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High Bile Titer and High Bile to Serum Ratio of CYFRA 21 − 1 Reliably Discriminate Malignant Biliary Obstruction Caused by Cholangiocarcinoma

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Abstract

Introduction

Previously we demonstrated that elevated serum CYFRA 21 − 1 is a reliable diagnostic and prognostic biomarker for biliary tract cancers. This study aims to explore the diagnostic performance of bile CYFRA 21 − 1 (bCYFRA 21 − 1) in discriminating malignant biliary obstruction (MBO) caused by cholangiocarcinoma (CCA).

Methods

77 CCA patients ((17 intrahepatic CCA (iCCA), 49 perihilar CCA (pCCA) and 11 distal CCA (dCCA)) and 43 benign patients with biliary obstruction were enrolled. Serum and bile levels of CYFRA 21 − 1, carcinoembryonic antigen (CEA) and carbohydrate antigen 19 − 9 (CA19-9) were quantified. Diagnostic performances of these biomarkers were estimated by receiver operator characteristic curves. Subgroups analysis of these tumor markers among CCA subtypes was performed.

Results

High bCYFRA 21 − 1 (cut-off value of 59.25 ng/mL with sensitivity of 0.889 and specificity of 0.750) and high bile to serum ratio of CYFRA 21 − 1 (b/sCYFRA 21 − 1, cut-off value of 31.55 with sensitivity of 0.741 and specificity of 0.778) achieved better diagnostic performance than any other biomarker in discriminating MBO. Subgroup analysis revealed that bCYFRA 21 − 1 was significantly elevated in all CCA subtypes; moreover b/sCYFRA 21 − 1 was upregulated in pCCA and dCCA (the mean b/sCYFRA 21 − 1 of pCCA was highest among CCA subtypes: 57.90, IQR 29.82-112.27).

Conclusions

Both high biliary CYFRA 21 − 1 and high bile to serum ratio of CYFRA 21 − 1 were reliable diagnostic biomarkers for MBO caused by CCA.

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Data Availability

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors thank Dr. Ting Liao (Department of Clinical Laboratory, the First Affiliated Hospital of Sun Yat-sen University) for providing advice and technical assistance in measuring biomarkers.

Funding

Declaration: this work was supported by the Basic and Applied Basic Research Fund of Guangdong Province (2020A1515110485), National Natural Science Foundation of China (81201919), National Natural Science Foundation of China-Shenzhen Robotics Research Center Project (U1813204) and the Natural Science Foundation of Guangdong Province (2017A030313495).

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Author notes

  1. Jiancong Chen, Jiahua Liang and Borui Xu contributed equally to this work.

Authors and Affiliations

  1. Department of PancreatoBiliary Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, 510080, China

    Jiancong Chen, Jiahua Liang, Borui Xu, Mingjian Ma, Zicheng Wang, Qiongcong Xu, Lijian Liang, Jiaming Lai & Li Huang

  2. Department of Clinical Laboratory, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China

    Jianbo Liang

  3. Department of Gastrointestinal Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China

    Guangyan Zeng

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  1. Jiancong Chen
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  2. Jiahua Liang
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  4. Jianbo Liang
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Contributions

Conceptualization: JM Lai, L Huang; Acquisition of data, analysis and interpretation of data: JC Chen, JH Liang, BR Xu, JB Liang, MJ Ma, ZC Wang, GY Zeng, QC Xu; Writing-original draft: JC Chen, L Huang; Writing-review and editing: LJ Liang, JM Lai, L Huang; Supervision: JM Lai, L Huang.

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Correspondence to Jiaming Lai or Li Huang.

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Chen, J., Liang, J., Xu, B. et al. High Bile Titer and High Bile to Serum Ratio of CYFRA 21 − 1 Reliably Discriminate Malignant Biliary Obstruction Caused by Cholangiocarcinoma. J Gastrointest Canc (2024). https://doi.org/10.1007/s12029-024-01023-9

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