revealed acute AA in 161 patients (82.6%), and negative appendectomy (NA) in 19 patients (9.7%). Of the NA specimens, 16 were LH (8.2%). Thirteen patients (6.7%) had AA with simultaneous LH. White blood cell count (p=0.030, neutrophil (p=0.009), neutrophil percentage (p=0.009), and neutrophil/lymphocyte ratio (p=0.007) were significantly higher in AA whereas lymphocyte count (p=0.027), lymphocyte percentage (p=0.006) were significantly higher in LH. Multi logistic regression analysis revealed white blood cell count as the only independent predictor in distinguishing AA from LH with a 69.1% sensitivity, 80.0% specificity, 77.5% positive predictive value, and 72.1% negative predictive value. The cut-off value for white blood cell count was 11.3 Ku/L, and every one unit (1000/mm3) increase in white blood cell count raises the risk of AA by 1.24 times, while values below this value will increase the likelihood of LH. CONCLUSION: The most predictive complete blood count parameter in distinguishing LH from AA appears to be as white blood cell count.

Anahtar Kelime:

Akut apandisiti lenfoid hiperplaziden ayırmada hematolojik parametrelerin rolü

Öz:

AMAÇ: Sık karışan apendiküler patolojilerden biri, erken teşhis edildiğinde konservatif olarak tedavi edilebilen ve kendi kendini sınırlayabilen lenfoid hiperplazidir. Bu geriye dönük çalışmanın amacı akut apandisiti lenfoid hiperplaziyle hematolojik parametreler açısından karşılaştırmak ve iki hastalığı ayırt etmede hematolojik bir prediktör olup olmadığını saptamaktır. GEREÇ VE YÖNTEM: Akut apandisit tanılı hastalar ile lenfoid hiperplazi tanılı hastaların tam kan sayımları kıyaslandı. BULGULAR: Yüz doksan beş hastaya (118 erkek/77 kadın) apendektomi yapıldı. Histopatolojik incelemede 161 hastada (%82.6) akut apandisit, 19 hastada (%9.7) negatif apendektomi saptandı. Negatif apendektomilerin 16’sı lenfoid hiperplaziydi (%8.2). On üç hastada (%6.7) eş zamanlı lenfoid hiperplazi ile birlikte akut apandisit saptandı. Beyaz küre sayısı (p=0.030, nötrofil sayısı (p=0.009), nötrofil yüzdesi (p=0.009) ve nötrofil/ lenfosit oranı (p=0.007) akut apandisitte anlamlı olarak daha yüksek iken lenfosit sayısı (p=0.027), lenfosit yüzdesi (p=0.006) lenfoid hiperplazide anlamlı olarak daha yüksekti. Çoklu lojistik regresyon analizinde, akut apandisiti lenfoid hiperplaziden ayırmada beyaz küre sayısı %69.1 duyarlılık; %80 özgüllük; %77.5 pozitif prediktif değer ve %72.1 negatif prediktif değer ile tek bağımsız prediktör olarak saptandı. Kesit değeri 11.3 Ku/L olan beyaz küre sayısının her 1 birim (1000/mm3) artışı, akut apandisit riskini 1.24 kat arttırırken, bunun altındaki değerlerde lenfoid hiperplazi olma olasılığı artmaktadır. TARTIŞMA: Lenfoid hiperplaziyi akut apandisitten ayırmada en güçlü hematolojik parametre beyaz küre olarak gözükmektedir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KAYA A, Karaman K, Aziret M, Ercan M, KÖSE E, Kahraman Y, Karacaer C (2022). The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. , 434 - 439. 10.14744/tjtes.2020.69027
Chicago	KAYA Ahmet,Karaman Kerem,Aziret Mehmet,Ercan Metin,KÖSE Elif,Kahraman Yavuz Selim,Karacaer Cengiz The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. (2022): 434 - 439. 10.14744/tjtes.2020.69027
MLA	KAYA Ahmet,Karaman Kerem,Aziret Mehmet,Ercan Metin,KÖSE Elif,Kahraman Yavuz Selim,Karacaer Cengiz The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. , 2022, ss.434 - 439. 10.14744/tjtes.2020.69027
AMA	KAYA A,Karaman K,Aziret M,Ercan M,KÖSE E,Kahraman Y,Karacaer C The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. . 2022; 434 - 439. 10.14744/tjtes.2020.69027
Vancouver	KAYA A,Karaman K,Aziret M,Ercan M,KÖSE E,Kahraman Y,Karacaer C The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. . 2022; 434 - 439. 10.14744/tjtes.2020.69027
IEEE	KAYA A,Karaman K,Aziret M,Ercan M,KÖSE E,Kahraman Y,Karacaer C "The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia." , ss.434 - 439, 2022. 10.14744/tjtes.2020.69027
ISNAD	KAYA, Ahmet vd. "The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia". (2022), 434-439. https://doi.org/10.14744/tjtes.2020.69027

APA	KAYA A, Karaman K, Aziret M, Ercan M, KÖSE E, Kahraman Y, Karacaer C (2022). The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. Ulusal Travma ve Acil Cerrahi Dergisi, 28(4), 434 - 439. 10.14744/tjtes.2020.69027
Chicago	KAYA Ahmet,Karaman Kerem,Aziret Mehmet,Ercan Metin,KÖSE Elif,Kahraman Yavuz Selim,Karacaer Cengiz The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. Ulusal Travma ve Acil Cerrahi Dergisi 28, no.4 (2022): 434 - 439. 10.14744/tjtes.2020.69027
MLA	KAYA Ahmet,Karaman Kerem,Aziret Mehmet,Ercan Metin,KÖSE Elif,Kahraman Yavuz Selim,Karacaer Cengiz The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. Ulusal Travma ve Acil Cerrahi Dergisi, vol.28, no.4, 2022, ss.434 - 439. 10.14744/tjtes.2020.69027
AMA	KAYA A,Karaman K,Aziret M,Ercan M,KÖSE E,Kahraman Y,Karacaer C The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(4): 434 - 439. 10.14744/tjtes.2020.69027
Vancouver	KAYA A,Karaman K,Aziret M,Ercan M,KÖSE E,Kahraman Y,Karacaer C The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(4): 434 - 439. 10.14744/tjtes.2020.69027
IEEE	KAYA A,Karaman K,Aziret M,Ercan M,KÖSE E,Kahraman Y,Karacaer C "The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia." Ulusal Travma ve Acil Cerrahi Dergisi, 28, ss.434 - 439, 2022. 10.14744/tjtes.2020.69027
ISNAD	KAYA, Ahmet vd. "The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia". Ulusal Travma ve Acil Cerrahi Dergisi 28/4 (2022), 434-439. https://doi.org/10.14744/tjtes.2020.69027