| dc.description.abstract | Xanthogranulomatous cholecystitis (XGC) and gallbladder carcinoma (GBC) are rare diseases with several similarities. This
study aimed to evaluate the utility of the systemic immune inflammatory index (SII), a novel index that more accurately depicts
inflammatory and immunological balance, in distinguishing between XGC and GBC. This retrospective study included 33 XGC, 22
GBC patients diagnosed according to histopathological findings and 33 age-sex-matched healthy controls at Hacettepe University
Faculty of Medicine, General Surgery Department. The demographic, clinical and laboratory findings were recorded. Neutrophil to
lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio and SII were calculated from preoperative complete
blood count parameters. The receiver operating characteristic curve was performed to evaluate the utility of SII in differentiating
GBC and XGC. A P value < .05 was accepted as statistically significant. The preoperative neutrophil to lymphocyte ratio, monocyte
to lymphocyte ratio, platelet to lymphocyte ratio and SII were significantly higher in patients with GBC compared to XGC patients
and healthy controls (P < .001, P = .001, P = .001, P < .001, respectively). When receiver operating characteristic analysis was
made, the optimal cutoff value of SII was 640 for differential diagnosis of XGC and GBC preoperatively with a sensitivity of 77.3%
and a specificity of 66.7%, among which the positive likelihood ratio was 2.32, and Youden index was 0.44 (P = .006). The positive
predictive value was 60.7%, the negative predictive value was 81.5%, and the diagnostic accuracy was 79.9%. SII may be a
valuable, practical, and affordable method to differentiate between XGC and GBC, in addition to clinical and radiological signs,
prior to surgery. When supported by prospective trials with a larger study population, distinguishing GBC from XGC using SII
preoperatively may lead to a change in the management practice of GBC. | tr_TR |
