title: Do metabolic alterations serve as biochemical markers in the diagnosis of malignant biliary obstruction? An observational study.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Kizilay Sok. No. 2, PK 06100, Sihhiye, Ankara, Turkey. dr.mevlutkurt@gmail.com
authors.forename: Mevlut
authors.initials: M
authors.lastname: Kurt
authors.forename: Ibrahim K
authors.initials: IK
authors.lastname: Onal
authors.forename: Erkan
authors.initials: E
authors.lastname: Parlak
authors.forename: Ali
authors.initials: A
authors.lastname: Shorbagi
authors.forename: Murat
authors.initials: M
authors.lastname: Kekilli
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ibis
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
authors.forename: Nurgul
authors.initials: N
authors.lastname: Sasmaz
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D008076:Cholesterol, HDL; D008055:Lipids; D008075:Lipoproteins, HDL