Chitotriosidase and Neopterin as Potential Biomarkers for the Evaluation of Complicated Cholecystitis—A Pilot Study

Author:

Nechita Vlad-Ionuţ12,Hajjar Nadim Al23,Drugan Cristina4ORCID,Cătană Cristina-Sorina4,Moiş Emil23,Nechita Mihaela-Ancuţa5,Graur Florin23ORCID

Affiliation:

1. Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str. No. 6, 400349 Cluj-Napoca, Romania

2. Octavian Fodor Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania

3. Department of Surgery, Iuliu Hațieganu University of Medicine and Pharmacy, Croitorilor Str. No. 19–21, 400162 Cluj-Napoca, Romania

4. Department of Medical Biochemistry, Iuliu Haţieganu University of Medicine and Pharmacy, Louis Pasteur Str. No. 6, 400349 Cluj-Napoca, Romania

5. Ion Chiricuță Oncology Institute, Republicii Str. No. 34–36, 400015 Cluj-Napoca, Romania

Abstract

Gallstones are a common surgical pathology. Laparoscopic cholecystectomy represents the elective treatment. Complicated cases can increase the rate of conversion, the duration, and the difficulty of the intervention, along with the hospitalization period. A prospective cohort study was conducted on 51 patients with gallstones. Only subjects with normal renal, pancreatic, and hepatic functions were included. The severity of cholecystitis was evaluated by considering the ultrasound examination, intraoperative findings, and pathology report. We evaluated two potential biomarkers, namely neopterin and chitotriosidase, by comparing their levels before and after the intervention for chronic (n = 36) and complicated (n = 15) cases, as well as their eventual association with the hospitalization period. Subjects with complicated cholecystitis had significantly higher (p = 0.01) neopterin levels at presentation (16.82 nmol/L vs. 11.92 nmol/L, median values), but the differences in chitotriosidase activity between complicated (170.00 nmol/mL/h) and chronic (160.00 nmol/mL/h) cases were not significant (p = 0.66). Patients with neopterin levels above the cut-off value 14.69 nmol/L had a 3.34 times higher risk of complicated cholecystitis. Twenty-four hours after the laparoscopic cholecystectomy, the differences in neopterin level and chitotriosidase activity between chronic and complicated cases were not significant. A significant decrease in chitotriosidase activity was observed after the intervention, only for complicated cases (190 nmol/mL/h vs. 145 nmol/mL/h, p = 0.007); for neopterin, the postoperative decrease was not statistically significant (19.42 nmol/L vs. 10.92 nmol/L, p = 0.06). No significant association with the hospitalization period was observed. Neopterin may be a useful biomarker for complicated cholecystitis, and chitotriosidase may have prognostic utility in early patient follow-up.

Funder

“Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania, Doctoral Research Program

Publisher

MDPI AG

Subject

General Medicine

Reference29 articles.

1. Sorrentino, S.A. (2022, November 27). Gallstones. Radiology Reference Article. Available online: https://radiopaedia.org/articles/gallstones-1.

2. Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer;Stinton;Gut Liver,2012

3. Asymptomatic Cholelithiasis: Is Cholecystectomy Really Needed? A Critical Reappraisal 15 Years after the Introduction of Laparoscopic Cholecystectomy;Sakorafas;Dig. Dis. Sci.,2007

4. Gallbladder Stones: Imaging and Intervention;Bortoff;Radiographics,2000

5. Hassler, K.R., Collins, J.T., Philip, K., and Jones, M.W. (2022). Laparoscopic Cholecystectomy, StatPearls Publishing.

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