Comparison between the diagnostic values of serum inflammatory markers, interleukin-6 and C-reactive protein in detection the severity of acute appendicitis

ABSTRACT

The aim of this study was to compare the diagnostic values of serum inflammatory markers, C-reactive protein [CRP] and interleukin-6 [IL-6] in detection the severity of acute appendicitis. This is a prospective study from December 2008 to March 2009 included all patients who had appendectomy in Department of Surgery. Al-Kindy Teaching Hospital - Baghdad/ Iraq. Serum for estimating levels of C-reactive protein [CRP] and interleukin-6 [IL-6] was taken pre-operatively. Depending on the macroscopic evidence during the operation and the histopathological examination of the specimens, the patients were separated into 3 groups, group one with negative appendectomy [normal appendix], group two with non-complicated acute appendicitis [catarrhal, suppurative], and group three with complicated acute appendicitis [perforated, angrenous]. The histopathological results were correlated with CRP and IL-6 values statistically. A total number of 50 patients were included in this study, 28 males [56%] and 22 females [44%]. The mean age was 23 years [ranged from 7 to 50]. On the macroscopic evidence during the operation and the histopathological examination of the specimen, there were 7 patients [14%] in group one, 29 patients [58%] in group two, and 14 patients [285] in group three. Serum IL-16 and CRP values gave true negative results in 6% and 10% respectively, true positive results in 82% and 32% respectively, false negative results in 82% and 32% respectively, and false positive results in 8% and 4% respectively. Therefore, in the present study the sensitivity, specificity, and accuracy of serum IL-6 were calculated as 95.34%, 42.85%, and 88% respectively, and the sensitivity, specificity, and accuracy of CRP values were calculated as 37.20%, 77.42%, and 62% respectively. Laboratory results should be considered to be integrated within the clinical assessment. If used critically, CRP and IL-6 can provide surgeons with complementary information in discerning the necessity for urgent operation