NÖTROFİL LENFOSİT ORANI İLE RADYOLOJİK YÖNTEMLERİN KOMBİNASYONUNUN AKUT APANDİSİT TANISINDAKİ DEĞERİ

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.

Anahtar Kelimeler:

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

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

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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