Analysis Of The Differential Diagnosis Values Of NLR And PLR In Testicular Torsion And Epididymo-orchitis

Objective: A retrospective study was conducted to analyze the differential diagnostic value of the peripheral blood neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in patients with testicular torsion(TT)and epididymo-orchitis at emergency admission.And the value of these hematological indicators was evaluated in the diagnosis and treatment of TT,which may provid a new basis for the diagnosis of TT,thereby improving the testicular salvage rate to the greatest extent.Methods:(1)This study collected the data of 119 patients younger than 25 years old who were admitted to the First Affiliated Hospital of University of South China for acute scrotal pain within 12 hours from January 1,2012 to January 1,2022.(2)The clinical data and blood routines of the subjects were collected on admission to calculate the NLR and PLR.(3)The TT group was composed by the patients diagnosed with TT by surgical exploration;the epididymo-orchitis group was constituted by the patients who were diagnosed with epididymo-orchitis by scrotal color Doppler ultrasound and received improvement after conservative treatment.Statistical analysis was performed on the clinical data of two groups to obtain the statistically different indicators between two groups.The Receiver Operating Characteristic Curve(ROC)was constructed for the hematological indicators with statistical difference.Logistic multivariate regression analysis was used to analyze the combined indicators of hematological indicators with statistically significant differences,then constructing the ROC curve of these combined indicators and calculating their area under the curve(AUC),respectively.The optimal cut-off value,sensitivity,and specificity were calculated according to the Youden index,then evaluating whether there were significant differences in their diagnostic value for TT and epididymo-orchitis.Finally,a linear correlation analysis was performed on the correlations of statistically significant hematological index levels.Results:(1)Compared with the epididymo-orchitis group,the TT group had statistically significant differences in pain score,neutrophils,platelets,NLR,and PLR(p<0.05).These indicators were higher in the TT group than in the epididymo-orchitis group.But no significant difference was displayed in age,the onset time,BMI,affected testis,neutrophils,lymphocytes,monocytes,eosinophils,basophils,hematocrit,mean hemoglobin concentration,mean hemoglobin content,red blood cell distribution width,mean red blood cell volume,mean platelet volume,red blood cells,hemoglobin(p>0.05).(2)The AUC,optimal cut-off value,sensitivity and specificity of NLR were 0.741,9.72,42.6% and 92.3%,respectively.The AUC,optimal cut-off value,sensitivity and specificity of PLR was 0.6704,97.93,92.6%,and 36.9%,respectively.The AUC,optimal cut-off value,sensitivity and specificity of the combined index of NLR and PLR were 0.7413,0.56,46.3%,90.8%,respectively.However,there was no significant difference in the AUC of NLR,PLR and their combined indicators in pairwise comparison.(3)It was concluded that the NLR level was positively correlated with the PLR level by using linear correlation analysis to analyze correlation between NLR and PLR levels(p<0.001,r=0.632).Conclusions:NLR,PLR and their combined indicators can be used for the differential diagnosis of TT and epididymo-orchitis,and have certain reference value for guiding clinicians to distinguish TT from epididymo-orchitis.