The Relationship Between Neutrophil-to-Lymphocyte Ratio And Pathological Classification Of Cholecystitis

Objective:To investigate the relationship between Neutrophil-to-lymphocyte ratio and the pathological classification of Cholecystitis,and provide a new inflammation index for predicting the severity of Cholecystitis before surgical operation.Methods:Clinical data of patients who underwent cholecystectomy by hepatomegaly surgery of our hospital and and their postoperative pathological diagnose were Cholecystitis during September,2014 to December,2016 were analyzed.According to the clinical pathological type,the patients were divided into the simple Cholecystitis group(group A1)and severe Cholecystitis group(group A2).The diagnoses contained in group A2 were Perforated Cholecystitis,gangrenous Cholecystitis and xanthogranulomatous Cholecystitis.50 healthy subjects were selected as the control group(group B).The NLR ratio was calculated according to the results of routine blood tests of patients in each group and analyze the correlation of NLR ratio to the pathological type of Cholecystitis.Results:246 patients of 346 belong to group A1(71.1%)and 100 belong to A2(28.9%).NLR data of group Al:area under the ROC curve shows AUC=0.758,95%CI 0.373-0.771,When the Jorden index is the largest,cut-off=2.4561,AUC=0.758,sensitivity is 68.9%,specificity is 76.3%,significantly higher than group B(P<0.0001).NLR data of group A1 and A2:the area under the ROC curve of group A1 shows AUC=0.723,95%CI 0-0.661.When the Jorden index is the largest,cut-off=2.2122,sensitivity is 50.8%,specificity is 92.0%.Area under the ROC curve of group A2 shows AUC=0.794,95%CI 0.746?0.842.When the Jorden index is the largest,cut-off=2.700,sensitivity is 87%,specificity is 60.6%.The difference was significant in statistics(P<0.0001).The sensitivity and specificity of predicting severe Cholecystitis are 87%and 60.6%when NLR?2.7.Multiple-factor analysis shows that age>51.23(OR=2.234,CI 1.249-3.417,P<0.0001),NLR?2.7(OR=1.793,CI 1.236-2.798,P<0.0001)and emergency hospitalization(OR=0.005,CI 1.171-2.597,P=0.362)are the factors that prolong the hospital stay.Conclusion1.Preoperative NLR can be used as an indicator of the severity of Cholecystitis.2.Age,NLR>2.7 and emergency hospitalization are relevant factors that prolong the hospital stays.