scholarly journals Biliary hCGβ Is a Potential Novel Marker for Prediction of Biliary Neoplasia in Primary Sclerosing Cholangitis Patients

Livers ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 322-329
Author(s):  
Hannu Koistinen ◽  
Sonja Boyd ◽  
Johanna Arola ◽  
Kalle Jokelainen ◽  
Riitta Koistinen ◽  
...  
Keyword(s):  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Predictive Marker ◽  
Chronic Inflammatory Disease ◽  
The Other ◽  
Brush Cytology ◽  
Endoscopic Retrograde ◽  
Increased Risk ◽  
Serum Trypsinogen ◽  
Bile Samples

Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease, which is associated with an increased risk of cholangiocarcinoma (CCA). Novel markers, to complement or replace CA19-9, are urgently needed for the screening of PSC-associated biliary neoplasia. Previous studies have suggested that serum trypsinogen-2 and human chorionic gonadotropin β-subunit (hCGβ) may serve as such markers. Using highly specific in-house immunoassays, we studied trypsin(ogen)-2 and -3, SPINK1 and hCGβ in bile samples of 214 patients, referred for endoscopic retrograde cholangiography. We found that biliary trypsinogen-2 was decreased (p = 0.027) and hCGβ was elevated (p < 0.001) in PSC patients who were diagnosed 1.6 years (median, range 0.1–8.8 years) later with CCA or in whom biliary dysplasia was observed at least twice in brush cytology (n = 11) as compared to PSC patients without CCA or repeated dysplasia (n = 171). The other studied markers did not show significant differences between these groups. Our results warrant further evaluation of hCGβ as a predictive marker for PSC-associated biliary neoplasia.

Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis: A meta-analysis

2002 ◽  
Vol 56 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Roy M. Soetikno ◽  
Otto S. Lin ◽  
Paul A. Heidenreich ◽  
Harvey S. Young ◽  
Michael O. Blackstone
Keyword(s):  
Ulcerative Colitis ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Colorectal Neoplasia ◽  
Meta Analysis ◽  
Increased Risk

scholarly journals Suspicious brush cytology is an indication for liver transplantation evaluation in primary sclerosing cholangitis

2017 ◽  
Vol 23 (33) ◽  
pp. 6147-6154 ◽  
Author(s):  
Sonja Boyd ◽  
Marko Vannas ◽  
Kalle Jokelainen ◽  
Helena Isoniemi ◽  
Heikki Mäkisalo ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Brush Cytology

Cholestatic Liver Injury: Care of Patients With Primary Biliary Cholangitis or Primary Sclerosing Cholangitis

2016 ◽  
Vol 27 (4) ◽  
pp. 441-452 ◽  
Author(s):  
Laurie Larson ◽  
Michelle James ◽  
Andrea Gossard
Keyword(s):  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Disease Recurrence ◽  
Outpatient Setting ◽  
Primary Biliary Cholangitis ◽  
Malignant Neoplasms ◽  
Cholestatic Liver Disease ◽  
Gallbladder Polyps ◽  
Increased Risk ◽  
Common Causes

The most common causes of chronic cholestatic liver disease are primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Both disease processes are characterized by a destruction of intrahepatic and/or extrahepatic biliary ducts. The etiology is not entirely clear; however, there is an underlying autoimmune component contributing to both disease processes. Although PBC and PSC are often diagnosed and managed in the outpatient setting, in some instances, a patient may have jaundice, fatigue, and pruritus requiring evaluation and determination of the cholestatic cause. Patients with PSC should be monitored for evidence of cholangiocarcinoma, colon cancer, and gallbladder polyps as they are at an increased risk of malignant neoplasms. Liver transplant has the potential for improving quality of life, although disease recurrence is a risk.

scholarly journals New approach to decrease post-ERCP adverse events in patients with primary sclerosing cholangitis

2017 ◽  
Vol 05 (08) ◽  
pp. E710-E717 ◽  
Author(s):  
Udayakumar Navaneethan ◽  
Dennisdhilak Lourdusamy ◽  
Norma Gutierrez ◽  
Xiang Zhu ◽  
John Vargo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Primary Sclerosing Cholangitis ◽  
Stent Placement ◽  
Sclerosing Cholangitis ◽  
Balloon Dilation ◽  
Bivariate Analysis ◽  
Contrast Injection ◽  
Group I ◽  
Increased Risk ◽  
Group Ii

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is often performed in patients with primary sclerosing cholangitis (PSC). Our aim was to validate a treatment approach with the objective of decreasing ERCP related adverse events (AEs). Patients and methods All patients who had undergone ERCP for PSC during the period from 2002 – 2012 were identified (group I). This group had traditional ERCP (no bile aspiration prior to contrast injection with balloon dilation and stent placement for treatment of dominant strictures). To decrease ERCP-related AEs, we changed the ERCP approach in which bile aspiration was performed prior to contrast injection and balloon dilation alone was performed for treatment of dominant strictures. This was tested prospectively in all patients undergoing ERCP for PSC from 2012 – 2014 (group II). Results The risk of overall AEs and cholangitis was relatively less in group II compared with group I [(2.1 % vs. 10.3 %; P = .38) and (0 % vs. 4.4 %; P = .68)]. On bivariate analysis, change in ERCP approach was associated with decreased risk of post-procedure cholangitis (0 % vs. 10.2 %, P = .03) and overall AE (0 % vs. 18.6 %, P = .03). There were no AEs in 22/46 patients in group II who had bile aspiration with balloon dilation. On multivariate analysis, only biliary stent placement was associated with increased risk of AEs (OR 4.10 (1.32 – 12.71); P = .02) and cholangitis (OR 5.43, 1.38 – 21.38; P = .02) respectively. Conclusion Biliary aspiration and avoidance of stenting approach after dilation of strictures during ERCP in PSC patients appears to be associated with decreased risk of cholangitis and overall AEs. Future prospective randomized controlled trials are needed to validate our observation.

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