Study Objective

To determine clinical and laboratory characteristics of ovarian torsion (OT; n = 28) compared with a non-OT control (OC; n = 64) group.

Design

Retrospective single-center review performed between January 2006 and December 2016.

Setting

Academic department of pediatric surgery.

Participants and Interventions

Postoperative diagnosis of pediatric ovarian pathology (International Classification of Diseases, 10th Revision code N83) in 88 patients who underwent 92 surgeries for suspected OT, aged from 3 days to 17.8 years.

Main Outcome Measures

Predictive value for OT according to biometric, procedural, and laboratory parameters at the time of admission.

Results

Compared with OC, OT in patients aged older than 1 year was associated with elevated values regarding white blood cell count, neutrophils, neutrophil to lymphocyte ratio (NLR; all P < .001), platelet to lymphocyte ratio (PLR; P = .003), platelets (P = .011), and a trend toward raised C-reactive protein (P = .054), whereas lymphocytes and lymphocyte to C-reactive protein ratio (both P < .001) were decreased. Using receiver operating characteristic analysis for differentiating OC from OT, besides lymphocytes and NLR (both area under the curve > 0.9), PLR elicited strongest discriminatory accuracy (area under the curve = 0.946 ± 0.037; P < .001; sensitivity 82%; specificity 90%). At binary logistic regression analysis PLR (P = .018) was independently predictive of OT. OT was suspected on ultrasound imaging in 15/18 (83%), showed a right-sided dominance in 13/18 (72%), and was associated with younger age (P = .003). No differences regarding laboratory or procedural parameters in patients aged younger than 1 year were discerned.

Conclusion

Blood count indices such as PLR, NLR, and lymphocyte to C-reactive protein ratio might be helpful in identification of inflammatory processes as induced by ischemia in OT. Together with ultrasound and clinical features, these parameters constitute potential predictors of OT in girls aged older than 1 year.

中文翻译：

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中性粒细胞与淋巴细胞的比例和血小板与淋巴细胞的比例可能预测小儿卵巢扭转：单机构经验和文献综述

研究目的

为了确定卵巢扭转（OT； n = 28）与非OT对照组（OC； n = 64）组的临床和实验室特征。

设计

在2006年1月至2016年12月之间进行了回顾性单中心回顾。

环境

小儿外科学术系。

参与者与干预

对88例因可疑OT接受了92例手术的小儿卵巢病理（国际疾病分类，第10修订版代码N83）进行术后诊断，年龄从3天到17.8岁。

主要观察指标

入院时根据生物特征，程序和实验室参数得出的OT预测值。

结果

与OC相比，1岁以上患者的OT与白细胞计数，中性粒细胞，中性粒细胞与淋巴细胞比率（NLR；所有P  <.001），血小板与淋巴细胞比率（PLR；P  = 0.003 ）的升高相关。），血小板（P =  .011）和C反应蛋白升高的趋势（P  = .054），而淋巴细胞和淋巴细胞与C反应蛋白的比率 均下降（均P <.001）。使用接收器工作特性分析来区分OT和OC，除淋巴细胞和NLR（曲线下的面积均大于0.9）之外，PLR产生的辨别力最强（曲线下的面积= 0.946±0.037；P <.001; 敏感度82％；特异性90％）。在二元逻辑回归分析中，PLR（P  = .018）独立预测OT。超声检查怀疑OT占15/18（83％），右侧占13/18（72％），并且与年龄较小有关（P  = .003）。未发现1岁以下患者在实验室或手术参数方面存在差异。

结论

血细胞计数指数（如PLR，NLR和淋巴细胞与C反应蛋白之比）可能有助于鉴定OT缺血引起的炎症过程。结合超声和临床特征，这些参数构成了1岁以上女孩中OT的潜在预测指标。