Annals of Coloproctology

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Hyperbilirubinemia Is a Significant Indicator for the Severity of Acute Appendicitis: Young Ran Hong, Chul-Woon Chung, Jong Woo Kim, Chang Il Kwon, Dae Ho Ahn, Sung Won Kwon, Seong Ki Kim; J Korean Soc Coloproctol. 2012;28(5):247-252. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.247

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27 Citations

Purpose

This study aims to reveal more effective clinical or laboratory markers for the diagnosis of acute appendicitis and to score the severity based on a sufficiently large number of patients with acute appendicitis.

Methods

We identified 1,195 patients with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 1,271 patients that underwent a laparoscopic or an open appendectomy between 2009 and 2010. A retrospective chart review of the medical records, including laboratory and histologic results, was conducted. We then analyzed the data using univariate and multivariate analyses.

Results

Among the 1,195 patients, a laparoscopic appendectomy was performed in 685 cases (57.32%), and an open appendectomy was performed in 510 cases (42.68%). The univariate analysis demonstrated significant differences for white blood cell count (P < 0.0001), segmented neutrophils (P = 0.0035), total bilirubin (P < 0.0001), and systemic inflammatory response syndrome (SIRS) score between groups (P < 0.0001). The multivariate analysis demonstrated that total bilirubin (odds ratio, 1.772; 95% confidence interval, 1.320 to 2.379; P = 0.0001) and SIRS score (odds ratio, 1.583; 95% confidence interval, 1.313 to 1.908; P < 0.0001) have statistically significant diagnostic value for perforated appendicitis.

Conclusion

Hyperbilirubinemia is a statistically significant diagnostic marker for acute appendicitis and the likelihood of perforation.

Citations

Citations to this article as recorded by

Hyperbilirubinemia and acute appendicitis: a cohort study
Harris BARTIMEUS, Ibrahim LABEDA, Julianus A. UWURATUW, Joko HENDARTO, Prihantono PRIHANTONO, Muhammad I. KUSUMA, Muhammad FARUK
Chirurgia.2025;[Epub] CrossRef
Role of immature granulocyte and blood biomarkers in predicting perforated acute appendicitis using machine learning model
Zeynep Kucukakcali, Sami Akbulut
World Journal of Clinical Cases.2025;[Epub] CrossRef
Hyperbilirubinemia as a Marker for Complicated Acute Appendicitis: A Systematic Review
Alicja Czyszczon, Bartosz Maczkowski, Aneta Tkaczyk, Marek Drozdz, Wiktoria Boral, Szymon Mikler, Magdalena Mandyna, Aleksandra Przelaskowska, Jan Pulinski
Cureus.2025;[Epub] CrossRef
Diagnostic Value of Hematological and Biochemical Markers in Pediatric Appendicitis: A ROC-Based Retrospective Evaluation
Sevgi Buyukbese Sarsu
Medical Bulletin of Haseki.2025; 63(5): 236. CrossRef
Diagnostic value of laboratory parameters for complicated appendicitis: A two‑center study
Qian Zhang, Hongwei Zhao, Fangli Wang, Wenqiang Li, Peng Zhang
Biomedical Reports.2024;[Epub] CrossRef
Letter to the Editor regarding “A novel Appendicitis TriMOdal prediction Score (ATMOS) for acute appendicitis in pregnancy: a retrospective observational study”
Rıfat Peksöz, Ferdi Cambaztepe, Sabri Selçuk Atamanalp
Updates in Surgery.2023; 75(1): 265. CrossRef
Individual biomarkers in the blood are not yet applicable in diagnosing complicated appendicitis: A scoping review
Binyamin Sikander, Jacob Rosenberg, Siv Fonnes
The American Journal of Emergency Medicine.2023; 67: 100. CrossRef
Elevated total and direct bilirubin are associated with acute complicated appendicitis: a single-center based study in Saudi Arabia
Mohammed S. Alfehaid, Ayman M. Babiker, Abdullah Hamad Alkharraz, Hamad yousef Alsaeed, Ali Abdullah Alzunaydi, Adi Abdulaziz Aldubaiyan, Hanan Abdalla Sinyan, Bshayr K. Alkhalaf, Rakan Alshuwaykan, Rehana Khalil, Osama Al-Wutayd
BMC Surgery.2023;[Epub] CrossRef
Significance of laboratory parameters in diagnosing acute appendicitis during pregnancy
Rıfat Peksöz, Esra Dişçi, Abdulkadir Kaya, Enes Ağırman, Ercan Korkut, Nurhak Aksungur, Necip Altundaş, Salih Kara, Sabri Selçuk Atamanalp
ANZ Journal of Surgery.2022; 92(1-2): 121. CrossRef
Hyperbilirubinemia and Hyponatremia as Predictors of Complicated Appendicitis
Abdullah Shuaib, Nour Alhamdan, Husain Arian, Mohamed Alaa Sallam, Ali Shuaib
Medical Sciences.2022; 10(3): 36. CrossRef
Evaluation of role of hyperbilirubinemia as a new diagnostic marker of complicated appendicitis
Sabyasachi Bakshi, Nilay Mandal
BMC Gastroenterology.2021;[Epub] CrossRef
Clinical predictors of gangrenous appendicitis: elevated total bilirubin level and computed tomography scan findings
Itsuki Naya, Kensuke Adachi, Koichi Takeuchi, Yuno Ariyama, Akihiro Hosaka, Kazuhiro Imamura, Yasuhiro Morita, Shigeki Matsubara, Alan Kawarai Lefor, Hisanaga Horie
Acute Medicine & Surgery.2021;[Epub] CrossRef
THE UTILITY OF SERUM BILIRUBIN AS A MARKER IN ACUTE ABDOMEN
P N Sreeramulu, Shashidhar K N, Varsha A
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2021; : 16. CrossRef
Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem
Sintija Lapsa, Arturs Ozolins, Ilze Strumfa, Janis Gardovskis
Geriatrics.2021; 6(3): 93. CrossRef
Obstructive-Type Jaundice without Bile Duct Dilatation in Generalized Peritonitis Is a Specific Sign of Spontaneous Gall Bladder Perforation
Vicky Sumarki Budipramana, Maria Meilita
Case Reports in Medicine.2020; 2020: 1. CrossRef
Diagnostic accuracy of procalcitonin for overall and complicated acute appendicitis in children: a meta-analysis
Wei Cui, Haipeng Liu, Hong Ni, Xianhui Qin, Liran Zhu
Italian Journal of Pediatrics.2019;[Epub] CrossRef
A Prospective Study to Evaluate the Role of Serum Bilirubin in Acute Appendicitis
Siva Kumar Puligundla, Gandikota Venkata Prakash, Ajay Babu, Boddukura Sahithi Priya, Sreedhar Sreedhar, Anugna Anugna, Sumesh Raja, Tejaswi S.
Journal of Evidence Based Medicine and Healthcare.2019; 6(48): 3039. CrossRef
Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital
Seerwan Hama Shareef, Dara Ahmed Mohammed, Goran Ameer Ahmed
Kurdistan Journal of Applied Research.2018; : 15. CrossRef
Lack of utility of measuring serum bilirubin concentration in distinguishing perforation status of pediatric appendicitis
William Bonadio, Santina Bruno, David Attaway, Logesh Dharmar, Derek Tam, Peter Homel
The American Journal of Emergency Medicine.2017; 35(6): 885. CrossRef
Hyperbilirubinaemia: its utility in non‐perforated appendicitis
Anna Sandstrom, David A. Grieve
ANZ Journal of Surgery.2017; 87(7-8): 587. CrossRef
Biomarkers of acute appendicitis: systematic review and cost–benefit trade-off analysis
Amish Acharya, Sheraz R. Markar, Melody Ni, George B. Hanna
Surgical Endoscopy.2017; 31(3): 1022. CrossRef
Hyperbilirubinaemia alone cannot distinguish a perforation in acute appendicitis
Fábio R. Silva, Maria Inês da Rosa, Bruno R. Silva, Carla Simon, Maria Cecília Alexandre, Lidia R. Medeiros, Fabrício S. Bitencourt, Maria Eduarda Fernandes dos Reis
ANZ Journal of Surgery.2016; 86(4): 255. CrossRef
Predictive value of abnormally raised serum bilirubin in acute appendicitis: A cohort study
A.C. Chambers, S.L. Bismohun, H. Davies, P. White, A.V. Patil
International Journal of Surgery.2015; 13: 207. CrossRef
Diagnostic markers in acute appendicitis
Yahya A. Al-Abed, Nasser Alobaid, Fiona Myint
The American Journal of Surgery.2015; 209(6): 1043. CrossRef
Diagnostic accuracy of hyperbilirubinaemia in anticipating appendicitis and its severity
Sven Muller, Claudius Falch, Steffen Axt, Peter Wilhelm, Dirk Hein, Alfred Königsrainer, Andreas Kirschniak
Emergency Medicine Journal.2015; 32(9): 698. CrossRef
Serum total bilirubin elevation is a predictor of the clinicopathological severity of acute appendicitis
Satoshi Nomura, Masanori Watanabe, Osamu Komine, Takeshi Shioya, Tetsutaka Toyoda, Hideki Bou, Tetsuo Shibuya, Hideyuki Suzuki, Eiji Uchida
Surgery Today.2014; 44(6): 1104. CrossRef
Elevated serum bilirubin in assessing the likelihood of perforation in acute appendicitis: A diagnostic meta-analysis
Salvatore Giordano, Markus Pääkkönen, Paulina Salminen, Juha M. Grönroos
International Journal of Surgery.2013; 11(9): 795. CrossRef

Relationship between Metabolic Syndrome and MTHFR Polymorphism in Colorectal Cancer: Bong Su Kang, Dae Ho Ahn, Nam Keun Kim, Jong Woo Kim; J Korean Soc Coloproctol. 2011;27(2):78-82. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.78

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33 Download
18 Citations

Abstract PDF

Purpose

There have been studies on the relations between metabolic syndrome and colorectal cancer or on the relations between methylenetetrahydrofolate reductase (MTHFR) polymorphism and colorectal cancer, but reports on the relationship between metabolic syndrome, MTHFR polymorphism and colorectal cancer all together are rare. The aim of this study is to find the interrelation between metabolic syndrome and MTHFR polymorphism in colorectal cancer.

Methods

This study investigated 255 colorectal cancer patients (cancer group) who underwent surgery in our hospital from March 2003 to December 2008 and compared those patients to 488 healthy patients (control group). The diagnostic criterion for metabolic syndrome was based on the National Cholesterol Education Program-Adult Treatment Panel III (NCEP ATP III), and the MTHFR 677 polymorphism was analyzed.

Results

When colorectal cancer patients and patients in the control group were classified as MTHFR 677 subtypes, there was no difference between the two groups: CC 87 (34.1%), CT 134 (52.6%), and TT 34 (13.3%) for the cancer group and CC 145 (32.4%), CT 238 (53.1%), and TT 65 (14.5%) for the control group. Distributions of MTHFR 677C/T genotype and allele frequencies in the individuals with and without metabolic syndrome in the cancer group showed no differences. Moreover, we could find no differences in distributions of MTHFR 677C/T genotypes in the clinical and the biomedical variables of individuals with and without metabolic syndrome in the cancer group.

Conclusion

Our results show no relation between metabolic syndrome and MTHFR polymorphism in colorectal cancer. However, a further prospective study, based on a precise diagnostic criterion for metabolic syndrome, is needed.

Citations

Citations to this article as recorded by

Meta Analysis of Methylenetetrahydrofolate Reductase (MTHFR) C677T polymorphism and its association with folate and colorectal cancer
Meng Ye, Guojie Xu, Liming Zhang, Zhihui Kong, Zhenhua Qiu
BMC Cancer.2025;[Epub] CrossRef
Unveiling the link: Evaluating MTHFR gene polymorphisms and colorectal cancer risk through meta-analysis
Yu-wei Wang, Ze-yi Huang, Chen-xue Jin, Xiao-hui Shen, Xiao-feng He, Chang-qing Yang, Mohammad Safiqul Islam
PLOS One.2025; 20(7): e0305517. CrossRef
Prognostic significance of three endothelial nitric oxide synthase (eNOS) polymorphisms and metabolic syndrome (MetS) in patients with colorectal cancer
Eun Ju Ko, Eo Jin Kim, Hye Jung Cho, Jisu Oh, Han Sung Park, Chang Soo Ryu, Jung Oh Kim, Hak Hoon Jun, So Young Chong, Jong Woo Kim, Nam Keun Kim
Genes & Genomics.2022; 44(6): 659. CrossRef
Associations of MTRR and TSER polymorphisms related to folate metabolism with susceptibility to metabolic syndrome
Young Ree Kim, Seung-Ho Hong
Genes & Genomics.2019; 41(8): 983. CrossRef
Association of MTHFR C677T gene polymorphism with metabolic syndrome in a Chinese population: a case–control study
Jin Wang, Lijuan Xu, Hongmiao Xia, Ying Li, Shiqi Tang
Journal of International Medical Research.2018; 46(7): 2658. CrossRef
Methylenetetrahydrofolate reductase C677T polymorphism and colorectal cancer susceptibility: a meta-analysis
Lingyan Xu, Zhiqiang Qin, Feng Wang, Shuhui Si, Lele Li, Peinan Lin, Xiao Han, Xiaomin Cai, Haiwei Yang, Yanhong Gu
Bioscience Reports.2017;[Epub] CrossRef
Associations of MTHFR C677T polymorphism with insulin resistance, results of NURSE Study (Nursing Unacquainted Related Stress Etiologies)
Motahareh Kheradmand, Zhila Maghbooli, Sedigheh Salemi, Mahnaz Sanjari
Journal of Diabetes & Metabolic Disorders.2017;[Epub] CrossRef
Association between methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism and risk of ischemic stroke in North Indian population: A hospital based case–control study
Amit Kumar, Shubham Misra, Anjali Hazarika, Pradeep Kumar, Ram Sagar, Abhishek Pathak, Kamalesh Chakravarty, Kameshwar Prasad
Egyptian Journal of Medical Human Genetics.2016; 17(4): 359. CrossRef
Risk of prostate cancer and thrombosis-related factor polymorphisms
SOMAYEHSADAT GHASEMI, AYDIN TAVAKOLI, MOHAMAD MOGHADAM, MOHAMAD ALI ZARGAR, MARYAM ABBASPOUR, NASIM HATAMNEJADIAN, AHMAD EBRAHIMI
Biomedical Reports.2014; 2(1): 53. CrossRef
The methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and tumor risk: evidence from 134 case–control studies
Min Tang, Shang-Qian Wang, Bian-Jiang Liu, Qiang Cao, Bing-Jie Li, Peng-Chao Li, Yong-Fei Li, Chao Qin, Wei Zhang
Molecular Biology Reports.2014; 41(7): 4659. CrossRef
Associations of MTHFR C677T and MTRR A66G Gene Polymorphisms with Metabolic Syndrome: A Case-Control Study in Northern China
Boyi Yang, Shujun Fan, Xueyuan Zhi, Da Wang, Yongfang Li, Yinuo Wang, Yanxun Wang, Jian Wei, Quanmei Zheng, Guifan Sun
International Journal of Molecular Sciences.2014; 15(12): 21687. CrossRef
Association of MTHFR C677T polymorphisms and colorectal cancer risk in Asians: evidence of 12,255 subjects
X.-P. Guo, Y. Wang, H. Zhao, S.-D. Song, J. Zhou, Y. Han
Clinical and Translational Oncology.2014; 16(7): 623. CrossRef
Association of methylenetetrahydrofolate reductase C677T and A1298C polymorphisms with colorectal cancer risk: A meta-analysis
MENGMENG ZHAO, XUELIAN LI, CHENGZHONG XING, BAOSEN ZHOU
Biomedical Reports.2013; 1(5): 781. CrossRef
The 677C>T (rs1801133) Polymorphism in the MTHFR Gene Contributes to Colorectal Cancer Risk: A Meta-Analysis Based on 71 Research Studies
Zan Teng, Lei Wang, Shuang Cai, Ping Yu, Jin Wang, Jing Gong, Yunpeng Liu, Rossella Rota
PLoS ONE.2013; 8(2): e55332. CrossRef
MTHFR C677T polymorphism contributes to colorectal cancer susceptibility: evidence from 61 case–control studies
Xuewen Sheng, Yanxi Zhang, Erjiang Zhao, Su Lu, Xiaoli Zheng, Hong Ge, Weiquan Lu
Molecular Biology Reports.2012; 39(10): 9669. CrossRef
MTHFR C677T Polymorphism and Colorectal Cancer Risk in Asians, a Meta-analysis of 21 Studies
Zhen Yang, Xie-Fu Zhang, Hong-Xiang Liu, Yong-Shun Hao, Chun-Lin Zhao
Asian Pacific Journal of Cancer Prevention.2012; 13(4): 1203. CrossRef
Quantitative assessment of the association between MTHFR C677T polymorphism and colorectal cancer risk in East Asians
Shan Zhong, Jia-He Yang, Kai Liu, B. H. Jiao, Zhi-Jie Chang
Tumor Biology.2012; 33(6): 2041. CrossRef
Metabonomic Variations Associated with AOM-Induced Precancerous Colorectal Lesions and Resveratrol Treatment
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