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Abstract
Cholangiocarcinoma (CCA) is a highly malignant disease, originating from the duct-ular epithelm of [he extra-hepatic and intra- hepatic biliary apparatus. Unfortunately, both diagnosis and management aiv complex and difficult. CCA presents fale and lias a poor prognosis. Surgical resection is the only curative treatment, but most patients present \i\(c. Current diagnostic tests have a poor sensitivity and specificity. Hence the need for new biological hiojiiarkerx to the disease earJy and improve survival.
The overall aims of this thesis were to identify Ihc characteristic demographic and cJinico-pathologica] features of Rgyptian patients with CCA and to identify potential early disease markers using MRS for metabolic profiling <if bile Emd iiriii<; in patients with CCA. Ultimately, the identification of appropriate markers would improve prognosrs and survival from the dtscase.
h
Eg>pptian patients \vith CCA presented ai n younger age and find higher hUimliin Jcvci than other patterns. They presented iatc, so That airJtive stirgical rescefion was occasionally feasible.
ic prollling of bile using MRS in patients with benign and malignant biJiary diseases identified signiJicant JilT^rcnces in the major components of bile. conjugated bile acids, phosphatidylcholine and cholesterol. The concentration of tauiinc-and gly cine- conjugated bile acids were elevated in bile from patients with CCA, compared to bile from patients with benign biliary diseases. Therefore, bile acids may ptoy a role in the actiopathogencsis of CCA and may serve as a disease biomarker.
Biliary cholesterol JeveJ^ in patients with CCA were shown to be reduced, when compared to controls. The otfier nmjor significant finding from the MR study was
a reduced concentration of phosphatidylcliGline (PtC) in CCA