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Do metabolic alterations serve as biochemical markers in the diagnosis of malignant biliary obstruction? An observational study

Kurt, Mevluta; Onal, Ibrahim K.a; Parlak, Erkana; Shorbagi, Alib; Kekilli, Murata; Ibis, Mehmeta; Hayran, Mutluc; Sasmaz, Nurgula

European Journal of Gastroenterology & Hepatology: January 2010 - Volume 22 - Issue 1 - p 58-60
doi: 10.1097/MEG.0b013e32833036c3
Original Articles: Biliary Disorders

Objectives The aim of this study was to investigate the changes in serum lipid profiles in biliary obstruction associated with benign and malignant conditions and to find whether they can be used as adjunctive biochemical tumor markers in the differential diagnosis.

Methods One hundred and twenty patients (60 malignant, 60 benign) who underwent endoscopic retrograde cholangiopancreatography with the clinical picture of intrahepatic and extrahepatic cholestasis were reviewed in the period from January to July 2008.

Results In the malignant group, significantly higher cholesterol (P<0.001), low-density lipoprotein (P<0.001), and triglycerides (P<0.001) were observed, whereas high-density lipoprotein (P<0.001) levels were lower. The receiver operating characteristic analysis showed that high-density lipoprotein 19.5 mg/dl or less [sensitivity: 88.3%, specificity: 83.3%, area under the curve: 0.906 (0.851–0.961), P<0.001] and total to –high-density lipoprotein cholesterol ratio at least 17.7 [sensitivity: 80.0%, specificity: 93.1%, area under the curve: 0.921 (0.871–0.971)] were strong predictors of malignant biliary obstruction.

Conclusion Serum lipid profile may be used as an adjunctive marker to identify malignant causes of the obstructive jaundice.

aDepartment of Gastroenterology, Turkiye Yuksek Ihtisas Teaching and Research Hospital

Departments of bGastroenterology

cPreventive Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey

Correspondence to Dr Mevlut Kurt, MD, Department of Gastroenterology, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Kızılay Sok. No. 2, PK 06100, Sıhhiye, Ankara, Turkey

Tel: +90 505 2762812; fax: +90 312 3124120; e-mail:

Received 19 April 2009 Accepted 29 June 2009

© 2010 Lippincott Williams & Wilkins, Inc.