Evaluation of Diagnostic Value of Neutrophil-Lymphocyte Ratio in Acute and Complicated Appendicitis of Adults

Introduction & The neutrophil-lymphocyte ratio test has extensive application in diagnosis of appendicitis، but its accuracy has some contraversies. According to the importance of this disease and to determin the efficiency of this test، this study was done on adults who referred to Shahid Beheshti hospital of Kashan in 2008، with diagnosis of appendicitis. In this descriptive-analytic study، blood for measurement of CBC & diffrentiation was collected pre-operatively from 106 patients. The patients according to the histopathology of the appendix were divided in two groups; to positive (acute and complicated Appendicitis) and negative (normal) and the ratio of Neutrophiles to Lymphocits، compared in two groups. In this study، 106 patients with suspicious diagnosis of acute appendicitis were studied. Out of a total 106 patients، 94 patients (88. 7%) had positive appendicitis. WBC count was 12798±4181 mm3 in positive appendectomies and 10561±5699 mm3 in negative group (P=0. 03). Neutrophil percent was 80±36 % in positive group and 66 ±11% in negative group (P=0. 005). Lymphocyte percent was 15±9% in positive group and 24 ±11% in negative group (P=0. 013). Neut/Lym ratio percent was 7±5 in positive group and 4 ±3 in negative group (P=0. 01). Neut/Lym ratio /8% were males and 38. 1% were females، Male to female ratio being 1. 6:1. On histological examination، 86. 9% had acute appendicitis whereas 13. 1% had normal appendix. Sensitivify، Specificity، Positive predictive Vulue and negative predictive value of Neut/Lym ratio test was respectively: 74%، 67%، 94%، 25% the area under the ROC Curve was 0. 730. The Neut/Lym ratio test، in spite of significant difference doesn''t have necessary efficiency in diagnosis of acute and complicated appondicitis.