earticle

영어

The incidence of cholangiocarcinoma (CCA), a bile duct cancer, is high in the northeastern part of Thailand. At present, there is no known marker that can be used as an early marker for CCA. The surveillance of people at risk of CCA is the effective strategy to detect patients with early CCA, the stage at which surgery for completely cure can be offered. There is accumulated evidence indicated that people with chronic inflammation of bile duct epithelia and peribiliary fibrosis have high risk of CCA. Recently, a high resolution ultrasonography of peri-portal fibrosis was shown to be the acceptable approach to identify people at high risk or early CCA. However, the ultrasonography has to be conducted and determined by an experience radiologist and the operation cannot be offered for people in rural area. In this study, we aimed to find a suitable serum marker that can distinguish people who has benign bilirary diseases (BBD) or CCA from healthy subjects, liver fluke infected persons and patients with other gastro-intestinal cancers. Serum was electrophoresesed in a 12% SDS-polyacrylamide gel electrophoresis and ConA-binding glycoproteins were determined using lectin-biotin/avidin-peroxidase system. ConA blotting of serum from 29 CCA and 23 benign biliary diseases were compared with those from healthy persons (n = 20), active liver fluke infected people (n =10), patients with hepatoma (n =15) and other gastro-intestinal cancers (n =20). A high molecular weight of ConA binding glycoprotein was frequently detected in 85% of serum from CCA and BBD comparing to 24.6% of all serum from the control group. This marker can identify person who had CCA or BBD with a 81.6% sensitivity, 75.4% specificity, 73.3% and 85.9% positive and negative predictive values, respectively. The value of this ConA-specific marker in differentiating people who are at risk of CCA should be re-investigated in a larger cohort including people from the villages that are in the endemic area of liver fluke infection and patients with various pathological conditions.