MONOSİT DAĞILIM GENİŞLİĞİNİN; AKUT KOMPLİKE APENDİSİT OLGULARINDA ERKEN TANI MARKERI OLARAK KULLANILABİLİNİR Mİ? ÖN ÇALIŞMA
Year 2021,
Volume: 54 Issue: 3, 424 - 428, 01.01.2022
Koray Koşmaz
,
Abdullah Durhan
,
Abdullah Şenlikci
,
Marlen Süleyman
,
Can Ersak
,
Ender Ergüder
,
Yusuf Murat Bag
,
Mehmet Şeneş
,
Mevlüt Recep Pekcici
Abstract
AMAÇ: Bu çalışmanın amacı, apandisit (AA) tanısında ve ayrıca basit apandisit (SA) ile komplike apandisit (CA) arasında ayırıcı tanıda monosit dağılım genişliğinin etkinliğini araştırmaktı.
GEREÇ VE YÖNTEM : Bu çalışma, apandektomi yapılan 107 erişkin hastanın verileri kullanılarak gerçekleştirildi. Demografik detaylar, preoperatif beyaz kan hücresi (WBC) sayısı, immatür granülosit sayısı (IG) ve yüzdesi ( IG % ), monosit dağılım genişliği ( MDW ), nötrofil-lenfosit oranı (NLR) ve patoloji sonuçları geriye dönük olarak değerlendirildi. Hastalar patoloji raporlarına göre AA ve normal apendiks (NA) olarak gruplandı ve AA olguları intraoperatif bulgulara göre SA ve CA gruplarına ayrıldı.
BULGULAR: Akut apandisit ile normal apandisit olgularını birbirinden ayırt etmede WBC, IG, IG%, NLR ve MDW değerleri istatiksel olarak anlamlı bulundu (p < 0.05 ). Bu parametreler içerisinde AA tanısı için en güçlü parametre ise NLR olduğu görüldü (sensitivitesi : 76%, spesifite : 89%, p < 0.001). Komplike apandisit olgularının tanısında ise IG değeri istatiksel olarak anlamlı bulundu( p < 0.05)
SONUÇ: MDW, AA tanısında hızlı, güvenilir ve kolay ulaşılabilir bir parametredir. Ancak SA ile CA ayrımın da MDW değerleri CA olgularında yükseldiği görülse de istatiksel olarak anlamlı bulunmadı. Daha net bir değerlendirme için daha kapsamlı çalışmalara ihtiyaç vardır.
Supporting Institution
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References
- 1. Becker K, Höfler H. Pathology of appendicitis. Chirurg 2002;73:777‑81.
- 2. Narci H, Turk E, Karagulle E, et al. The role of red cell distribution width in the diagnosis of acute appendicitis: a retrospective case-controlled study. World J Emerg Surg. 2013;8:46.
- 3. Nshuti R, Kruger D, Luvhengo TE. Clinical presentation of acute appendicitis in adults at the Chris Hani Baragwanath Academic Hospital. Int J Emerg Med 2014;7:12.
- 4. Franz MG, Norman J, Fabri PJ. Increased morbidity of appendicitis with advancing age. Am Surg 1995;61:40
- 5. Yamini D, Vargas H, Bangard F, et al. Perforated appendicitis: is it truly a surgical urgency? Am Surg 1998;64:970–5.
- 6. Lee JF, Leow CK, Lau WY. Appendicitis in the elderly. ANZ J Surg 2000;70:593–6.
- 7. Lunca S, Bouras G, Romedea NS. Acute appendicitis in the elderly patient:diagnostic problems, prognostic factors and outcomes. Rom J Gastroenterol 2004;13:299–303.
- 8. Senlikci A, Guven R. Prognostic Value of Neutrophil / Lymphocyte Ratio and Mean Platelet Volume Value in the Diagnosis of Acute Appendicitis. Surg Chron 2018; 23: 167-9.
- 9. 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;31:121–9.
- 10. Sepas HN, Negahi A, Mousavie SH, et al. Evaluation of the Potential Association of Platelet Levels, Mean Platelet Volume and Platelet Distribution Width with Acute Appendicitis. Maced J Med Sci. 2019;7:2271–6.
- 11. Unal Y. A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes. Ulus Travma Acil Cerrahi Derg. 2018;24:434-9.
- 12. Crouser ED, Parrillo JE, Seymour CW, et al. Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients. Crit Care Med. 2019;47:1018-25.
- 13. Broker ME, van Lieshout EM, van der Elst M, et al. Discriminating between simple and perforated appendicitis. J Surg Res 2012;176:79–83
- 14. Sevinc MM, Kınacı E, Cakar E, et al. Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis: an analysis of 3392 cases. Ulus Travma Acil Cerrahi Derg 2016;22:155–62.
- 15. Shin DH, Cho YS, Kim YS, et al. Delta neutrophil index: a reliable marker to differentiate perforated appendicitis from non-perforated appendicitis in the elderly. J Clin Lab Anal. 2018;32:e22177
- 16. Moon HM, Park BS, Moon DJ. Diagnostic value of C-reactive protein in complicated appendicitis. J Korean Soc Coloproctol. 2011;27:122‐6.
- 17. Abdelhalim MA, Stuart JD, Nicholson GA. Augmenting the decision making process in acute appendicitis: a retrospective cohort study. Int J Surg. 2015;17:5‐9.
- 18. Demircan A, Aygencel G, Karamercan M, et al. Ultrasonographic findings and evaluation of white blood cell counts in patients undergoing laparotomy with the diagnosis of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2010; 16: 248-52.
- 19. Ertekin B, Kara H, Erdemir E, et al. Efficacy of Use of Red Cell Distribution Width as a Diagnostic Marker in Acute Appendicitis. Eurasian J Emerg Med 2017; 16: 29-33.
- 20. Kahramanca S, Ozgehan G, Seker D, et al. Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2014;20:19–22
- 21. Senthilnayagam B, Kumar T, Sukumaran J, et al. Automated measurement of immature granulocytes: performance characteristics and utility in routine clinical practice. Pathol Res Int 2012;2012:483670
- 22. Mathews EK, Griffin RL, Mortellaro V, et al. Utility of immature granulocyte percentage in pediatric appendicitis. J Surg Res 2014;190:230–4.
- 23. Park JS, Kim JS, Kim YJ, et al. Utility of the immature granulocyte percentage for diagnosing acute appendicitis among clinically suspected appendicitis in adult. J Clin Lab Anal. 2018;32:e22458.
- 24. Crouser ED, Parrillo JE, Seymour C, et al. Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker. Chest. 2017;152:518-26.
- 25. Crouser ED, Parrillo JE, Martin GS, et al. Monocyte distribution width enhances early sepsis detection in the emergency department beyond SIRS and qSOFA. J Intensive Care. 2020;8:33.
- 26. Ognibene A, Lorubbio M, Magliocca P, et al. Elevated monocyte distribution width in COVID-19 patients: The contribution of the novel sepsis indicator [published online ahead of print, 2020 Jun 3]. Clin Chim Acta. 2020;509:22-4
MONOCYTE DISTRIBUTION WIDTH; CAN IT BE USED AS AN EARLY DIAGNOSIS MARKER IN CASES OF ACUTE COMPLICATED APPENDICITIS? A PRELIMINARY STUDY
Year 2021,
Volume: 54 Issue: 3, 424 - 428, 01.01.2022
Koray Koşmaz
,
Abdullah Durhan
,
Abdullah Şenlikci
,
Marlen Süleyman
,
Can Ersak
,
Ender Ergüder
,
Yusuf Murat Bag
,
Mehmet Şeneş
,
Mevlüt Recep Pekcici
Abstract
AİM : The aim of this study was to investigate the effectiveness of monocyte distribution width in both the diagnosis of acute appendicitis (AA) and in differentiating between simple appendicitis (SA) and complicated appendicitis (CA).
METHODS: This study was conducted using data from 107 adult patients who underwent appendectomy. Demographic details, preoperative white blood cell (WBC) count, immature granulocyte count (IG) and percentage (IG %), monocyte distribution width (MDW), neutrophil-lymphocyte ratio (NLR) and pathology results were evaluated retrospectively. Patients were grouped as AA and normal appendix (NA) according to the pathology reports, and the AA cases were divided into SA and CA groups according to the intraoperative findings.
RESULTS: WBC, IG, IG%, NLR and MDW values were found to be statistically significant for the differentiation of acute appendicitis from normal appendicitis cases (p < 0.05). Of these parameters, the strongest parameter for the diagnosis of AA was NLR (sensitivity: 76%, specificity: 89%, p< 0.001). The IG value was found to be statistically significant in the diagnosis of complicated appendicitis cases (p < 0.05)
CONCLUSION: The MDW value is a fast, reliable and easily accessible parameter in the diagnosis of AA. However, although MDW values were found to be high in CA cases in the differentiation of SA and CA, they were not statistically significant. More comprehensive studies are needed for a clearer assessment.
References
- 1. Becker K, Höfler H. Pathology of appendicitis. Chirurg 2002;73:777‑81.
- 2. Narci H, Turk E, Karagulle E, et al. The role of red cell distribution width in the diagnosis of acute appendicitis: a retrospective case-controlled study. World J Emerg Surg. 2013;8:46.
- 3. Nshuti R, Kruger D, Luvhengo TE. Clinical presentation of acute appendicitis in adults at the Chris Hani Baragwanath Academic Hospital. Int J Emerg Med 2014;7:12.
- 4. Franz MG, Norman J, Fabri PJ. Increased morbidity of appendicitis with advancing age. Am Surg 1995;61:40
- 5. Yamini D, Vargas H, Bangard F, et al. Perforated appendicitis: is it truly a surgical urgency? Am Surg 1998;64:970–5.
- 6. Lee JF, Leow CK, Lau WY. Appendicitis in the elderly. ANZ J Surg 2000;70:593–6.
- 7. Lunca S, Bouras G, Romedea NS. Acute appendicitis in the elderly patient:diagnostic problems, prognostic factors and outcomes. Rom J Gastroenterol 2004;13:299–303.
- 8. Senlikci A, Guven R. Prognostic Value of Neutrophil / Lymphocyte Ratio and Mean Platelet Volume Value in the Diagnosis of Acute Appendicitis. Surg Chron 2018; 23: 167-9.
- 9. 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;31:121–9.
- 10. Sepas HN, Negahi A, Mousavie SH, et al. Evaluation of the Potential Association of Platelet Levels, Mean Platelet Volume and Platelet Distribution Width with Acute Appendicitis. Maced J Med Sci. 2019;7:2271–6.
- 11. Unal Y. A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes. Ulus Travma Acil Cerrahi Derg. 2018;24:434-9.
- 12. Crouser ED, Parrillo JE, Seymour CW, et al. Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients. Crit Care Med. 2019;47:1018-25.
- 13. Broker ME, van Lieshout EM, van der Elst M, et al. Discriminating between simple and perforated appendicitis. J Surg Res 2012;176:79–83
- 14. Sevinc MM, Kınacı E, Cakar E, et al. Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis: an analysis of 3392 cases. Ulus Travma Acil Cerrahi Derg 2016;22:155–62.
- 15. Shin DH, Cho YS, Kim YS, et al. Delta neutrophil index: a reliable marker to differentiate perforated appendicitis from non-perforated appendicitis in the elderly. J Clin Lab Anal. 2018;32:e22177
- 16. Moon HM, Park BS, Moon DJ. Diagnostic value of C-reactive protein in complicated appendicitis. J Korean Soc Coloproctol. 2011;27:122‐6.
- 17. Abdelhalim MA, Stuart JD, Nicholson GA. Augmenting the decision making process in acute appendicitis: a retrospective cohort study. Int J Surg. 2015;17:5‐9.
- 18. Demircan A, Aygencel G, Karamercan M, et al. Ultrasonographic findings and evaluation of white blood cell counts in patients undergoing laparotomy with the diagnosis of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2010; 16: 248-52.
- 19. Ertekin B, Kara H, Erdemir E, et al. Efficacy of Use of Red Cell Distribution Width as a Diagnostic Marker in Acute Appendicitis. Eurasian J Emerg Med 2017; 16: 29-33.
- 20. Kahramanca S, Ozgehan G, Seker D, et al. Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2014;20:19–22
- 21. Senthilnayagam B, Kumar T, Sukumaran J, et al. Automated measurement of immature granulocytes: performance characteristics and utility in routine clinical practice. Pathol Res Int 2012;2012:483670
- 22. Mathews EK, Griffin RL, Mortellaro V, et al. Utility of immature granulocyte percentage in pediatric appendicitis. J Surg Res 2014;190:230–4.
- 23. Park JS, Kim JS, Kim YJ, et al. Utility of the immature granulocyte percentage for diagnosing acute appendicitis among clinically suspected appendicitis in adult. J Clin Lab Anal. 2018;32:e22458.
- 24. Crouser ED, Parrillo JE, Seymour C, et al. Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker. Chest. 2017;152:518-26.
- 25. Crouser ED, Parrillo JE, Martin GS, et al. Monocyte distribution width enhances early sepsis detection in the emergency department beyond SIRS and qSOFA. J Intensive Care. 2020;8:33.
- 26. Ognibene A, Lorubbio M, Magliocca P, et al. Elevated monocyte distribution width in COVID-19 patients: The contribution of the novel sepsis indicator [published online ahead of print, 2020 Jun 3]. Clin Chim Acta. 2020;509:22-4