Alvaro Domenico
Division of Gastroenterology, Department of Clinical Medicine, Polo Pontino, University of Rome La Sapienza, Rome, Italy.
Curr Opin Gastroenterol. 2009 May;25(3):279-84. doi: 10.1097/mog.0b013e328325a894.
To discuss recent studies proposing new markers in serum or bile for the diagnosis and prognosis of cholangiocarcinoma (CCA), which could help in the differential diagnosis between malignant and benign biliary disorders or for the surveillance of disorders at risk, including primitive sclerosing cholangitis.
In the last few years, efforts have been made to identify biomarkers with adequate diagnostic accuracy for CCA in serum or biological fluid. Studies have been focused on cytokines, growth factors or enzymes produced and secreted by CCA cells as well as on the proteomic analysis of serum and bile.
The serum levels of interleukin 6, trypsinogen, mucin-5AC, soluble fragment of cytokeratin 19 and the platelet-lymphocyte ratio have been recently shown to help in the diagnosis of CCA with, in some cases, a prognostic value. As far as bile is concerned, the ratio of pancreatic elastase/amylase, mucin-4, minichromosome maintenance replication protein and insulin-like growth factor 1 have been explored, with the insulin-like growth factor 1 biliary concentration capable of completely discriminating CCA from benign biliary disorders and pancreatic cancer. We have also discussed advances in the proteomic of serum and bile, which seem promising in identifying new markers for CCA.
讨论近期提出的用于胆管癌（CCA）诊断和预后的血清或胆汁新标志物的研究，这些标志物有助于鉴别恶性和良性胆道疾病，或用于监测包括原发性硬化性胆管炎在内的高危疾病。
在过去几年中，人们致力于在血清或生物体液中鉴定对CCA具有足够诊断准确性的生物标志物。研究集中在CCA细胞产生和分泌的细胞因子、生长因子或酶，以及血清和胆汁的蛋白质组分析。
白细胞介素6、胰蛋白酶原、粘蛋白-5AC、细胞角蛋白19可溶性片段的血清水平以及血小板-淋巴细胞比率最近已被证明有助于CCA的诊断，在某些情况下还具有预后价值。就胆汁而言，已对胰腺弹性蛋白酶/淀粉酶比率、粘蛋白-4、微小染色体维持复制蛋白和胰岛素样生长因子1进行了研究，胰岛素样生长因子1的胆汁浓度能够完全区分CCA与良性胆道疾病和胰腺癌。我们还讨论了血清和胆汁蛋白质组学的进展，这在识别CCA新标志物方面似乎很有前景。
