title: Insulin-Like Growth Factor-1 and Vascular Endothelial Growth Factor in Malignant and Benign Biliary Obstructions.
abstract: BACKGROUND
  Despite the presence of various diagnostic tools, the differential diagnosis between malignant and benign biliary obstructions is so difficult. This study aimed to evaluate the role of serum and biliary insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) in this differential diagnosis.
  
  
  METHODS
  Patients (n = 109, 61 men and 48 women) with diagnosis of benign (n = 62) or malignant (n = 47) biliary obstruction were included. Serum and biliary IGF-1 and VEGF markers were analyzed by the chemiluminescent immunometric method.
  
  
  RESULTS
  Mean age was 62.7 ± 8.1 years for the malignant group and 58.5 ± 15.4 years for the benign group (P = 0.092). Choledocholithiasis (79%), cancer head of the pancreas (53.2%) and cholangiocarcinoma (38.3%) were the most common etiologies. No statistical difference was detected regarding serum IGF-1 and VEGF levels between 2 groups. At a cutoff value of 308.55 and 0.5ng/mL, biliary IGF-1 and VEGF had (91.4% and 90.3%) sensitivity and (89.5% and 84.9%) specificity differential diagnosis between malignant and benign biliary obstructions (area under the curve: 0.943, 0.915), respectively.
  
  
  CONCLUSIONS
  Biliary levels of IGF-1 and VEGF significantly increase in malignant than benign obstructive lesions. Measurement of these markers in the bile of these patients may aid in the detection of biliary tumors.
authors.affiliation: From the Tropical Medicine Department, (AAR). Electronic address: Ahmedabdelrazik76@gmail.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdel-Razik
authors.affiliation: General Surgery, Department (YE, EE); Gastroenterology Surgical Center (YE, EE).
authors.forename: Youssif
authors.initials: Y
authors.lastname: ElMahdy
authors.affiliation: General Surgery, Department (YE, EE); Gastroenterology Surgical Center (YE, EE).
authors.forename: Ehab El
authors.initials: EE
authors.lastname: Hanafy
authors.affiliation: Clinical Pathology Department (RanE, RasE).
authors.forename: Rania
authors.initials: R
authors.lastname: Elhelaly
authors.affiliation: Clinical Pathology Department (RanE, RasE).
authors.forename: Rasha
authors.initials: R
authors.lastname: Elzehery
authors.affiliation: Diagnostic and Interventional Radiology (AT).
authors.forename: Ahmed
authors.initials: A
authors.lastname: M Tawfik
authors.affiliation: Medical Microbiology and Immunology Department (WE), Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Waleed
authors.initials: W
authors.lastname: Eldars
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D018281:Cholangiocarcinoma / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D002779:Cholestasis / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007334:Insulin-Like Growth Factor I
keywords: Biliary obstruction; Insulin-like growth factor-1; Vascular endothelial growth factor