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. 2025 May 2;30(1):350.
doi: 10.1186/s40001-025-02616-1.

The role of serum and urıne neopterın levels on the determınatıon of acute cholecystıtıs severıty

Mesut Yavaş  1 , Yunushan Furkan Aydoğdu  2 , Ramazan Kozan  3 , Cemalettin Aybay  4 , Mustafa Şare  3
Affiliations

The role of serum and urıne neopterın levels on the determınatıon of acute cholecystıtıs severıty

Mesut Yavaş et al. Eur J Med Res. .

Abstract

Objective: Acute cholecystitis (AC) is one of the most common causes of hospital admissions due to abdominal pain. Early diagnosis and prompt initiation of treatment positively impact morbidity and mortality in AC. The aim of our study was to determine serum and urine concentrations of additional biomarkers at different stages of the disease, beyond those currently used in acute cholecystitis severity staging, and to evaluate their potential inclusion as new staging parameters.

Methods: This study prospectively analyzed data from 63 patients diagnosed with acute cholecystitis and treated by the same surgical team in 2020. In patients with AC, WBC, CRP, and PCT values, as outlined in the TG18 guidelines, showed an increasing trend. These values are commonly used to determine disease stage.

Results: A correlated increase in these infectious parameters was observed as disease severity progressed. The mean S-NEO value in Stage 1-2 patients was 20.082 ± 9.517 nmol/L, while the mean U-NEO value was 3.46 ± 2.95 µmol/L. In Stage 3 patients, the mean S-NEO value was 40.92 ± 7.878 nmol/L, and the mean U-NEO value was 4.4 ± 2.42 µmol/L. The Mann-Whitney U test revealed a significant difference in S-NEO values between Stage 1-2 and Stage 3 groups (p < 0.001). However, no significant difference was observed between these groups in terms of U-NEO values (p = 0.18).

Conclusion: In patients with acute cholecystitis, S-NEO and U-NEO levels can serve as complementary biomarkers alongside existing diagnostic and staging parameters. Particularly in staging severity, S-NEO levels may play a crucial role in early diagnosis and timely initiation of treatment, given their high specificity and sensitivity at defined cut-off values.

Keywords: Acute cholecystitis; Biomarker for inflammation; Inflammatory markers in cholecystitis; Serum neopterin (S-NEO); Urine neopterin (U-NEO).

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Approval for this study was obtained from the Gazi University Faculty of Medicine Institutional Review Board Ethics Committee, and signed informed consent forms were obtained from all patients. Animal and human rights statement: All procedures performed in this study were by the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its subsequent amendments or similar ethical standards. No animal or human studies were performed by the authors for this article. Scientific responsibility statement: The authors declare that they are responsible for the scientific content of the article, including study design, data collection, analysis and interpretation, writing, part or all of the outline, preparation and scientific review of the content, and approval of the final version of the article. Consent for publication: Consent for publication was obtained from all participants. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of patient inclusion and exclusion in the study
Fig. 2
Fig. 2
ROC analysis of ınflammatory markers for acute cholecystitis severity staging
See this image and copyright information in PMC

References

    1. Yokoe M, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Gomi H, et al. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo guidelines. J Hepatobiliary Pancreat Sci. 2012;19(5):578–85. - PMC - PubMed
    1. Sekimoto M, Takada T, Kawarada Y, Nimura Y, Yoshida M, Mayumi T, et al. Need for criteria for the diagnosis and severity assessment of acute cholangitis and cholecystitis: Tokyo guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):11–4. - PMC - PubMed
    1. Mayumi T, Takada T, Kawarada Y, Nimura Y, Yoshida M, Sekimoto M, et al. Results of the Tokyo consensus meeting Tokyo guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):114–21. - PMC - PubMed
    1. Miura F, Takada T, Kawarada Y, Nimura Y, Wada K, Hirota M, et al. Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):27–34. - PMC - PubMed
    1. Friedman GD. Natural history of asymptomatic and symptomatic gallstones. Am J Surg. 1993;165(4):399–404. - PubMed

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