Akut apandisit tanısında yeni bir biyobelirteç olarak trombosit büyük hücre oranının kullanımı

Öz

Amaç: Akut apandisit, akut karnın yaygın nedenlerinden biridir. Klasik belirti ve semptomlara rağmen, her zaman kolay ve hızlı bir şekilde teşhis edilemeyebilir. Birçok laboratuvar ve görüntüleme yöntemi ve risk skorlama sistemi mevcut olmasına rağmen, yeni biyobelirteçleri bulmak için çalışmalar devam etmektedir. Bu çalışmada trombosit parametrelerinden biri olan Trombosit-Büyük Hücre Oranının (P-LCR) yeni bir biyobelirteç olarak kullanılıp kullanılamayacağını araştırmayı amaçladık.
Yöntem: Çalışma, retrospektif tanımlayıcı bir çalışma olarak planlanarak, 01 Ocak 2019 ve Kasım 2019 tarihleri arasında gerçekleştirildi. Akut apandisit tanılı hastaların kayıtları tarandı. Hastalar histopatolojik sonuçlarına göre normal apendektomili, non-komplike apandisitli ve komplike apandisitli olmak üzere üç gruba ayrıldı. Gruplar P-LCR ve diğer trombosit parametreleri açısından karşılaştırıldı.
Bulgular: Toplam 425 hasta çalışmaya dâhil edildi. Gruplardaki kadın hasta sayıları sırasıyla 12 (%36,4), 42 (%45,7) ve 121 (%40,3) idi. Hastaların yaş ortalaması 27,2 (16,1) idi. Komplike ve komplike olmayan apendektomi grupları, normal apendektomi grubu ile karşılaştırıldığında, anlamlı derecede yüksek WBC düzeyleri ve düşük PDW ve P-LCR değerleri saptandı ( P=0,007; P=0,027 ve P=0,036). WBC sayısı eğri altındaki alan (AUC) 0,63 idi ve diğer parametrelere göre güçlü ayırt edici özelliğe sahip idi ( P=0,013). WBC’nin cut-off değeri 11,47 alındığında sensitivitesi %71,9, spesifisitesi %51,5 bulundu. P-LCR’nin cut-off değeri 19,85 alındığında ise sensitivitesi %67,6, spesifisitesi %32,4 idi (AUC=0,396; P=0,047).
Sonuç: P-LCR'nin akut apandisit tanısında kullanılabilirliği ile ilgili yapılan bu ilk çalışmada, tam kan sayımı parametreleri olan WBC, PDW ve P-LCR değerlerinin akut apandisit tanısında kullanılabileceği bulunmuştur.

Anahtar Kelimeler

• Akut apandisit
• Trombosit büyük hücre oranı
• Trombosit sayısı
• Ortalama trombosit hacmi
• Trombosit dağılım hacmi

Use of platelet large cell ratio as a new biomarker in the diagnosis of acute appendicitis

Öz

Aim: Acute appendicitis (AA) is one of the common causes of acute abdomen. Despite classical signs and symptoms, it may not always be easily and quickly diagnosed. Although many laboratory and imaging methods and risk scoring systems are available, studies are currently underway to find new biomarkers. In this study, we aimed to investigate whether Platelet-Large Cell Ratio (P-LCR), one of the platelet parameters, can be used as a new biomarker.
Methods: This retrospective cross-sectional study was performed by scanning the hospital records of AA patients, as determined with histopathological examination, who were diagnosed between 01 January-November 2019. The patients were divided into three as normal appendectomy (Group 1), non-complicated appendicitis (Group 2) and complicated appendicitis (Group 3) groups, which were compared in terms of P-LCR and other platelet parameters.
Results: A total of 425 patients were included in the study. The number of female patients in Groups 1, 2 and 3 were 12 (36.4%), 42 (45.7%), and 121 (40.3%), respectively. The mean age of the patients was 27.2 (16.1) years. Among all, complicated and uncomplicated appendectomy groups had significantly higher WBC and lower PDW and P-LCR values compared to the normal appendectomy group (P=0.007, P=0.027 and P=0.036, respectively). The cut-off values of WBC and P-LCR were 11.47 (71.9% sensitivity, 51.5% specificity) and 19.85 (75.8% sensitivity, 32.4% specificity), respectively. The WBC and P-LCR values had strong distinguishing features compared to other parameters (AUC=0.630, P=0.013 and AUC=0.604, P=0.047, respectively).
Conclusion: This is the first study investigating the P-LCR value in the diagnosis of AA. We found that WBC, PDW and P-LCR values, which are whole blood count parameters, can be used in the diagnosis of AA.

Anahtar Kelimeler

• Acute appendicitis
• Platelet large cell ratio
• Platelet count
• Mean platelet volume
• Platelet distribution volume

Kaynakça

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