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. 2023 Sep 22;39(1):274.
doi: 10.1007/s00383-023-05558-z.

Flow cytometric characterization of cecal appendix lymphocyte subpopulations in children: a pilot study

Javier Arredondo Montero  1   2 , Andrea Torres López  3 , Guillermina Hurtado Ilzarbe  3 , Giuseppa Antona  4 , Raquel Ros Briones  4 , Natalia López-Andrés  5 , Nerea Martín-Calvo  6   7   8
Affiliations

Flow cytometric characterization of cecal appendix lymphocyte subpopulations in children: a pilot study

Javier Arredondo Montero et al. Pediatr Surg Int. .

Erratum in

Abstract

Introduction: Scientific literature regarding the characterization of lymphocyte subpopulations of the cecal appendix is sparse, with few precedents limited to immunohistochemical techniques.

Methods: We conducted a prospective pilot study to characterize lymphocyte subpopulations of the cecal appendix in children. Participants were divided into three groups: (1) patients without histological acute appendiceal inflammation, (2) patients with histological uncomplicated acute appendicitis, and (3) patients with histological complicated acute appendicitis (gangrenous, perforated). A fresh sample of the base of the appendix was taken from all patients and a flow cytometric study was performed. Quantitative variables were compared using Kruskal-Wallis test and Mann-Whitney U test.

Results: This study included 57 patients divided into Group 1 (n = 5), Group 2 (n = 37), and Group 3 (n = 15). Median values (IQR) of the percentage of B-lymphocytes were 67.8 [66.8-68.1] in group 1, 61.15 [53.74-66.4] in group 2, and 52.1 [33-62.02] in group 3 (p = 0.02). Median values (IQR) of the percentage of NK-lymphocytes were 0.26 [0.2-0.3] in group 1, 0.55 [0.37-0.66] in group 2, and 0.84 [0.35-1.45] in group 3 (p = 0.008). Median values (IQR) of the percentage of T-lymphocytes were 31.9 [31.7-33.1] in group 1, 37.68 [32.15-45.69] in group 2, and 46.9 [37.03-67] in group 3 (p = 0.02). Pair comparisons of groups 2 and 3 also showed significant differences in the percentage of B lymphocytes (p = 0.03) and NK-lymphocytes (p = 0.02).

Conclusions: Significant differences in lymphocyte subpopulations were identified according to the histologic grade of the cecal appendix. More specifically, a lower percentage of B-lymphocytes and a higher percentage of T- and NK-lymphocytes were observed in cases of acute appendicitis. These findings must be confirmed and their etiopathogenic, diagnostic, and prognostic implications elucidated in future studies with larger sample sizes.

Keywords: B-lymphocytes; Flow cytometry; NK-lymphocytes; Pediatric acute appendicitis; T-lymphocytes.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Graphical representation of the percentage of B-lymphocytes by group. NCAA non-complicated pediatric acute appendicitis, CAA complicated pediatric acute appendicitis
Fig. 2
Fig. 2
Graphical representation of the percentage of T-lymphocytes by group. NCAA non-complicated pediatric acute appendicitis, CAA complicated pediatric acute appendicitis
Fig. 3
Fig. 3
Graphical representation of the percentage of NK-lymphocytes by the group. NCAA non-complicated pediatric acute appendicitis, CAA complicated pediatric acute appendicitis. Note the presence of outliers in groups 2 (NCAA) and 3 (CAA)
Fig. 4
Fig. 4
Graphical representation of the flow cytometric analyses performed. Top row: patient from group 1 (absence of inflammation in the cecal appendix). Middle row: patient from group 2 (NCAA). Bottom row: patient from group 3 (CAA)
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