A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes

BACKGROUND: The aim of this study was to investigate the effectiveness of the immature granulocyte (IG) count (IGC) and percentage (IG%) in both diagnosing acute appendicitis (AA) and discriminating between simple appendicitis (SA) and complicated appendicitis (CA).
METHODS: This study was carried out using the data of 438 adult patients who underwent an appendectomy. Demographic details, the preoperative white blood cell (WBC) count, neutrophil/lymphocyte ratio (NLR), IGC and IG%, operation findings, and pathology results were assessed retrospectively. The patients were grouped as AA and normal appendix (NA) according to the pathology reports, and the AA cases were subdivided into SA and CA groups according to the intraoperative findings.
RESULTS: WBC, NLR, IGC, and IG% were significant parameters in the diagnosis of AA. The area under the receiver operating characteristic curve (AUROC: 0.795), sensitivity (55.5%) and specificity (96.1%) values of IGC were higher than the other parameters. All of the parameters were also significant for a CA diagnosis; however, the value of IG% in a CA diagnosis was stronger than the other parameters (IG% AUROC: 0.979, sensitivity: 94.4%, specificity: 97.9%).
CONCLUSION: The IG value is a fast, easily available, and reliable parameter in both diagnosing AA and discriminating between SA and CA.

Akut komplike apandisit tanýsýnda yeni ve erken bir belirteç: Ýmmatür granülosit

AMAÇ: Çalýþmamýzýn amacý immatür granülosit sayýsý (IGS) ve yüzdesinin (IG%) hem akut apandisit tanýsýnda hem de basit apandisit (BA) ile komplike apandisiti (KA) ayýrmadaki etkinliðini araþtýrmaktýr.
GEREÇ VE YÖNTEM: Bu çalýþma apendektomi yapýlan 438 eriþkin hasta üzerinde yapýldý. Hastalarýn demografik verileri, beyaz küre (BK) sayýmý, nötrofil/lenfosit oraný (NLO), IGS ve IG%’si, ameliyat bulgularý ve patoloji sonuçlarý geriye dönük olarak deðerlendirildi. Hastalar patoloji raporlarýna göre akut apandisit (AA) ve normal apendiks (NA) olarak, akut apandisitler de ameliyattaki bulgulara göre BA ve KA olarak gruplara ayrýldý.
BULGULAR: Beyaz küre, NLO, IGS, IG% akut apandisit tanýsýnda anlamlý parametrelerdi. Bu parametrelerin arasýnda IGS’nin AUROC, duyarlýlýk ve özgüllük deðerleri diðerlerinden daha yüksek idi. IGC için AUROC; 0.795, duyarlýlýk: %55.5, özgüllük: %96.1 idi. Tüm parametreler komplike apandisit tanýsýnda da anlamlý idi ancak IG%’nin komplike apandisit tanýsýndaki deðeri diðer parametrelerden daha güçlü idi (AUROC: 0.979, duyarlýlýk: %94.4, özgüllük: %97.9 idi.
TARTIÞMA: Ýmmatür granülosit hem akut apandisit tanýsý koymada, hem de basit ve komplike apandisiti ayýrmada hýzlý, kolay ulaþýlabilir ve güvenilir bir parametredir.