Abstract

Mehmet Ilker Turan, Mehmet Celik, Mehmet Akif Turkoglu, Direnc Yigit

ABSTRACT

Objective: The aim of this study was to investigate the efficacy of simple accessible laboratory parameters such as neutrophil-lymphocyte ratio (NLR) in the diagnosis of acute appendicitis and the incidence of neuroendocrine tumors in patients operated with an initial diagnosis of acute appendicitis. Materials and methods: Postoperative pathology diagnosis, neutrophil-lymphocyte ratio, age, sex, perforation of 952 patients with an initial diagnosis of acute appendicitis between January 2009 and December 2015 were reviewed retrospectively. Acute appendicitis cases were divided into two groups as complicated (perforated) and simple uncomplicated cases. NLR ratio was calculated. Receiver operating characteristic (ROC) curve analysis was used to define important parameters in multivariate analysis. Cut-off values, sensitivity, specificity and accuracy calculations were made for the parameters under the curve area (AUC)> 0.600. Results: 23 patients were excluded from the study due to incomplete data. Normal appendix in 1 (0.1%), endometriosis in 1 (0.1%), adenocarcinoma in 4 (0.4%) cases, neuroendocrine tumor in 7 (0.8%) cases, lymphoid hyperplasia in 138 (14.9%) cases and acute appendicitis was detected in 778 (83.7%) cases. Of the 778 patients, 124 (15.9%) had a perforation. NLR sensitivity and specificity were found in cases with acute appendicitis but not in complicated cases. However, the cut-off point of NLR with the sensitivity of 85% and a specificity of 94% was found to be> 4,526 in the complicated acute appendicitis. Conclusion: NLR> 4.526 in subjects with perforation was found to be significantly associated with acute appendicitis.