Application of Neutrophil CD64 Index in the Early Diagnosis of Acute Appendicitis in Children

Abstract

Objective To explore the clinical value of neutrophil CD64 index in the early diagnosis of acute appendicitis in children. Methods From December 2011 to December 2013, a total of 90 children with suspected acute appendicitis in Hospital for Women and Children of Qingdao were enrolled into this study. Neutrophil CD64 index and blood culture detections were used to diagnose acute appendicitis. And those who were diagnosed as acute appendicitis definitely by blood cultures were included into acute appendicitis group. Compare the diagnosis results of neutrophil CD64 index and blood culture detections by statistical methods. Analyze the sensitivity and specificity of neutrophil CD64 index detection. 50 cases of children with normal physical examination in our hospital during the same period were included into control group. They also received neutrophil CD64 index detection as the acute appendicitis group and both the two groups received blood routine examination. Compare the neutrophil CD64 index, C-reactive protein (CRP) and white blood cell (WBC) counts between the two groups. The study protocol was approved by the Ethical Review Board of Investigation of Hospital for Women and Children of Qingdao. Informed consent was obtained from all participants' parents. Results Among the 90 children with suspected acute appendicitis, there were 44 cases who were diagnosed as acute appendicitis definitely by blood cultures, and were included into acute appendicitis group. There were no significance differences between acute appendicitis group and control group in gender, age etc. baseline data (P>0.05). The sensitivity of neutrophil CD64 index detection was 97.73% (43/44), the specificity was 95.65% (44/46). The positive predictive value and negative predictive value were 95.56% (43/45), and 97.78% (44/45), respectively. There was no significant difference between the diagnosis results of neutrophil CD64 index and blood culture detections (P>0.05). The neutrophil CD64 index, levels of CRP and WBC counts in acute appendicitis group were significantly higher than those in control group (P<0.05). Conclusions Neutrophil CD64 index detection can be used as an effective method to diagnose and early clinical screen acute appendicitis in children for its advantages of simple and rapid diagnosis. Though the sensitivity and specificity of neutrophil CD64 index detection are slightly lower than those of blood culture detection, they both have their advantages and disadvantages, clinicians should make a reasonable choice between the two methods according to the actual situation. Key words: Neutrophil CD64 index; Blood culture; Appendicitis, acute; Early diagnosis; Child