Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 16, 2015; 7(4): 308-317
Published online Apr 16, 2015. doi: 10.4253/wjge.v7.i4.308
Biomarkers in bile-complementing advanced endoscopic imaging in the diagnosis of indeterminate biliary strictures
Vennisvasanth Lourdusamy, Benjamin Tharian, Udayakumar Navaneethan
Vennisvasanth Lourdusamy, Benjamin Tharian, Udayakumar Navaneethan, Center for Interventional Endoscopy, Institute for Minimally Invasive Surgery, Florida Hospital, Orlando, FL 32803, United States
Author contributions: Lourdusamy V and Tharian B contributed to paper preparation; Navaneethan U contributed to paper concept, preparation and critical revisions.
Conflict-of-interest: Navaneethan U has received fees for serving as a speaker (such as a consultant and/or an advisory board member) for AbbVie; None of the other authors have any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Udayakumar Navaneethan, MD, FACP, Center for Interventional Endoscopy, Institute for Minimally Invasive Surgery, Florida Hospital, 601 E Rollins Street, Orlando, FL 32803, United States. udhaykumar81@gmail.com
Telephone: +1-216-5020981 Fax: +1-407-3032585
Received: August 19, 2014
Peer-review started: August 20, 2014
First decision: September 16, 2014
Revised: January 5, 2015
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: April 16, 2015
Core Tip

Core tip: Pancreato-biliary malignancies remain a diagnostic challenge despite advances in endoscopy and imaging. Serum carbohydrate antigen 19-9 which is the most commonly used tumor marker has not been able to complement the endoscopic techniques effectively. Bile fluid is a better representative of the pancreato-biliary malignancies and various tumor markers in bile have been described recently with advances in proteomics. Carcinoembryonic cell adhesion molecule 6, neutrophil gelatinase-associated lipocalin and other novel biliary markers seem promising with high sensitivities and specificities, little affected by the presence of inflammation or the degree of biliary obstruction. These are potential future tumor markers that can complement endoscopic techniques in diagnosing malignant biliary strictures.