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Volume 40 Issue 3
Mar.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(3): 568-572

Clinical significance of determining the level of biliary calprotectin in patients with cholangiocarcinoma or choledocholithiasis

DOI: 10.12449/JCH240321

  • Department of Gastroenterology，The First Affiliated Hospital of Anhui Medical University，Hefei 230000，China

Research funding:

Youth Project of Natural Science Foundation of Anhui Province (2008085QH415)

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  • Corresponding author: MEI Qiao， meiqiaomq@aliyun.com （ORCID： 0000-0002-0635-6564）
  • Received Date: 2023-06-16
  • Accepted Date: 2023-07-14
  • Published Date: 2024-03-20
    Abstract
  •   Objective  To investigate the difference in the level of biliary calprotectin between patients with cholangiocarcinoma and those with choledocholithiasis.  Methods  Clinical data and bile samples were collected from 34 patients with cholangiocarcinoma and 78 patients with choledocholithiasis who were diagnosed and treated with endoscopic retrograde cholangiopancreatography in The First Affiliated Hospital of Anhui Medical University from May 2021 to September 2022. Fluorescence lateral flow immunoassay was used to measure the levels of calprotectin， hemoglobin， and lactoferrin in bile. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups； the Spearman correlation test was used for correlation analysis； the DeLong test was used for comparison of the area under the ROC curve （AUC）.  Results  Compared with the choledocholithiasis group， the cholangiocarcinoma group had significant increases in the levels of calprotectin ［4 795.50 （2 286.79‍ ‍—‍ ‍20 179.73） ng/mL vs 411.16 （67.03‍ ‍—‍ ‍1 991.88） ng/mL， Z=5.572， P<0.001］ and fluoride ［115.70 （109.10‍ — ‍125.50） mmol/L vs 106.60 （98.60‍ ‍—‍ ‍114.40） mmol/L， Z=2.702， P=0.007］. The patients with cholangiocarcinoma were further divided into high cholangiocarcinoma group and low cholangiocarcinoma group， and there was no significant difference between the two groups in the level of calprotectin ［3 867.71 （2 235.66‍ — ‍26 407.40） ng/mL vs 4 795.50 （2 361.15‍ — ‍13 070.53） ng/mL， Z=0.129， P>0.05］. Biliary calprotectin level was correlated with white blood cell count， hemoglobin concentration， and lactoferrin concentration in bile （r=0.316， 0.353， and 0.464， all P<0.05）. The ROC curve analysis showed that biliary calprotectin （with a sensitivity of 79.4% and a specificity of 75.6%）， blood CA19-9 （with a sensitivity of 82.4% and a specificity of 78.2%）， and their combination （with a sensitivity of 88.2% and a specificity of 73.1%） had good sensitivity and specificity in the diagnosis of cholangiocarcinoma.  Conclusion  There is an increase in the level of biliary calprotectin in patients with cholangiocarcinoma， and therefore， it might become a biomarker for the diagnosis of cholangiocarcinoma.

     

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