Abstract
The present study was designed to comparatively assess alteration of biochemical parameters in bile duct cancer and gall stone disease. A hospital based case-control study was carried out in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between 1st January 2010 and 31st December 2012. The variables collected were age, gender, serum total cholesterol, total bilirubin, AST, ALT, serum alkaline phosphatase, albumin and hemoglobin. One way ANOVA was used to examine the statistical significance of differences between groups. A post-hoc LSD test was applied for the comparison of means of control versus case groups. A p-value of <0.05 (two-tailed) was considered significant. The mean age of cases and controls was 53.2±21.2 years. The levels of serum cholesterol were higher in cases of cancer 192.5±21.5 mg/dl in comparison to stone cases 168.7±16.1 mg/dl (p value: 0.0001). The total bilirubin showed the marked difference in cases of cancer 7.6±3.2 mg/dl in comparison to stone cases 2.5±0.8 mg/dl of bile duct. There was discernible divergence in values of alkaline phosphatase in cases of cancer 251.5±20.1 IU/l when compared to stone cases 173.2±12.6 IU/l of bile duct. In contrast, there was no apparent deviation in values of aspartate transaminases and alanine transaminases in cases of cancer 59.1±8.9 IU/l and 105.5±26.5 IU/l when compared to stone cases 56.9±7.9 IU/l and 84.5±13.5 IU/l respectively. LFT analysis for pre-operative assessment was a good predictive marker in setting apart bile duct cancer and gall bladder stone.
Highlights
The total bilirubin showed the marked difference in cases of cancer 7.6±3.2 mg/dl in comparison to stone cases 2.5±0.8 mg/dl of bile duct
There was discernible divergence in values of alkaline phosphatase in cases of cancer 251.5±20.1 IU/l when compared to stone cases 173.2±12.6 IU/l of bile duct
There was no apparent deviation in values of aspartate transaminases and alanine transaminases in cases of cancer 59.1±8.9 IU/l and 105.5±26.5 IU/l when compared to stone cases 56.9±7.9 IU/l and 84.5±13.5 IU/l respectively
Summary
Bile duct cancer instigates from the bile duct epithelium; it is further classified into intrahepatic cholangiocarcinoma, extrahepatic bile duct cancer, and gallbladder cancer (Luke et al, 2010). Large gallstones (>3 cm) are one of the predominant risk factors for gallbladder cancer. The present study was designed to comparatively assess alteration of biochemical parameters in bile duct cancer and gall stone disease. The levels of serum cholesterol were higher in cases of cancer 192.5±21.5 mg/dl in comparison to stone cases 168.7±16.1 mg/dl (p value: 0.0001). The total bilirubin showed the marked difference in cases of cancer 7.6±3.2 mg/dl in comparison to stone cases 2.5±0.8 mg/dl of bile duct. There was discernible divergence in values of alkaline phosphatase in cases of cancer 251.5±20.1 IU/l when compared to stone cases 173.2±12.6 IU/l of bile duct. There was no apparent deviation in values of aspartate transaminases and alanine transaminases in cases of cancer 59.1±8.9 IU/l and 105.5±26.5 IU/l when compared to stone cases 56.9±7.9 IU/l and 84.5±13.5 IU/l respectively. Conclusions: LFT analysis for pre-operative assessment was a good predictive marker in setting apart bile duct cancer and gall bladder stone
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