Biomarkers in bile-complementing advanced endoscopicimaging in the diagnosis of indeterminate biliary strictures

• 作者: Vennisvasanth Lourdusamy Benjamin Tharian Udayakumar Navaneethan
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Bile Pancreato-biliary MALIGNANCIES Biomarkers CHOLANGIOCARCINOMA Pancreatic CANCERS Biliary STRICTURES
• 年，卷（期）: 2015,（4）
• 页码范围: 308-317
• 页数: 10页
• 分类号: R

摘要

Biliary strictures present a diagnostic challenge and aconundrum, particularly when an initial work up includingabdominal imaging and endoscopic retrogradecholangiopancreatography based sampling are nondiagnostic.Advances in endoscopic imaging have helpedus diagnose these strictures better. However, even withmodern technology, some strictures remain a diagnosticchallenge. The proximity of bile fluid to the bile ductepithelia makes it an attractive option to investigatefor bio-markers, which might be representative of thefunctions/abnormal changes taking place in the biliarysystem. A number of biomarkers in bile have beendiscovered recently in approaching biliary strictureswith their potential future diagnostic utility, furthersupported by the immunohistochemical analysis of theresected tissue specimens. Novel biliary biomarkersespecially carcinoembryonic cell adhesion molecule 6and neutrophil gelatinase-associated lipocalin seempromising in differentiating malignant from benign biliarystrictures. Recent developments in lipidomic profiling ofbile are also very promising. Biliary biomarkers appearto complement endoscopic imaging in diagnosingmalignant etiologies of biliary stricture. Future studiesaddressing these biomarkers need to be incorporatedto the current endoscopic techniques to determine thebest approach in determining the etiology of biliarystrictures.