Yu.S. Pankratova1, O.Yu. Karpukhin1,2
1Kazan State Medical University, Kazan
2Republican Clinical Hospital, Kazan
Pankratova Yuliya S. — assistant of the Department of Surgical Diseases of Kazan State Medical University
49 Butlerov Str., Kazan, 420012, Russian Federation, tel. +7-960-060-38-04, e-mail: iuliiaps@gmail.com
Abstract. Determination of the ONL index (the ratio of neutrophils to lymphocytes) is a simple, inexpensive, very popular method abroad that allows to predict the course and outcomes of a wide range of diseases. The possibility of application of ONL in the diagnosis, course prognosis and differential diagnosis of diverticular disease of the colon represents significant clinical interest.
Aim — to determine the diagnostic significance of the ONL index in complicated diverticulitis.
Material and methods. In retrospective analysis, the ONL index was evaluated in 58 patients with diverticular disease, 42 patients with colon cancer, 31 patients with inflammatory bowel diseases and 46 patients with hemorrhoidal disease, who were hospitalized in the coloproctology department of the Republican Clinical Hospital of Tatarstan for the period from 2015 to 2021.
Results. Average of ONL in patients with DD (diverticular disease) were 7,96±5,43, minimal value — 1,16, maximal — 27,42. ONL increased according to aggravation of inflammatory changes in the walls of diverticulum, its spreading beyond the bowel wall. On the contrary, decrease of ONL was marked as a result of relief of inflammation by conservative or surgical treatment, which allowed to state the tendency of decrease of the index at discharge from hospital to 2,75±1,3 (p<0,05). There was also a correlation in the prolongation of patients’ hospital treatment with high ONL indexes as a result of severe inflammatory complications. The correlation coefficient was rxy = 0,468 (p <0,05). There was a statistically significant difference in the ONL index in patients with diverticular disease and patients with cancer of the colon (p <0,05), as well as a significant difference in the ONL index between patients with diverticular disease and patients with hemorrhoidal disease (p <0,001), while the ONL index in patients with diverticular disease and patients with inflammatory bowel diseases did not demonstrate such differences (p >0,05).
Conclusion. Thus, the determination of the ONL index can be used in clinical practice not only for the diagnosis and control of the disease, but also for differential diagnosis with other diseases of the colon.
Key words: inflammatory marker, neutrophil to lymphocyte ratio index, diverticular disease.