Ulus Travma Acil Cerrahi Derg. 2020; 26(6): 887-892 | DOI: 10.14744/tjtes.2020.04501

Anorektal apsede nötrofil lenfosit oraný ve trombosit lenfosit oranýnýn deðerlendirilmesi

Çaðrý Akalýn
Ordu Üniversitesi Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Anabilim Dalý, Ordu

AMAÇ: Anorektal apse (ARA) yaygýn görülen cerrahi bir durumdur. Amacýmýz ARA’da nötrofil lenfosit oraný (NLO) ve platelet lenfosit oranýný (PLO) deðerlendirmektir.
GEREÇ VE YÖNTEM: Ocak 2014–Mart 2019 tarihleri arasýnda ARA tanýlý hastalar geriye dönük olarak analiz edilip hasta grubu oluþturuldu. Kontrol grubu için saðlýklý bireyler çalýþmaya dahil edildi. Gruplarýn demografik özellikleri, tam kan sayýmý (CBC), C-reaktif protein (CRP) deðerleri olarak analiz edildi. Hastalarýn apse lokalizasyonu için bilgisayarlý tomografi sonuçlarý deðerlendirildi. CBC’teki parametrelerden beyaz küre sayýsý (WBC), NLO ve PLO deðerleri saptandý. Receiver operating characteristic (ROC) analizi ile verilerin kestirim deðerleri, duyarlýlýk ve özgüllüðü saptandý.
BULGULAR: Hasta grubunda WBC, CRP, NLO ve PLO deðerleri istatistiksel olarak anlamlý derecede yüksek saptandý (p<0.001). Hastalarýn supralevator apse lokalizasyonu ile diðer ARA lokalizasyonlarý karþýlaþtýrýldýðýnda WBC’de istatistiksel olarak anlamlý fark saptanýrken (p=0.003), CRP, NLO ve PLO’da istatistiksel olarak anlamlý fark saptanmadý (p>0.05). ROC analizinde, ARA tanýsý için, WBC’de 9.99 103/μL kestirim deðerinin %95 duyarlýlýk, %95 özgüllüðe; CRP’de 2.5 mg/dL kestirim deðerinin %88 duyarlýlýk, %95 özgüllüðe; NLO’da 3.96 cutoff deðerinin %82 duyarlýlýk, %95 özgüllüðe; PLO’da 112.84 cutoff deðerinin %71 duyarlýlýk ve %68 özgüllüðe sahip olduðu belirlendi.
TARTIÞMA: ARA tanýsýnda NLO’nun tanýya yardýmcý bir belirteç olarak kullanýlabileceðini fakat PLO’nun ise düþük sensitive ve spesiviteye sahip olduðunu düþünmekteyiz.

Anahtar Kelimeler: Anorektal apse, duyarlýlýk; nötrofil lenfosit oraný; özgüllük; trombosit lenfosit oraný.

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The evaluation of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in anorectal abscess

Çaðrý Akalýn
Deparment of General Surgery, Ordu University Training and Research Hospital, Ordu-Turkey

BACKGROUND: Anorectal abscess (ARA) is a commonly observed surgical situation. Our aim is to evaluate neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in ARA.
METHODS: From January 2014 to March 2019, patients diagnosed with ARA were retrospectively analysed, and a patient group was formed. Healthy individuals were included in this study as a control group. The demographic characteristics, completed blood count (CBC) and c-reactive protein (CRP) values of patients were analysed. Localisation of abscess in patients was assessed using computed tomography results. From CBC parameters, white blood count (WBC), NLR and PLR values were identified. The cut-off values for data, sensitivity and specificity were identified using the receiver operating curve (ROC) analyses.
RESULTS: In the patient group, WBC, CRP, NLR and PLR values were identified to be statistically significantly increased (p<0.001). When supralevator abscess localisation was compared with other ARA localisations, there was a statistically significant difference for WBC (p=0.003), but no statistically significant differences were identified for CRP, NLR and PLR (p>0.05). ROC analysis found WBC had cut-off value of 9.99 103/μL for ARA diagnosis with 95% sensitivity and 95% specificity, a CRP had 2.5 mg/dL cut-off value with 88% sensitivity and 95% specificity, NLR had a cut-off of 3.96 with a sensitivity of 82% and specificity of 95% and PLR had a cut-off value of 112.84 with a sensitivity of 71% and specificity of 68%.
CONCLUSION: We believe NLR may be used as a helpful diagnostic marker for ARA diagnosis; however, PLR has low sensitivity and specificity.

Keywords: Anorectal abscess, neutrophil to lymphocyte ratio; platelet to lymphocyte ratio; sensitivity; specificity.

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