RESUMO
AIM: Accurate diagnosis of complicated appendicitis is of importance to ensure that patients receive early and effective treatment, minimizing the risk of postoperative complications to promote successful recovery. Biochemical markers are a promising tool to identify complicated appendicitis. We aimed to evaluate the potential role of novel parameters related with neutrophil activation, known as "Extended Inflammation Parameters" (EIP), included in blood cell count reported by Sysmex XN-Series analyzers, compared to other canonical biomarkers in identifying complicated appendicitis. METHOD: Prospective observational study including patients with confirmed diagnosis of acute appendicitis. C-reactive protein (CRP), procalcitonin, cell blood count, including white blood cell (WBC), absolute neutrophil (ANC) and immature granulocyte (IG) count and EIP (neutrophil reactivity [NEUT-RI] and granularity intensity [NEUT-GI]) were analyzed before surgery. Their accuracy to diagnose complicated appendicitis was tested in an ROC curve analysis. RESULTS: Our population study included 119 patients, and appendicitis was complicated in 58 (48.7%). NLR, CRP and procalcitonin levels, ANC and IG count and NEUT-RI and NEUT-GI were higher in patients with complicated appendicitis. Regarding accuracy for complicated appendicitis, CRP was the biomarker with the highest performance (ROC AUC: 0.829), with an optimal cutoff of 73.1 mg/L (sensitivity: 63.8%, specificity: 88.5%). NEUT-RI and NEUT-GI achieved both significant but poor accuracy, with ROC AUC of 0.606 and 0.637, respectively. CONCLUSIONS: Novel laboratory tests reported by Sysmex XN-Series analyzers have poor accuracy for identifying complicated appendicitis. In this study, CRP was the biomarker with the highest performance and may be useful as predictor of the severity of acute appendicitis.
Assuntos
Apendicite , Biomarcadores , Proteína C-Reativa , Ativação de Neutrófilo , Pró-Calcitonina , Apendicite/sangue , Apendicite/diagnóstico , Apendicite/cirurgia , Humanos , Estudos Prospectivos , Feminino , Masculino , Adulto , Proteína C-Reativa/análise , Pessoa de Meia-Idade , Biomarcadores/sangue , Pró-Calcitonina/sangue , Doença Aguda , Contagem de Leucócitos/métodos , Contagem de Leucócitos/instrumentação , Testes Hematológicos/métodos , Testes Hematológicos/instrumentação , Curva ROC , Idoso , Neutrófilos , Inflamação/sangueAssuntos
Erros de Diagnóstico , Glucagonoma/complicações , Neoplasias Pancreáticas/complicações , Psoríase/diagnóstico , Dermatopatias/etiologia , Biópsia , Diagnóstico Diferencial , Glucagonoma/diagnóstico por imagem , Glucagonoma/secundário , Glucagonoma/cirurgia , Humanos , Neoplasias Hepáticas/secundário , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Dermatopatias/patologia , Tomografia Computadorizada por Raios XAssuntos
Abdome Agudo/etiologia , Divertículo/complicações , Doenças do Jejuno/complicações , Abdome Agudo/diagnóstico por imagem , Idoso , Divertículo/diagnóstico por imagem , Feminino , Humanos , Perfuração Intestinal/complicações , Perfuração Intestinal/diagnóstico por imagem , Doenças do Jejuno/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Resumen El linfoma difuso de células grandes B (LDCGB) es el tipo de linfoma más frecuente, constituyendo un 35% de todos los casos de linfoma no Hodgkin (LNH). El linfoma no-Hodgkin primario de bazo (LNHPB) presenta una incidencia menor al 1% de todos los linfomas. Los linfomas doble hit están relacionados con el reordenamiento del gen MYC asociado a otra alteración molecular. Tienden a presentarse en varones de edad avanzada y se caracterizan principalmente por su comportamiento agresivo.
Abstract Diffuse Large-cell Lymphoma B (DLCLB) is the most common type of lymphoma, constituting 35% of all cases of Non-Hodgkin's Lymphoma (NHL). Primary Splenic Non-Hodgkin Lymphoma (PS-NHL) has an incidence of less than 1% of all lymphomas. The ''double hit'' lymphomas are related to the rearrangement of the MYC gene associated with another molecular alteration. They used to appear in older men and are mainly characterised by their aggressive behaviour.