title: Differences in phosphatidylcholine and bile acids in bile from Egyptian and UK patients with and without cholangiocarcinoma.
abstract: BACKGROUND
  Cholangiocarcinoma (CC) is a fatal malignancy, the incidence of which is increasing worldwide, with substantial regional variation. Current diagnostic techniques to distinguish benign from malignant biliary disease are unsatisfactory. Metabolic profiling of bile may help to differentiate benign from malignant disease. No previous studies have compared the metabolic profiles of bile from two geographically and racially distinct groups of CC patients.
  
  
  OBJECTIVE
  This study aimed to compare metabolic profiles of bile, using in vitro proton magnetic resonance spectroscopy, from CC patients from Egypt and the UK, and from patients with CC and patients with non-malignant biliary disease.
  
  
  METHODS
  A total of 29 bile samples, collected at cholangiography, were analysed using an 11.7-T system. Samples were from eight CC patients in either Egypt (n = 4) or the UK (n = 4) and 21 patients with benign biliary disease (choledocholithiasis [n = 8], sphincter of Oddi dysfunction [n = 8], primary sclerosing cholangitis [n = 5]).
  
  
  RESULTS
  Bile phosphatidylcholine (PtC) was significantly reduced in CC patients. Egyptian CC patients had significantly lower biliary PtC levels compared with UK patients. Taurine- and glycine-conjugated bile acids (H-26 and H-25 protons, respectively) were significantly elevated in bile from patients with CC compared with bile from patients with benign diseases (P = 0.013 and P < 0.01, respectively).
  
  
  CONCLUSIONS
  Biliary PtC levels potentially differentiate CC from benign biliary disease. Reduced biliary PtC in Egyptian compared with UK patients may reflect underlying carcinogenic mechanisms.
authors: Hepatology and Gastroenterology Section, Division of Diabetes Endocrinology and Metabolism, Department of Medicine, Imperial College London, St Mary's Hospital, London, UK.
authors: Mohamed S
authors: MS
authors: Hashim Abdalla
authors: Simon D
authors: SD
authors: Taylor-Robinson
authors: Amar W
authors: AW
authors: Sharif
authors: Horace R T
authors: HR
authors: Williams
authors: Mary M E
authors: MM
authors: Crossey
authors: Gamal A
authors: GA
authors: Badra
authors: Andrew V
authors: AV
authors: Thillainayagam
authors: Devinder S
authors: DS
authors: Bansi
authors: Howard C
authors: HC
authors: Thomas
authors: Imam A
authors: IA
authors: Waked
authors: Shahid A
authors: SA
authors: Khan
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