The Role of Resolvin D1 in the Differential Diagnosis of the Cholangiocarcinoma and Benign Biliary Diseases

Abstract

Background: The discrimination of malignant biliary strictures from benign biliary diseases (BBDs) is challenging and complicated. We aimed to investigate whether Resolvin D1 (RvD1) would aid in the discrimination of cholangiocarcinoma (CCA) from BBDs. Methods: Thirty-one patients with CCA, 27 patients with BBD, and 30 healthy controls were enrolled in this crosssectional study. The diagnosis of CCA was based on results obtained from abdominal USG, MRCP, abdominal CT, endosonography, and tumor markers, including CEA and CA 19-9. Histopathological evaluation was performed in the majority of patients, and the final diagnosis was based on surgery or biopsy results. RvD1, CEA, and CA 19-9 were analyzed in all patients with CCA and BBD. Results: RvD1 was significantly lower in those with CCA compared to patients with BBD and healthy controls. In addition, CEA and Ca 19-9 levels were significantly higher in the CCA group than the BBD group (p < 0.001). RvD1 concentration, CA 19-9 concentration, and total bilirubin level were found to be correlated with tumor stage (r = -0.702, 0.390, and 0.569, respectively). ROC curve analysis revealed that an RvD1 concentration of < 380 ng/mL (AUC: 0.783, 95% CI: 0673 - 0.893, p < 0.001) and CA 19-9 concentration of > 94.5 U/mL (AUC: 0.94, 95% CI: 0.898 - 0.998, p < 0.001) could be used to discriminate patients with CCA from those with BBD. Conclusions: Resolvin D1 and CA 19-9 levels might be used to effectively discriminate between BBD and CCA. Moreover, both RvD1 and CA 19-9 levels are associated with the stage of CCA, indicating that they may also be used in assessing disease progression.