Do metabolic alterations serve as biochemical markers in the diagnosis of malignant biliary obstruction? An observational study.
OBJECTIVE
The aim of this study was to investigate the changes in serum lipid profiles in biliary obstruction associated with benign and malignant conditions and to find whether they can be used as adjunctive biochemical tumor markers in the differential diagnosis.


METHODS
One hundred and twenty patients (60 malignant, 60 benign) who underwent endoscopic retrograde cholangiopancreatography with the clinical picture of intrahepatic and extrahepatic cholestasis were reviewed in the period from January to July 2008.


RESULTS
In the malignant group, significantly higher cholesterol (P<0.001), low-density lipoprotein (P<0.001), and triglycerides (P<0.001) were observed, whereas high-density lipoprotein (P<0.001) levels were lower. The receiver operating characteristic analysis showed that high-density lipoprotein 19.5 mg/dl or less [sensitivity: 88.3%, specificity: 83.3%, area under the curve: 0.906 (0.851-0.961), P<0.001] and total to -high-density lipoprotein cholesterol ratio at least 17.7 [sensitivity: 80.0%, specificity: 93.1%, area under the curve: 0.921 (0.871-0.971)] were strong predictors of malignant biliary obstruction.


CONCLUSIONS
Serum lipid profile may be used as an adjunctive marker to identify malignant causes of the obstructive jaundice.
Kurt
Mevlut
M
Department of Gastroenterology, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Kizilay Sok. No. 2, PK 06100, Sihhiye, Ankara, Turkey. dr.mevlutkurt@gmail.com
Onal
Ibrahim K
IK
Parlak
Erkan
E
Shorbagi
Ali
A
Kekilli
Murat
M
Ibis
Mehmet
M
Hayran
Mutlu
M
Sasmaz
Nurgul
N
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D042883:Choledocholithiasis / Q000150:complications / Q000175:diagnosis; D002779:Cholestasis / Q000097:blood / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D003937:Diagnosis, Differential; D004067:Digestive System Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D008076:Cholesterol, HDL; D008055:Lipids; D008075:Lipoproteins, HDL