Novel Biomarkers for Improving the Diagnosis of Appendicitis in Pediatric Patients

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis Pub Date : 2025-05-03 DOI:10.1002/jcla.70048

Adir Alper, Yizhak Aronov, Lior Shlomov, Osnat Zmora

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引用次数: 0

Abstract

Introduction

Diagnosing appendicitis in pediatric patients remains a clinical challenge, especially in resource-limited settings where imaging tools are less accessible. Inflammatory markers, including the Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Neutrophil-to-Monocyte Ratio (NMR), Platelet-to-Lymphocyte Ratio (PLR), Neutrophil-to-Platelet Ratio (NPR), and C-reactive protein (CRP), offer a promising approach to enhancing diagnostic accuracy. We aimed to evaluate the utility of these inflammatory markers to diagnose appendicitis.

Methods

This retrospective study included 1027 pediatric patients who underwent appendectomy, with appendicitis confirmed histopathologically in 891 cases. Preoperative Inflammatory markers (NLR, MLR, NMR, PLR, NPR, and CRP) were analyzed and optimal cutoff values were determined using Receiver Operating Characteristic (ROC) curves.

Results

Elevated NLR, NMR, PLR, NPR, and CRP were strongly associated with appendicitis, while an inverse relationship was observed with MLR. NLR (≥ 4.42) and NPR (≥ 0.0327) demonstrated high diagnostic accuracy with sensitivity and specificity exceeding 75%. Surprisingly, MLR showed a statistically significant inverse relationship with AA risk. Temperature differences between groups were not statistically significant.

Conclusion

Each suggested novel inflammatory marker has the potential to improve the preoperative diagnosis of appendicitis in pediatric patients. Such a system could minimize reliance on imaging and expedite decision-making, especially in resource-constrained settings. Further prospective studies are needed to validate these findings and explore their clinical utility.

Abstract Image

查看原文本刊更多论文

改善小儿阑尾炎诊断的新生物标志物。

儿科患者阑尾炎的诊断仍然是一个临床挑战，特别是在资源有限的环境中，成像工具不易获得。炎症标志物，包括中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、中性粒细胞与单核细胞比值（NMR）、血小板与淋巴细胞比值（PLR）、中性粒细胞与血小板比值（NPR）和c反应蛋白（CRP），为提高诊断准确性提供了一种很有前途的方法。我们的目的是评估这些炎症标志物诊断阑尾炎的效用。方法：回顾性研究1027例行阑尾切除术的儿童患者，其中891例经组织病理学证实为阑尾炎。分析术前炎症标志物（NLR、MLR、NMR、PLR、NPR和CRP），并利用受试者工作特征（ROC）曲线确定最佳临界值。结果：NLR、NMR、PLR、NPR、CRP升高与阑尾炎密切相关，与MLR呈负相关。NLR（≥4.42）和NPR（≥0.0327）的诊断准确率较高，敏感性和特异性均超过75%。令人惊讶的是，MLR与AA风险呈显著负相关。各组间温度差异无统计学意义。结论：每一种提示的新型炎症标志物都有可能提高小儿阑尾炎的术前诊断。这种系统可以最大限度地减少对成像的依赖，加快决策，特别是在资源有限的情况下。需要进一步的前瞻性研究来验证这些发现并探索其临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.