Abstract
Hepatocellular carcinoma with bile duct tumor thrombus (BDTT) is a malignant disease. The most commonly used diagnosis methods for BDTT are MRCP/ERCP, ultrasonic diagnosis or CT scan. However, BDTT is often misdiagnosed as other bile duct diseases, such as extrahepatic cholangiocarcinoma (EHCC), choledochal cyst (Cyst) and common bile duct stone (Stone). Diagnostic methods, which are more accurate and less destructive, are urgently needed. In this paper, we analyzed the small molecule metabolites in the serum of BDTT, Stone, Cyst and EHCC patients and normal people using untargeted GC-MS, and identified 21 metabolites that show different levels among different samples. Using targeted UHPLC-QQQ-MS analysis, we found that several metabolites are significantly changed. ROC curve analysis revealed two metabolites, L-citrulline and D-aspartic acid, as potential biomarkers that can distinguish BDTT from other bile duct diseases.
Highlights
Hepatocellular carcinoma (HCC) is one of the most aggressive cancers worldwide[1]
We found that several metabolites are significantly changed in bile duct tumor thrombus (BDTT) patients compared with other groups
Though the increase of these serum markers is higher in extrahepatic cholangiocarcinoma (EHCC) and BDTT patients, it is still very difficult to distinguish among BDTT and other patients
Summary
Hepatocellular carcinoma (HCC) is one of the most aggressive cancers worldwide[1]. Though the vascular invasion has been well described in some HCC patients, the occurrence of bile duct tumor thrombus (BDTT) in those patients is still poorly understood[2,3,4]. The current diagnosis methods for BDTT are Magnetic resonance cholangiography (MRCP)/ Endoscopic Retrograde Cholangiopancreatography (ERCP), ultrasonic diagnosis, computerized tomography (CT) scan[11]. These medical imaging methods have decreased the rate of misdiagnosis of BDTT. ROC curve analysis showed that the combination of L-citrulline and D-aspartic acid shows a very high sensitivity and specificity in BDTT patients. They are potential biomarkers for BDTT diagnosis that can distinguish BDTT from other three diseases
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