Khan, S.A.; Cox, I.J.; Bansi, D.; Thillainayagam, A.; Thomas, H.C.; Taylor-Robinson, S.D.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA92
Academic Journal
Background: Mortality rates for cholangiocarcinoma have been widely reported to be increasing. In vitro phosphorus ([sup 31]P) NMR spectroscopy can be used to analyse body fluids for metabolite abnormalities and the presence of xenobiotics. Several NMR spectroscopy studies on organs and tissue extracts have highlighted differences in the ratio of phospholipid metabolites (phosphodiesters, PDE and phosphomonoesters, PME) between individuals with and without cancer. Decreases in resonances contributing to the PDE region are typically seen in malignancy, often with increases in resonances from the PME region, reflecting increasingly rapid cell turnover of tumour cells. Such a study of has not previously been performed on bile. Methods: [sup 31]P NMR spectra were obtained from bile samples from 24 patients, collected at ERCP. 13 patients had an underlying malignancy: pancreatic carcinoma, cholangiocarcinoma, or metastatic liver disease. 11 cases had non-malignant pathology. Results: A combination of a reduced glycerophosphorylcholine (GPC) signal from the PDE region with the presence of a resonance from the PME region, was seen in bile in 38% of cancer patients, but in only 25% of non-cancer patients. A low or absent GPC signal level was present in 77% of samples from cancer and only 50% of non-cancer patients. Conclusion: Although the difference in PME/PDE resonances between cancer and non-cancer patients did not reach statistical significance, the patterns found are consistent with previous NMR studies of changes in PME/PDE resonances and their constituent components in organs and tissue extracts. This is the first study to show that [sup 31]P NMR spectroscopy of bile can potentially be used to assess differences in phospholipid content between cancer and non-cancer patients. This has implications for the development of novel diagnostic and prognostic strategies.


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