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How do inflammatory marker dynamics shift with acute calculous cholecystitis severity?
Emre Erdoğan1, Ali Emre Naycı1, Mert Mahsuni Sevinc1
1Department of General Surgery, Istanbul Training and Research Hospital, Istanbul-Türkiye.
Summary
C-reactive protein (CRP), Neutrophil/Lymphocyte Ratio (NLR), and HLA-DR on monocytes increase with acute calculous cholecystitis severity. These markers, along with lymphocyte counts, aid in predicting disease prognosis.
Area of Science:
- Gastroenterology
- Immunology
- Clinical Pathology
Background:
- Gallstones can lead to severe complications like sepsis.
- Acute calculous cholecystitis requires understanding disease severity markers.
Purpose of the Study:
- To investigate changes in C-reactive protein (CRP) and immune cells based on acute calculous cholecystitis severity.
- To identify prognostic indicators for acute calculous cholecystitis.
Main Methods:
- Categorized patients into mild, moderate, and severe groups using Tokyo guidelines.
- Measured CRP, neutrophil, lymphocyte, T cell subsets, and monocyte HLA-DR via flow cytometry.
- Evaluated differences in immune markers across severity groups.
Main Results:
- Neutrophil count, Neutrophil/Lymphocyte Ratio (NLR), CRP, and monocyte HLA-DR expression significantly increased with cholecystitis severity.
- No significant differences in lymphocyte counts or T cell subsets were observed.
- CRP, NLR, and HLA-DR demonstrated varying sensitivity and specificity for predicting severe cholecystitis.
Conclusions:
- CRP, NLR, and HLA-DR expression on monocytes are valuable indicators of acute calculous cholecystitis severity.
- Immune cell profiles at hospital admission can inform disease prognosis.
- These markers assist clinicians in assessing patient outlook.
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