目的:探讨单核细胞计数在预测儿童睾丸扭转睾丸存活的价值,并分析其他血液学标志物如平均血小板体积(mean platelet volume,MPV)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)和血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)的预测能力.方法:回顾性分析2016年12月-2024年3月在江南大学附属儿童医院接受紧急睾丸扭转手术的85例患儿的临床资料.采用独立样本t检验、多因素lo-gistic 回归分析和受试者工作特征(receiver operating characteristic,ROC)曲线及其曲线下面积(area under the curve,AUC)分析评估包括单核细胞计数、MPV、NLR和PLR在内的血液学参数的预测准确性.结果:患儿根据手术方式分为睾丸切除组(36例)和睾丸固定组(49例),平均年龄分别为(120.27±59.60)个月和(139.06±38.60)个月.2组的症状持续时间和睾丸的扭转程度比较差异均有统计学意义(P＜0.05).单核细胞计数与睾丸切除显著相关(OR=350.18,P=0.018),最佳截断值为0.59 × 109/L(AUC=0.880).扭转程度也是关键预测因素(OR=1.006,P=0.029),最佳截断值为420°(AUC=0.767).相比之下,MPV、NLR和PLR的预测可靠性不足.结论:单核细胞计数是预测儿童睾丸扭转患者是否需要睾丸切除的可靠生物标志物,尤其在结合扭转程度时.MPV、NLR和PLR在此方面的实用性有限,建议重新评估这些指标在预测睾丸存活方面的作用.
Predictive value of monocyte counts in pediatric testicular torsion outcomes
Objective:To investigate the predictive value of monocyte counts for testicular survival outcomes in pedi-atric patients with testicular torsion,alongside other hematological markers such as mean platelet volume(MPV),neutro-phil-to-lymphocyte ratio(NLR),and platelet-to-lymphocyte ratio(PLR).Methods:Data from 85 pediatric patients un-dergoing emergency testicular torsion surgery at Affiliated Children's Hospital of Jiangnan University from December 2016 to March 2024 were retrospectively analyzed.The study utilized multivariate logistic regression and receiver operating characteristic(ROC)curve and area under the curve(AUC)analyses to assess the predictive accuracy of hematological pa-rameters including monocyte counts,MPV,NLR,and PLR.Results:The study divided patients into orchiectomy(n=36,mean age 120.27±59.60 months)and orchiopexy(n=49,mean age 139.06±38.60 months)groups.Symptom duration significantly differed,correlating with the severity of torsion.Monocyte counts showed a significant association with orchiectomy,with an OR of 350.18(P=0.018)and an optimal threshold of 0.59 × 109/L(AUC=0.880).The degree of torsion was also a critical predictor,with an OR of 1.006 per degree increase(P=0.029),and an optimal threshold of 420 degrees yielding an AUC of 0.77.Conversely,MPV,NLR,and PLR demonstrated inadequate predic-tive reliability with insufficient AUC values.Conclusion:Monocyte count is a reliable biomarker for predicting the need for orchiectomy in pediatric testicular torsion,particularly when combined with the degree of torsion.The findings under-score the limited utility of MPV,NLR,and PLR in this clinical context,recommending their reevaluation in predicting testicular survival.
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