Background/Objectives: Obstruction of the biliary duct may be caused by various conditions ranging from chronic inflammation to neoplasia, including cholangiocarcinoma (CCA). While the definite histological diagnosis of intrahepatic lesions is relatively straightforward, the diagnostic workup of biliary duct stenosis can be challenging, despite the availability of novel tools for intraductal diagnosis. This proof-of-principle study aimed to investigate whether microRNAs (miRNAs) from bile duct stents may be used as biomarkers to differentiate between various bile duct diseases. Methods: For this purpose, we included 100 patients with one or more bile duct stents for various reasons, including malignant disease (n= 40), stenosis due to liver transplantation or surgery (n= 60), and cholangitis (n= 42). During endoscopic retrograde cholangiography, the stents were collected, and miRNA analyses were performed to evaluate miR-16, miR-21, and miR-223. Results: All studied miRNAs were successfully detected from the specimens obtained from the bile duct stents and were comparable in different stents from the same subjects. Following normalization, significant increases in miR-16, -21, and -223 levels were identified in patients with cholangitis compared to specimens from a non-inflammatory cohort. However, when comparing the data from patients in the malignant and non-malignant cohorts, the individual levels of miR-16, miR-21, and miR-223 showed high variation, without reaching a statistically significant difference. Conclusions: In summary, bile duct stents can be considered as potential sources of intraductal biomarkers, specifically miRNAs. Further profiling and validation analyses are necessary to identify the most appropriate miRNA targets for differentiating bile duct diseases.
背景/目的：胆管梗阻可由多种病因引起，包括从慢性炎症到肿瘤性疾病（如胆管癌）。尽管目前已有新型腔内诊断工具，肝内病变的明确组织学诊断相对直接，但胆管狭窄的诊断评估仍具挑战性。本原理验证研究旨在探讨胆管支架中的微小RNA（miRNA）是否可作为区分不同胆管疾病的生物标志物。方法：本研究纳入100例因各种原因置入单个或多个胆管支架的患者，包括恶性疾病（40例）、肝移植或手术后狭窄（60例）及胆管炎（42例）。在内镜逆行胆管造影术中收集支架样本，通过miRNA分析检测miR-16、miR-21和miR-223的表达水平。结果：所有研究的miRNA均成功从胆管支架样本中检出，且同一受试者不同支架间的检测结果具有可比性。经标准化处理后发现，与非炎症组相比，胆管炎患者的miR-16、-21和-223水平显著升高。然而，在恶性与非恶性疾病组间比较时，miR-16、miR-21和miR-223的个体表达水平呈现高度异质性，未达到统计学显著差异。结论：胆管支架可作为腔内生物标志物（特别是miRNA）的潜在来源。未来需通过进一步谱系分析和验证研究，确定最适合用于鉴别胆管疾病的miRNA靶标。
Exploring microRNAs in Bile Duct Stents as Diagnostic Biomarkers for Biliary Pathologies
肿瘤(癌症)患者之家