Role of mean platelet volume-to-lymphocyte ratio in the diagnosis of childhood appendicitis

Abstract

Introduction. Mean platelet volume-to -lymphocyte ratio (MPVLR) has emerged as a novel parameter of inflammation and thrombosis. The aim was to evaluate whether MPVLR has a role in the diagnosis ofchildhood appendicitis. Population and methods. Retrospectively reviewed the medical records up to 18 year with suspected acute appendicitis (AA) who underwent appendectomy between January 2016 and December 2017. Based on histopathological evaluation, the patients were classified into normal appendix, and simple andperforatedappendicitis.Preoperativemean platelet volume (MPV), platelet distribution width (PDW), MPVLR, platelet-to-lymphocyte ratio (PLR), counts of platelets and white blood cells(WBC),andC-reactiveprotein(CRP)levels were measured. Results. A total of 219 children with clinically suspectedAAwhounderwentsurgicaltreatment forappendicitiswerereviewed,and100genderage matched healthy subjects were included. Compared with the controls, the mean levels of MPVLR, PLR, WBC and CRP were significantly higherinthechildrenunderwentappendectomy (p<0.001).Thesevaluesweresignificantlyhigher insimpleappendicitisthaninnormalappendices (p<0.01). Compared with simple appendicitis, these levels were significantly higher in the childrenwithperforatedappendicitis(p<0.001). TheareaundercurvesforMPVLRandPLRwere 0.771 and 0.726 in the prediction of appendicitis and 0.693 and 0.722 in the prediction of perforation, respectively. Conclusions. Increased level of MPVLR may be valuable for aiding the diagnosis of pediatric AA. In addition it can help discriminate simple and perforated appendicitis in children.