Prognostic importance of Galectin-3 levels in acute cholecystitis

Acute cholecystitis (AC) is the inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct due to gallstones. Clinically, it presents with symptoms such as abdominal pain, fever, and a positive Murphy's sign. Diagnosis is based on the combined evaluation of clinical presentation, laboratory tests, and imaging findings. The primary approach to treatment is laparoscopic cholecystectomy; however, in high-risk patients, conservative management strategies including drainage and antibiotic therapy may be employed. Galectin-3, a member of the β-galactoside-binding lectin family, plays roles in various intracellular and extracellular immunological processes. This protein, which can be localized in the cytoplasm, nucleus, mitochondria, and extracellular matrix, is involved in apoptosis regulation, cell growth, phagocytic activity, and macrophage activation. Elevated serum levels of Galectin-3 have been observed in inflammatory diseases and various infectious conditions. However, its diagnostic and prognostic significance in acute cholecystitis has not yet been adequately elucidated in the literature. Materials and Methods This study aimed to evaluate the diagnostic and predictive value of Galectin-3 in acute cholecystitis. Conducted prospectively between December 1, 2023, and December 1, 2024, at the Emergency Medicine Department of Ordu University Faculty of Medicine, the study included 50 patients diagnosed with acute cholecystitis and 50 healthy controls who presented with abdominal pain but were not found to have any organic pathology. Galectin-3 levels in blood samples collected from both groups were analyzed using the ELISA method. Additionally, standard laboratory parameters and inflammatory biomarkers were comparatively assessed. Results According to the findings, there was no statistically significant difference between the case and control groups in terms of age and gender. Laboratory parameters, including white blood cell count, neutrophil count, C-reactive protein (CRP), AST, ALT, bilirubin, and glucose levels, were significantly higher in the case group. Furthermore, novel inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) also exhibited statistically significant differences between the two groups. The primary parameter of the study, serum Galectin-3 levels, was found to be significantly higher in the case group (mean 265.04 pg/dL) compared to the control group (mean 171.17 pg/dL) (p<0.001). According to ROC analysis, the area under the curve (AUC) for Galectin-3 was 0.796, with a threshold value of >188.02 pg/dL, yielding a sensitivity of 90% and specificity of 65%. Multivariate logistic regression analysis identified Galectin-3, neutrophil count, and white blood cell count as independent predictors of acute cholecystitis. Conclusion In conclusion, this study demonstrates that Galectin-3 may serve as a significant biomarker in the diagnosis of acute cholecystitis. Particularly in cases where classical diagnostic methods are insufficient, evaluation of Galectin-3 levels may enhance diagnostic accuracy. Increasing the clinical utility of Galectin-3 in diagnosis, treatment planning, and prognosis assessment should be a focus of future research. Nevertheless, these findings require further validation through larger, multicenter, and long-term studies.