Vilkin A, Geller A, Levi Z, Niv Y. Mucin gene expression in bile of patients with and without gallstone disease, collected by endoscopic retrograde cholangiography. World J Gastroenterol 2009; 15(19): 2367-2371 [PMID: 19452580 DOI: 10.3748/wjg.15.2367]
Corresponding Author of This Article
Yaron Niv, Professor, Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100, Israel. yniv@clalit.org.il
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World J Gastroenterol. May 21, 2009; 15(19): 2367-2371 Published online May 21, 2009. doi: 10.3748/wjg.15.2367
Table 1 Demographic and clinical data (n = 29)
Clinical parameter
n(%) or mean ± SD
Age
mean ± SD (yr)
64.5 ± 16.8
Range
24-86
Sex
Men
13 (44.8)
Women
16 (55.2)
Main indication for ERC
Cholestasis/jaundice
16 (55.2)
Choledocholithiasis/dilated CBD
5 (17.2)
Cholangitis
3 (10.3)
SOL of papilla
3 (10.3)
Unresolved pancreatitis
2 (6.9)
Abdominal ultrasound results
Dilated CBD
15 (51.7)
Cholelithiasis
12 (41.4)
Dilated intrahepatic ducts
10 (34.5)
Choledocholithiasis
3 (10.3)
Pancreatitis
1 (3.4)
CBD width (mm)
mean ± SD
8.7 ± 3.7
Range
6-18
Liver function tests, mean ± SD (range)
Total bilirubin (mg/dL)
4.5 ± 6.9 (0.3-32)
Direct bilirubin (mg/dL)
3.0 ± 4.9 (0.1-23)
Alanine aminotransferase (U/L)
206.5 ± 243.3 (12-895)
Aspartate aminotransferase (U/L)
156.4 ± 185.6 (15-812)
Gamma glutamyl transpeptidase (U/L)
369.4 ± 370.4 (13-1337)
Alkaline phosphatase (U/L)
291.0 ± 371.4 (56-1893)
Table 2 Results of ERC (n = 29)
Clinical parameter
n(%) or mean ± SD
Diagnosis
CBD width (mm)
9.4 ± 4.0
Range
6-18
Choledocholithiasis
11 (37.9)
Pigmented stones
4 (13.8)
Cholelithiasis
5 (17.2)
Enlarged papilla
7 (24.1)
Dilated CBD
15 (51.7)
CBD stricture
4 (13.8)
Intrahepatic ducts dilation & stricture
3 (10.3)
Torn papilla
3 (10.3)
Bile leakage
1 (3.4)
Mirizzi syndrome
1 (3.4)
Treatment
Sphincterotomy
16 (55.2)
Biopsy of the papilla
5 (17.2)
Stent insertion
2 (6.9)
Cholecystostomy
1 (3.4)
Table 3 Mucin gene expression in bile collected in ERC
Mucin gene
Score mean ± SD (range)
Cases (%)
MUC1
0.62 ± 0.94 (0-3)
34.4
MUC2
0.58 ± 0.90 (0-3)
34.4
MUC3
0.79 ± 0.97 (0-3)
51.7
MUC5AC
1.06 ± 1.22 (0-3)
51.7
MUC5B
1.20 ± 1.26 (0-3)
55.1
MUC6
0.41 ± 0.73 (0-2)
27.5
Table 4 Correlation between the expression of the different mucin genes in bile collected by ERC
Mucin gene
Correlation with mucin gene
Pvalue
MUC1
MUC2
0.0001
MUC3
0.0001
MUC5AC
0.0125
MUC5B
0.049
MUC6
0.0001
MUC2
MUC3
0.0001
MUC5AC
0.0080
MUC5B
0.0001
MUC6
0.0001
MUC3
MUC5AC
0.0031
MUC6
0.0003
Table 5 Comparison between patients with (n = 17) and without (n = 12) gallstones
Gallstones diseas n (%)
No evidence for gallstones n (%)
Pvalue
Age, mean ± SD (years)
61.35 ± 20.13
69.00 ± 9.58
0.234
Sex (men)
8 (47.1)
5 (41.7)
0.927
Main indication for ERC
Jaundice
7 (41.1)
9 (75)
0.153
Dilated CBD
4 (23.5)
1 (8.0)
0.554
Cholangitis
3 (20.0)
0
0.288
SOL of papilla
1 (6.0)
2 (17.0)
0.737
Unresolved pancreatitis
2 (12.0)
0
0.288
Abdominal ultrasound results
Dilated CBD
10 (59.0)
5 (42)
0.599
Cholelithiasis
12 (70.6)
0
< 0.0001
Dilated intrahepatic ducts
6 (40)
4 (30)
0.873
Choledocholithiasis
3 (17.6)
0
0.360
Pancreatitis
1 (5.9)
0
0.861
CBD width (mm), mean ± SD
9.65 ± 4.39
7.50 ± 2.24
0.132
Liver function tests, mean ± SD
Total bilirubin (mg/dL)
5.12 ± 7.83
3.68 ± 5.52
0.589
Direct bilirubin (mg/dL)
3.38 ± 5.53
2.55 ± 4.03
0.662
Alanine aminotransferase (U/L)
245.41 ± 270.76
151.58 ± 196.14
0.315
Aspartate aminotransferase (U/L)
167.29 ± 150.54
141.08 ± 233.11
0.715
Gamma glutamyl transpeptidase (U/L)
443.47 ± 388.13
264.50 ± 331.14
0.206
Alkaline phosphatase (U/L)
352.88 ± 449.95
185.08 ± 174.44
0.323
ERC diagnosis
CBD width (mm), mean ± SD
9.59 ± 3.99
9.17 ± 4.37
0.790
Choledocholithiasis
11 (64.7)
0
0.002
Pigmented stones
4 (24.0)
0
0.198
Cholelithiasis
5 (29.0)
0
0.122
Enlarged papilla
3 (16.0)
4 (33.0)
0.533
Dilated CBD
10 (60.0)
5 (40.0)
0.494
CBD stricture
1 (10.0)
3 (30.0)
0.376
Torn papilla
3 (17.6)
0
0.360
Treatment
Sphincterotomy
12 (71.0)
4 (33.0)
0.099
Biopsy of the papilla
1 (10.0)
4 (33.0)
0.288
Mucin gene score, mean ± SD
Mucin concentration (mg/mL)
21.68 ± 7.87
24.54 ± 24.1
0.759
Protein concentration (mg/mL)
7.87 ± 4.53
8.61 ± 5.48
0.694
MUC1
0.59 ± 0.87
0.66 ± 1.07
0.848
MUC2
0.53 ± 0.80
0.66 ± 1.07
0.711
MUC3
0.88 ± 0.93
0.66 ± 1.07
0.560
MUC5AC
0.47 ± 0.80
0.33 ± 0.65
0.621
MUC5B
1.23 ± 1.25
0.83 ± 1.19
0.394
MUC6
1.29 ± 1.26
1.08 ± 1.31
0.667
Citation: Vilkin A, Geller A, Levi Z, Niv Y. Mucin gene expression in bile of patients with and without gallstone disease, collected by endoscopic retrograde cholangiography. World J Gastroenterol 2009; 15(19): 2367-2371