Review
Copyright ©The Author(s) 2015.
World J Gastrointest Endosc. Apr 16, 2015; 7(4): 308-317
Published online Apr 16, 2015. doi: 10.4253/wjge.v7.i4.308
Table 1 Potential biomarkers in bile
Bile biomarkersCut off valueIdentification of CCA/pancreatic cancerSensitivitySpecificityComments
VEGF[57]0.5 ng/mLPancreatic cancer (vs benign)93.3%72.7%VEGF level in bile in CCA was not elevated. Another study[58] demonstrated increased serum VEGF in CCA-possible basolateral secretion of VEGF in bile duct epithelia in CCA?
0.5 ng/mLPancreatic cancer (vs CCA)93.3%88.9%
IGF[58]NACCANANAROC (area under the curve = 1); Serum IGF levels were similar among CCA, pancreatic cancer and benign groups
CEAM6[50] CEAM6 + Serum CA 19-967.9 ng/mLMalignant (CCA + pancreatic cancer)93%83%Biliary levels were not critically affected by bile duct obstruction; Serum CEAM6 levels were not significantly different between the malignant and benign groups
97%83%
67.9 ng/mL, 157 kU/L
NGAL[37] NGAL + Serum CA 19-9459 ng/mL 459 ng/mL, 30.1 U/mLMalignant (CCA + pancreatic cancer)77.3% 91%72.2% 66.7%In both the studies, serum NGAL levels were not significantly different between benign and malignant groups; biliary levels were independent of serum bilirubin levels. Especially elevated in early well differentiated carcinomas in tissue immunohistochemistry-possible future application in PSC to R/O early malignant lesions/dysplasias
NGAL[38] NGAL + Serum CA 19-9570 ng/mL 3000 ng /mL, 125 U/LMalignant (CCA + Pancreatic cancer + GB carcinoma + metastasis)94% 85%55% 82%
HSP[67]
HSP 272.52 ng/mLCCA90%90%Serum levels of these markers were not significantly different between CCA and benign strictures
HSP 705.67 ng/mL80%80%
HSP 27 + HSP 7010.2 ng/mL90%100%
Galectin Ligands
Mac 2-BP[76]853 ng/mLAll malignant strictures69%67%Serum levels were not elevated in malignancies
Fibronectin[77]40 ng/μmolCCA57%79%-
MCM 5[82]1000 (cells)CCA + Pancreatic cancer66%94%MCM 5 levels in bile were significantly more sensitive than brush cytology (66% vs 20%; P = 0.004)
Pancreatic Elastase/ Amylase[83]0.065CCA82%89%mRNA of PE 3B was also up-regulated in CCA tissues
Lipids[84]
ON-PC6020.1 nmol/LCCA85.7%80.3%-
S-PC12 nmol/LCCA83.3%77.8%
ON-PC + S-PC6032.2 nmol/LCCA100%83.3%
VOCs
(TMA, acetone, isoprene, dimethyl sulfide, and acetaldehyde)[86]Logarithmic modelPancreatic cancer83.3%81.9%-
(Acrylonitrile, methyl hexane and benzene)[87]Logarithmic modelCCA in the setting of PSC90.5%72.7%Biliary levels of VOCs in CCA (in the setting of PSC) were significantly lower than (benign) PSC