RESUMO
Objective:To detect the bile and serum survivin levels in patients with obstructive and to determine whether bile and/or serum survivin be helpful in distinguishing malignant obstructive jaundice (cholangiocarcinoma) from benign obstructive jaundice.Methods:Bile and serum survivin levels were determined using enzyme-linked immunosorbent assay.Receiver operating characteristic (ROC) curve was used to evaluate the feasibility of bile and/or serum in differentiating malignant obstructive jaundice from benign obstructive jaundice.Results:Mean bile survivin concentrations were significantly higher in cholangiocarcinoma compared to choledocholithiasis,benign biliary stricture,compressive stenosis and normal controls(P＜ 0.05,respectively).However,only mean serum survivin concentrations were significantly higher in cholangiocarcinoma than normal controls(P=0.009).For bile survivin,the area under the curve (AUC) was 0.780(P ＜ 0.001),and the optimal cut-off value determined was 772.28 pg/mL,providing a sensitivity of 67.27 ％ and a specificity of 80.85 ％.But the AUC was only 0.600 for serum survivin (P=0.084).Conclusions:These findings reveal that bile survivin is significantly increased in patients with cholangiocarcinoma,and bile survivin may be a useful indicator in differentiating distinguishing cholangiocarcinoma from benign obstructive jaundice.