Insulin-Like Growth Factor-1 and Vascular Endothelial Growth Factor in Malignant and Benign Biliary Obstructions

• Published in: The American journal of the medical sciences 2016-03, Vol.351 (3), p.259-264
• Main Authors: Abdel-Razik, Ahmed, MD, ElMahdy, Youssif, MD, hanafy, Ehab El, MD, Elhelaly, Rania, MD, Elzehery, Rasha, MD, M. Tawfik, Ahmed, MD, Eldars, Waleed, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bile Duct Neoplasms - blood; Bile Duct Neoplasms - diagnosis; Bile Duct Neoplasms - metabolism; Biliary obstruction; Biomarkers - blood; Biomarkers - metabolism; Biomarkers, Tumor - blood; Biomarkers, Tumor - metabolism; Cholangiocarcinoma - blood; Cholangiocarcinoma - diagnosis; Cholangiocarcinoma - metabolism; Cholestasis - blood; Cholestasis - diagnosis; Cholestasis - metabolism; Cross-Sectional Studies; Female; Humans; Insulin-Like Growth Factor I - metabolism; Insulin-like growth factor-1; Internal Medicine; Male; Middle Aged; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - blood; Vascular Endothelial Growth Factor A - metabolism
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1016/j.amjms.2015.12.013

Abstract Background Despite the presence of various diagnostic tools, the differential diagnosis between malignant and benign biliary obstructions is so difficult. This study aimed to evaluate the role of serum and biliary insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) in this differential diagnosis. Materials and Methods Patients ( n = 109, 61 men and 48 women) with diagnosis of benign ( n = 62) or malignant ( n = 47) biliary obstruction were included. Serum and biliary IGF-1 and VEGF markers were analyzed by the chemiluminescent immunometric method. Results Mean age was 62.7 ± 8.1 years for the malignant group and 58.5 ± 15.4 years for the benign group ( P = 0.092). Choledocholithiasis (79%), cancer head of the pancreas (53.2%) and cholangiocarcinoma (38.3%) were the most common etiologies. No statistical difference was detected regarding serum IGF-1 and VEGF levels between 2 groups. At a cutoff value of 308.55 and 0.5 ng/mL, biliary IGF-1 and VEGF had (91.4% and 90.3%) sensitivity and (89.5% and 84.9%) specificity differential diagnosis between malignant and benign biliary obstructions (area under the curve: 0.943, 0.915), respectively. Conclusions Biliary levels of IGF-1 and VEGF significantly increase in malignant than benign obstructive lesions. Measurement of these markers in the bile of these patients may aid in the detection of biliary tumors.