title: Ability of biochemical parameters to distinguish between bile duct cancer and gall bladder stones--a case control study in a tertiary care hospital of Pokhara Valley.
abstract: BACKGROUND
  The present study was designed to comparatively assess alteration of biochemical parameters in bile duct cancer and gall stone disease.
  
  
  METHODS
  A hospital based case-control study was carried out in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between 1st January 2010 and 31st December 2012. The variables collected were age, gender, serum total cholesterol, total bilirubin, AST, ALT, serum alkaline phosphatase, albumin and hemoglobin. One way ANOVA was used to examine the statistical significance of differences between groups. A post-hoc LSD test was applied for the comparison of means of control versus case groups. A p-value of <0.05 (two-tailed) was considered significant.
  
  
  RESULTS
  The mean age of cases and controls was 53.2±21.2 years. The levels of serum cholesterol were higher in cases of cancer 192.5±21.5 mg/dl in comparison to stone cases 168.7±16.1 mg/dl (p value: 0.0001). The total bilirubin showed the marked difference in cases of cancer 7.6±3.2 mg/dl in comparison to stone cases 2.5±0.8 mg/dl of bile duct. There was discernible divergence in values of alkaline phosphatase in cases of cancer 251.5±20.1 IU/l when compared to stone cases 173.2±12.6 IU/l of bile duct. In contrast, there was no apparent deviation in values of aspartate transaminases and alanine transaminases in cases of cancer 59.1±8.9 IU/l and 105.5±26.5 IU/l when compared to stone cases 56.9±7.9 IU/l and 84.5±13.5 IU/l respectively.
  
  
  CONCLUSIONS
  LFT analysis for pre-operative assessment was a good predictive marker in setting apart bile duct cancer and gall bladder stone.
authors.affiliation: Department of Biochemistry, Manipal College of Medical Sciences, Pokhara, Nepal. shambhuyadav47@gmail.com
authors.forename: Shambhu Kumar
authors.initials: SK
authors.lastname: Yadav
authors.forename: Ankush
authors.initials: A
authors.lastname: Mittal
authors.forename: Kumar
authors.initials: K
authors.lastname: Sapkota
authors.forename: Satrudhan Prasad
authors.initials: SP
authors.lastname: Gupta
authors.forename: Brijesh
authors.initials: B
authors.lastname: Sathian
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D005260:Female; D042882:Gallstones / Q000175:diagnosis*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal; D012709:Serum Albumin; D062606:Tertiary Care Centers; D063128:Tertiary Health Care
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D012709:Serum Albumin; D002784:Cholesterol; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin