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Abstract：
Background Acute appendicitis (AA) is one of the most frequent causes of abdominal pain requiring emergency intervention in adults. Approximately one-third of cases present with atypical clinical symptoms. This study aims to compare the monocyte-to-lymphocyte ratio (MLR), red cell distribution width (RDW) to lymphocyte ratio (RLR), and systemic immune inflammation index (SII) with other biomarkers in distinguishing patients with and without AA. Methodology A total of 347 patients (AA 125, nonspecific abdominal pain 90, and control group 132) were enrolled in the study according to the cross-sectional study design. Receiver operating characteristic (ROC) analysis was used to determine the cutoff in diagnostic value measurements. Statistical significance was determined by the statistics of sensitivity, specificity, positive predictive value, and negative predictive value. Comparison of ROC curves of C-reactive protein (CRP), white blood cell (WBC), neutrophil count (NEU), neutrophil-to-lymphocyte ratio (NLR), MLR, and SII was evaluated with the pairwise comparison of ROC curves and 95% confidence interval. Results In detecting AA, CRP, WBC, NEU, NLR, MLR, and SII have excellent diagnostic power (area under the curve [AUC] 0.80-0.88), while RDW, lymphocyte count, monocyte (MON) count, and RLR had acceptable diagnostic power (AUC 0.70-0.77). When the power in the diagnosis of AA was compared, a significant difference was found between CRP and NEU, CRP and SII, WBC and NEU, and WBC and SII. Conclusions The diagnosis of AA remains dependent on many factors. Inflammatory biomarkers assist this process. MLR and SII may be recommended to use in diagnosing AA in adults, along with other clinical findings. RLR is adequate but not superior.
摘要：
背景急性阑尾炎（AA）是成人腹痛的最常见原因之一，需要紧急干预。大约三分之一的病例表现出不典型的临床症状。这项研究旨在比较单核细胞与淋巴细胞比率（MLR），红细胞分布宽度（RDW）与淋巴细胞比率（RLR），和全身免疫炎症指数（SII）与其他生物标志物在区分患有和不患有AA的患者中。方法根据横断面研究设计，共纳入347例患者（AA125，非特异性腹痛90例，对照组132例）。接收器工作特性（ROC）分析用于确定诊断值测量中的截止值。通过灵敏度的统计来确定统计显著性，特异性，正预测值，和阴性预测值。C反应蛋白(CRP)的ROC曲线比较,白细胞（WBC），中性粒细胞计数（NEU），中性粒细胞与淋巴细胞比率（NLR），MLR,和SII用ROC曲线和95%置信区间的成对比较进行评价。结果在检测AA，CRP,WBC,NEU,NLR,MLR,和SII具有出色的诊断能力（曲线下面积[AUC]0.80-0.88），而RDW,淋巴细胞计数,单核细胞（MON）计数，和RLR具有可接受的诊断能力（AUC0.70-0.77）。当比较AA的诊断能力时，CRP和NEU之间存在显着差异，CRP和SII，WBC和NEU,WBC和SII.结论AA的诊断仍取决于多种因素。炎性生物标志物有助于这一过程。MLR和SII可能被推荐用于诊断成人AA，以及其他临床发现。RLR是足够的，但不是优越的。
