Ability of Biochemical Parameters to Distinguish between BileDuct Cancer and Gall Bladder Stones - A Case Control Studyin a Tertiary Care Hospital of Pokhara Valley

Background: The present study was designed to comparatively assess alteration of biochemical parameters inbile duct cancer and gall stone disease. Materials and
Methods: A hospital based case-control study was carriedout in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between 1st January2010 and 31st December 2012. The variables collected were age, gender, serum total cholesterol, total bilirubin,AST, ALT, serum alkaline phosphatase, albumin and hemoglobin. One way ANOVA was used to examine thestatistical significance of differences between groups. A post-hoc LSD test was applied for the comparison ofmeans of control versus case groups. A p-value of <0.05 (two-tailed) was considered significant.
Results: Themean age of cases and controls was 53.2±21.2 years. The levels of serum cholesterol were higher in cases ofcancer 192.5±21.5 mg/dl in comparison to stone cases 168.7±16.1 mg/dl (p value: 0.0001). The total bilirubinshowed the marked difference in cases of cancer 7.6±3.2 mg/dl in comparison to stone cases 2.5±0.8 mg/dl ofbile duct. There was discernible divergence in values of alkaline phosphatase in cases of cancer 251.5±20.1IU/l when compared to stone cases 173.2±12.6 IU/l of bile duct. In contrast, there was no apparent deviation invalues of aspartate transaminases and alanine transaminases in cases of cancer 59.1±8.9 IU/l and 105.5±26.5IU/l when compared to stone cases 56.9±7.9 IU/l and 84.5±13.5 IU/l respectively.
Conclusions: LFT analysis forpre-operative assessment was a good predictive marker in setting apart bile duct cancer and gall bladder stone.