Diagnostic Performance of Immature Granulocytes in the Early Diagnosis of Acute and Perforated Appendicitis in Children: A Retrospective Study

Yıl 2025, Cilt: 7 Sayı: 3, 784 - 91, 09.09.2025

Nurcan Çoşkun , İlknur Kaba

Öz

Aim: Timely identification and intervention in acute appendicitis (AA) are essential to avoid complications. Despite technological advances in diagnostics, challenges persist, particularly in pediatric populations. As a result, the search continues for reliable, rapid, low-cost, and accessible biomarkers. Immature granulocytes (IGs) have recently been proposed as promising indicators of inflammation severity. This study aims to evaluate the diagnostic function of IG and its percentage in distinguishing AA from perforated appendicitis (PA) in pediatric population.
Material and Method: A retrospective study was performed, comprising 201 pediatric cases who had surgery due to appendicitis and 42 healthy controls. Participants were categorized based on histopathological findings into AA, PA, and control groups. Laboratory variables including white blood cell (WBC) count, hemoglobin (Hb), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT), IG, %IG, and C-reactive protein (CRP) were compared across groups. Diagnostic performance was assessed through Receiver Operating Characteristic (ROC) curve analysis.
Results: No significant variations were observed in PLT and MPV values. However, significant differenc were detected in WBC, CRP, Hb, lymphocyte, monocyte, neutrophil, IG, and %IG levels across the study cohorts (p<0.001 for most; Hb: p=0.001). In PA, IG and %IG showed area under the curve (AUC) values of 0.956 and 0.930. In AA, AUC values were 0.929 for IG and 0.924 for %IG. Cutoff points of 25 (IG) and 0.25 (%IG) yielded good sensitivity and specificity for both conditions.
Conclusion: IG and %IG may provide valuable support in diagnosing AA and PA in pediatric patients. However, their use should complement clinical and laboratory assessments rather than serve as independent diagnostic tools.

Anahtar Kelimeler

Acute appendicitis , immature granulocyte , paediatric , perforated appendicitis

Etik Beyan

The study protocol was approved by Hitit University Faculty of Medicine Clinical Research Ethics Committee with the decision dated 31/01/2023 and numbered 2023/09.

Kaynakça

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