The Study About NLR And PLR To The Diagnostic Value Of Clinicopathological Classification In Adult With Acute Appendicitis

Objective To investigate the relationship among neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR) with clinicopathological classification of patients with acute appendicitis(AA) and its clinical significance.Methods The present study selected 353 patients who underwent appendicectomy presented with acute appendicitis from January 2012 to August 2015. All patients were confirmed by pathology finally, and 50 cases of healthy adults in the same period. AA patients were divided into acute simple appendicitis group (Al), acute cellular appendicitis group (A2), acute gangrenous appendicitis group (A3); healthy adults group (B).The routine blood test results were collected preoperation and calculated the NLR and PLR. To analyse the relationship among the NLR,PLR and the pathological type of AA.Results 1.The NLR and PLR of A group were significantly higher than that of the B group (P< 0.0001); the data of NLR and PLR in A group were statistically significant difference (P<0.0001);the NLR were significant difference (P<0.0001) among the A1-A3 groups; the PLR were statistically significant difference (P< 0.0001) between A1 and A3 grous. The PLR were no difference between Al and A2 groups, and A2 and A3 groups (all P>0.017).2.1n A1-A3 groups,the area under the ROC curve of NLR were 0.707,0.952 and 0.972, and PLR were 0.737,0.791 and 0.829, respectively;compared with the healthy group,there were significant differences in A1-A3 groups (all P<0.0001).3. The cut-off value of NLR was 1.63,4.97 and 5.89 in A1-A3 groups, and the sensitivity were 52.08%,89.51% and 96.88%,and the specificity were 68.55%,98% and 98%(all P<0.0001),respectively. The cut-off value of PLR was 81.63,131.78 and 184.54; the sensitivity was 41.35%,53.23% and 60.42%,all of the specificity were 100%;(all P<0.00015).Conclusion We suggest that the preoperative NLR and PLR are useful parameters to differentiate among simple appendicitis, cellular appendicitis and gangrenous appendicitis; NLR has better diagnostic sensitivity than PLR in acute appendicitis.