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A novel combined neutrophil-platelet score for diagnosing complicated appendicitis: a retrospective and prospective
Xiang Li1,2, Jiangshun Yang1, Dengyang Fang1
1Chongqing University - Chongqing University Fuling Hospital - Department of Gastrointestinal Surgery - Chongqing - China.
Insights
The combined neutrophil-platelet score (CNPS) effectively diagnoses and predicts complicated appendicitis, outperforming the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). This new inflammatory marker shows significant clinical utility.
Area of Science:
- Surgical pathology
- Inflammatory markers
- Diagnostic accuracy
Background:
- Complicated appendicitis diagnosis relies on clinical and imaging findings.
- Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are investigated as potential inflammatory markers.
- Novel scoring systems may improve diagnostic and predictive capabilities.
Purpose of the Study:
- To evaluate the diagnostic and predictive performance of NLR and PLR for complicated appendicitis.
- To introduce and assess a novel combined neutrophil-platelet score (CNPS) as an inflammatory marker.
- To determine the clinical utility of CNPS in diagnosing and predicting complicated appendicitis.
Main Methods:
- Retrospective analysis of clinicopathological data from appendectomy patients.
- Evaluation of diagnostic performance using receiver operating characteristic (ROC) curves and area under the curve (AUC).
- Multivariate logistic regression to identify independent risk factors; prospective validation of CNPS.
Main Results:
- Multivariate analysis identified onset time and NLR as independent risk factors; PLR was not significant.
- CNPS demonstrated superior diagnostic and predictive performance compared to NLR and PLR.
- Prospective validation showed an AUC of 0.707 for CNPS in predicting complicated appendicitis.
Conclusions:
- The combined neutrophil-platelet score (CNPS) exhibits high diagnostic and predictive value for complicated appendicitis.
- CNPS serves as a valuable tool for the diagnosis and prediction of complicated appendicitis.
- The study highlights the potential of CNPS in clinical practice for managing appendicitis.
Purpose:
We investigated the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) and combined them to create an inflammatory marker, the combined neutrophil-platelet score (CNPS), to serve as a diagnostic and predictive tool for complicated appendicitis.
Methods:
A retrospective analysis was conducted on the clinicopathological data of patients who underwent appendectomy. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the diagnostic performance of various inflammatory parameters. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for complicated appendicitis. A prospective study was then carried out to validate the clinical utility of the CNPS.
Results:
In total, 322 patients were included in the retrospective analysis. Multivariate analysis identified only onset time and NLR as independent risk factors for complicated appendicitis, whereas the PLR was not. CNPS demonstrated superior diagnostic and predictive performance for complicated appendicitis compared to NLR and PLR. Moreover, after adjusting for confounders, CNPS remained an independent risk factor for complicated appendicitis. In the prospective study, 264 patients were included for analysis, and the AUC of CNPS for predicting complicated appendicitis was 0.707.
Conclusion:
The CNPS, combining NLR and PLR, demonstrates high diagnostic and predictive value for complicated appendicitis.
