Malignant Biliary Obstruction Increases Significantly Serum Lipid Levels: A Novel Biochemical Tumor Marker?
ABSTRACT Background/Aims: We aimed to investigate the alterations in serum lipid levels due to biliary obstruction associated with benign and malignant cases. Also, we aimed to examine the possibility of the theory that extremely high serum lipid levels can predict the malignant biliary obstruction in the differantial diagnosis. Methodology: Three hundred twenty two patients who were performed endoscopic retrograde cholangiopancreatography with the intrahepatic and extrahepatic cholestasis were reviewed in the period from September 2007 to October 2010. Results:In the malignant obstruction group, meaningfully higher total cholesterol (p<0,001), low-density lipoprotein (p>0.05) and triglycerides (p<0.05) were observed but high-density lipoprotein (p<0.05) levels were lower. The receiver operating characteristic analysis showed that total cholesterol (246.74mg/dL or less), sensitivity (84.3%), specificity (83.3%) area under the curve (0.705, range 0.620-0.790; p<0.001) and high-density lipoprotein cholesterol area under the curve (0.577, range 0.444-0.710) were predictors of malignant biliary obstruction. Conclusions: Serum lipid profile may be used as an applicant marker to identify malignant reasons of the obstructive jaundice.