Usefulness of extended inflammatory parameters related to neutrophil activation reported by Sysmex XN-1000 hematology analyzer for predicting complicated acute appendicitis. Comparison with canonical inflammatory laboratory tests.

Autor: Díaz López MI; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain., Crespo Álvarez E; General Surgery Department, Hospital Universitario Santa Lucía, Cartagena, Spain., Martínez Manzano Á; General Surgery Department, Hospital Universitario Santa Lucía, Cartagena, Spain., Urrechaga E; Biocruces Bizkaia Health Research Institute, Baracaldo, Spain; Laboratory Medicine Department, Hospital Galdakao-Usansolo, Galdakao, Spain., Orgaz Morales MT; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain., González Morales M; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain., Martín García E; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain., de Guadiana-Romualdo LG; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain. Electronic address: lgr28w@ad.sms.carm.es.
Jazyk: angličtina
Zdroj: Cirugia espanola [Cir Esp (Engl Ed)] 2024 Jun; Vol. 102 (6), pp. 300-306. Date of Electronic Publication: 2024 Feb 09.
DOI: 10.1016/j.cireng.2023.11.022
Abstrakt: 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.
(Copyright © 2024 AEC. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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