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Background <p>Corrosive substance ingestion is a significant clinical problem in the pediatric population, with challenges in early assessment due to the inconsistent relationship between symptoms and the severity of esophageal injury. Easily accessible inflammatory biomarkers have been proposed as adjunctive tools for early clinical evaluation. This study aimed to evaluate the association between inflammatory biomarkers and symptom presence in pediatric patients with corrosive substance ingestion and to assess their discriminative performance.</p> Methods <p>This retrospective study included 213 pediatric patients (aged 0–18 years) with corrosive substance ingestion. Patients were classified according to the type of ingested substance and the presence of symptoms. Inflammatory biomarkers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV) were calculated, and their association with symptom presence was analyzed.</p> Results <p>The proportion of symptomatic patients was 8.5% (<i>n</i> = 18), with vomiting and hypersalivation being the most common symptoms. Neutrophil levels were higher (<i>P</i> = 0.016) and lymphocyte levels were lower (<i>P</i> = 0.007) in symptomatic patients, resulting in significantly elevated NLR (<i>P</i> = 0.002). PLR (<i>P</i> = 0.006), SII (<i>P</i> = 0.004), SIRI (<i>P</i> = 0.020), and PIV (<i>P</i> = 0.019) were also higher. NLR showed the best discriminative performance (AUC = 0.723; 95% CI: 0.557–0.888), with 61.1% sensitivity and 90.3% specificity at a cut-off of 2.15. Logistic regression confirmed a significant association between elevated NLR and symptom presence.</p> Conclusions <p>Inflammatory biomarkers, particularly NLR, were associated with symptom presence; however, their diagnostic or prognostic value is limited. They should not replace endoscopic evaluation. Further prospective studies are needed to validate their clinical utility.</p>

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Inflammatory biomarkers and symptom presence in pediatric corrosive substance ingestion: a retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月1日

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  • Hülya İpek,
  • Gül Doğan,
  • Mehmet Metin,
  • Nurcan Çoşkun,
  • Çağatay Evrim Afşarlar

摘要

Background

Corrosive substance ingestion is a significant clinical problem in the pediatric population, with challenges in early assessment due to the inconsistent relationship between symptoms and the severity of esophageal injury. Easily accessible inflammatory biomarkers have been proposed as adjunctive tools for early clinical evaluation. This study aimed to evaluate the association between inflammatory biomarkers and symptom presence in pediatric patients with corrosive substance ingestion and to assess their discriminative performance.

Methods

This retrospective study included 213 pediatric patients (aged 0–18 years) with corrosive substance ingestion. Patients were classified according to the type of ingested substance and the presence of symptoms. Inflammatory biomarkers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV) were calculated, and their association with symptom presence was analyzed.

Results

The proportion of symptomatic patients was 8.5% (n = 18), with vomiting and hypersalivation being the most common symptoms. Neutrophil levels were higher (P = 0.016) and lymphocyte levels were lower (P = 0.007) in symptomatic patients, resulting in significantly elevated NLR (P = 0.002). PLR (P = 0.006), SII (P = 0.004), SIRI (P = 0.020), and PIV (P = 0.019) were also higher. NLR showed the best discriminative performance (AUC = 0.723; 95% CI: 0.557–0.888), with 61.1% sensitivity and 90.3% specificity at a cut-off of 2.15. Logistic regression confirmed a significant association between elevated NLR and symptom presence.

Conclusions

Inflammatory biomarkers, particularly NLR, were associated with symptom presence; however, their diagnostic or prognostic value is limited. They should not replace endoscopic evaluation. Further prospective studies are needed to validate their clinical utility.