Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis

Background Acute cholecystitis (AC) is a common condition in emergency departments (EDs), where timely diagnosis and severity assessment are critical for treatment decisions and outcome prediction. Methods This study included 194 patients with AC to evaluate the diagnostic and severity-grading performance of procalcitonin (PCT) and C-reactive protein (CRP). Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for discriminating between severity grades according to the Tokyo Guidelines. Results Elevated levels of PCT and CRP were observed in 73.2 and 67% of cases, respectively. PCT demonstrated a sensitivity of 75.6% and specificity of 64.8% at a cut-off value of ≤ 0.595 ng/mL for distinguishing grade I from grades II to III. For differentiating grade III from grades I to II, PCT showed a sensitivity of 62.5% and specificity of 92.1% at a cut-off value of ≥5.095 ng/mL. Similarly, CRP had a sensitivity of 82.9% and specificity of 64.8% at a cut-off value of ≤78 mg/L for grade I versus grades II to III, and a sensitivity of 62.5% and specificity of 69.7% at a cut-off value of ≥82.5 mg/L for grade III versus grades I to II. Conclusion Both PCT and CRP are valuable biomarkers for diagnosing AC and assessing its severity.