NÖTROFİL LENFOSİT ORANI İLE RADYOLOJİK YÖNTEMLERİN KOMBİNASYONUNUN AKUT APANDİSİT TANISINDAKİ DEĞERİ

Year 2018, Volume: 51 Issue: 2, 79 - 83, 29.08.2018

Mete Canpolat Yılmaz Ünal

Abstract

AMAÇ: Akut apandisit
tanısında anamnez ve fzik muayene bulgularının yanısıra
laboratuvar tetkikleri ve görüntüleme yöntemlerinin kullanılması
da tanıya yardımcıdır. Çalışmamızda nötrofil lenfosit
oranını (NLO) abdominal ultrasonografi (USG) ve bilgisayarlı
tomografi (BT) ile kombine ederek akut apandisit tanısındaki
değerini araştırmayı amaçladık.

GEREÇ VE YÖNTEMLER: Çalışmamız
Haziran 2014-Aralık 2016 tarihleri arasında S.B. Ankara Eğitim ve
Araştırma Hastanesi Genel Cerrahi Kliniğinde akut apandisit
tanısıyla opere edilen 1340 hasta dahil edildi. Tüm hastaların
demografik verileri NLO değerleri abdominal USG ile BT raporları ve
patoloji raporları retrospektif olarak analiz edildi.

BULGULAR: Hastaların 764’ü
erkek (%57), 576’sı kadın (%43), ortalama yaş 34,8 (17-92) idi.
Patolojik tanıların 1128’i (%84,2) akut apandisit, 212’si
(%15,8) normal apendiks olarak raporlandı. Çalışmamızda NLO
değerinin cut-off değeri 3,17, duyarlılılğı tüm hastalarda
%77,3, erkek hastalarda%84,8, kadın hastalarda %58,4 bulundu.
USG’nin duyarlılığı tüm hastalarda %60, erkek hastalarda
%61,7, kadın hastalarda %57,7; BT’nin duyarlılığı tüm
hastalarda %63,3, erkek hastalarda %69,7, kadın hastalarda %55,1
bulundu. NLO<3,17+USG duyarlılığı%55,9, NLO<3,17+BT
duyarlılığı%64,9, NLO>3,17+USG duyarlılığı %60,9,
NLO>3,17+BT duyarlılığı %64,9 olarak bulundu.

SONUÇ: Yardımcı
tanı yöntemlerinin akut apandisit tanısında tanısal değeri ve
yol göstericiliği olmakla birlikte gerekli klinik durumlarda
cerrahın tecrübesi ön plana çıkarak karar verilmelidir. 

Keywords

Akut apandisit, tanı, nötrofil/lenfosit oranı, görüntüleme yöntemleri

DIAGNOSTIC VALUE OF COMBINATION OF NEUTROPHYL TO LYMPHOCYTE RATIO WITH IMAGING METHODS IN THE ACUTE APENDICITIS

Abstract

OBJECTIVE: The use of laboratory tests
and imaging methods as well as history of patient and physical
examination findings are helpful in the diagnosis of acute
appendicitis. We aimed to investigate value of combination
neutrophyl to lymphocyte ratio (NLR) with abdominal ultrasonography
(USG) and computed tomography (CT) in the diagnosis of acute
appendicitis.

MATERIALS AND METHODS: Our study was
conducted on 1340 patients who were underwent appendectomy in the
General Surgery Clinic of Ankara Training and Research Hospital
between June 2014 and December 2016 . Demographic datas, NLR values,
abdominal USG with CT reports and pathology reports of all patients
were analyzed retrospectively.The data obtained were evaluated in the
IBM SPSS statistical package program.

RESULTS: Of all patients,764 (57%) were
male , 576 (43%) were female and the mean age was 34,8 (17-92). 1128
(84.2%) of the pathologic diagnoses were reported as acute
appendicitis and 212 (15.8%) were normal appendicitis. In our study,
the cut-off value of NLR was 3.17, sensitivity was 77.3% in all
patients, 84.8% in male patients and 58.4% in female patients. The
sensitivity of USG is 60% in all patients, 61.7% in male patients,
57.7% in female patients; The sensitivity of CT was 63.3% in all
patients, 69.7% in male patients and 55.1% in female patients. NLR
<3,17 + USG sensitivity 55,9%, NLR <3,17 + BT sensitivity
64,9%, NLR 3,17 + USG sensitivity 60,9%, NLR 3,17 + BT sensitivity
64,9% was found.

CONCLUSION: The combination of NLR
values
with imaging methods in the diagnosis of acute appendicitis may be
helpful but the surgeon should determine in doubtful cases by
experience.

Keywords

acute appendicitis, diagnosis, neutrophil lymphocyte ratio, imaging methods

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