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Bile proteomics for differentiation of malignant from benign biliary strictures: a pilot study.
[cholangiocarcinoma]
Determining
the
etiology
of
biliary
strictures
is
challenging
,
and
the
sensitivities
of
the
current
tests
to
diagnose
them
are
low
.
Protein
biomarkers
in
bile
,
in
combination
with
other
tests
,
may
improve
sensitivity
in
diagnosing
biliary
strictures
.
To
analyse
the
differential
abundance
of
proteins
in
benign
and
malignant
biliary
strictures
through
proteomic
analysis
of
bile
.
In
this
prospective
,
cross-sectional
study
,
bile
was
aspirated
in
24
patients
undergoing
endoscopic
retrograde
cholangiopancreatography
(
ERCP
)
including
six
patients
with
primary
sclerosing
cholangitis
(
PSC
)
,
three
with
cholangiocarcinoma
(
CCA
)
,
ten
with
pancreatic
cancer
,
and
five
with
benign
biliary
conditions
.
Liquid
chromatography
/
mass
spectrometry
was
used
to
examine
the
bile
for
differential
abundance
of
protein
biomarkers
.
The
relative
abundance
of
various
proteins
was
compared
in
the
malignant
vs
.
benign
groups
and
in
CCA
vs
.
The
majority
of
the
proteins
identified
in
bile
were
similar
to
those
of
the
plasma
(
plasma
proteins
)
and
certain
proteins
were
differentially
expressed
among
the
different
groups
(
CCA
,
pancreatic
cancer
,
PSC
or
benign
)
.
A
total
of
18
proteins
were
identified
as
being
more
abundant
in
the
malignant
group
(
CCA
and
pancreatic
cancer
)
than
in
the
benign
strictures
group
,
including
myeloperoxidase
,
complement
C
3
,
inter-alpha-trypsin
inhibitor
heavy
chain
H
4
,
apolipoprotein
B
-
100
,
and
kininogen-
1
isoform
2
.
A
total
of
30
proteins
were
identified
to
be
less
abundant
in
the
malignant
group
than
in
the
benign
group
,
including
trefoil
factor
2
,
superoxide
dismutase
[
Cu-
Zn
]
,
kallikrein-
1
,
carboxypeptidase
B
and
trefoil
factor
1
.
Protein
biomarkers
in
bile
may
differentiate
malignant
from
benign
biliary
strictures
.
Larger
studies
are
warranted
to
validate
these
observations
.
Diseases
Validation
Diseases presenting
"pancreatic cancer"
symptom
cholangiocarcinoma
esophageal adenocarcinoma
esophageal squamous cell carcinoma
systemic capillary leak syndrome
This symptom has already been validated