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

Abstract EN

Objective: 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. Methods: 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, gangrenous).

The histopathological results were correlated with CRP and IL-6 values statistically. Results: 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 (28%) in group three.

Serum IL-6 and CRP values gave true negative results in 6% and 10% respectively, true positive results in 82% and 32% respectively, false negative results in 4% and 54% 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. Conclusions: 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.