The bile exosomal miR-200 family could be potential biomarkers for cholangiocarcinoma, confirmed a study published in the journal Frontiers in Oncology.

The study also found that high levels of exosomal miR-200a-3p and miR-200c-3p in the bile and exosomal miR-200c-3p in serum are associated with worse clinical outcomes.

“The diagnostic ability of exosomal [noncoding] RNAs in human bile is better than that in blood,” the study authors wrote.

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Exosomal non-coding RNAs have been previously proposed as potential biomarkers for several cancers. Here, a team of researchers from China investigated the potential of specific non-coding RNAs in the bile as early diagnostic and prognostic biomarkers in cholangiocarcinoma, a disease lacking such biomarkers.

Read more about the diagnosis of cholangiocarcinoma

The researchers analyzed 100 patients, 50 of whom had cholangiocarcinoma and 50 of whom had biliary stones. They collected exosomes from their bile and serum.

They found exosomal miR-141-3p, miR-200a-3p, miR-200c-3p in serum and bile, and miR-200b-3p and ENST00000588480.1 in bile had areas under the curve larger than 0.7 in diagnosing cholangiocarcinoma, which is considered acceptable.

The area under the curve of bile exosomal miR-200c-3p was 0.87; therefore, this miRNA had the best diagnostic value. When they combined serum CA19-9 into the model, the researchers found that the area under the curve increased to 0.906. They also found bile exosomal miR-200a-3p and miR-200c-3p as being independent predictors of cholangiocarcinoma.

Furthermore, serum and bile exosomal miR-200c-3p and bile exosomal miR-200a-3p could significantly predict the recurrence of cancer, while serum exosomal miR-200c-3p could predict cancer death.

Finally, high serum exosomal miR-200c-3p levels were associated with unfavorable tumor-free survival and overall survival.


Pan Y, Shao S, Sun H, Zhu H, Fang H. Bile-derived exosome noncoding RNAs as potential diagnostic and prognostic biomarkers for cholangiocarcinoma. Front Oncol. 2022;24;12:985089. doi: 10.3389/fonc.2022.985089