Serum NGAL to Clinically Distinguish Cholangiocarcinoma from Benign Biliary Tract Diseases

Kawin Leelawat,Jerasak Wannaprasert,Surang Leelawat,Siriluck Narong

doi:10.4061/2011/873548

Kawin Leelawat, Jerasak Wannaprasert + Show 2 more

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https://doi.org/10.4061/2011/873548

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Abstract

Aim. To determine whether the serum level of NGAL can discriminate cholangiocarcinoma from benign biliary tract disease in patients. Methods. This study was performed according to a prospective-specimen-collection, retrospective-blinded-evaluation (PRoBE) design. A total of 50 cholangiocarcinoma and 50 benign biliary tract disease cases were randomly selected from a cohort of consecutive cases of biliary tract diseases. Their sera were measured for the levels of NGAL and the widely used serum cholangiocarcinoma marker, carbohydrate antigen 19-9 (CA19-9). Results. The serum CA19-9 and NGAL levels were significantly elevated in cholangiocarcinoma patients (CA19-9: P < .001, NGAL: P < .001). The area under the curve (AUC) of a receiver operating characteristic (ROC) curve analysis for the diagnosis of cholangiocarcinoma of CA19-9 and NGAL was 0.81 and 0.79, respectively. Conclusion. The diagnostic accuracy of serum NGAL and CA19-9 makes them good candidates for use as biomarkers to discriminate cholangiocarcinoma patients from benign biliary tract disease patients.

Highlights

Cholangiocarcinoma (CCA) is one of the most aggressive malignant tumors and is associated with local invasiveness and a high rate of metastasis [1, 2]
The levels of serum bilirubin and alkaline phosphatase (ALP) were significantly higher in cholangiocarcinoma patients than in the control patients
There are two common tumor markers used for detecting cholangiocarcinoma, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) [16]

Summary

Introduction

Cholangiocarcinoma (CCA) is one of the most aggressive malignant tumors and is associated with local invasiveness and a high rate of metastasis [1, 2]. Most cholangiocarcinoma patients present with symptoms of biliary tract obstruction. Many cases of benign biliary tract diseases present with similar clinical symptoms [3]. This tumor typically grows along the bile duct without projecting outward from the bile ducts as a forming mass. Computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI) are often inadequate to reveal this lesion [4]. Identification of tumor markers in the serum would be beneficial in the clinical management of this disease

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