Researchers found differences in serum microRNA (miRNA) expression that could improve differential diagnosis in cholangiocarcinoma (CCA) and presented their results at the Cholangiocarcinoma Foundation Annual Conference (February 23-25, 2022).

“When distal cholangiocarcinomas (dCCAs) cross the pancreatic head, it is clinically challenging to distinguish them from pancreatic ductal adenocarcinomas (PDACs) or even benign pancreatic diseases (BPDs) by using currently available imaging techniques or established biomarkers,” the authors wrote.

Hence, they isolated miRNAs from serum samples of patients with dCCA (n=35), PDAC (n=38), and BPD (cysts, n=22, or pancreatitis, n=20), as well as healthy individuals (n=45). All groups showed distinct serum miRNA profiles.

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The authors highlighted 4 miRNAs that allowed for the discrimination between diseases: miR-95-3p (upregulated in dCCA and downregulated in PDAC), miR-154-5p (downregulated in dCCA), miR-200c-3p (upregulated in BPD chronic pancreatitis), and miR-204-5p (upregulated in BPD cysts).

From those, miR-154-5p performed better in distinguishing dCCA and PDAC, both in terms of sensibility and sensitivity. When compared with carbohydrate antigen 19-9 (CA 19-9), a nonspecific tumor marker commonly used to help distinguish CCA from PDAC, miR-154-5p showed higher specificity (66.67% vs 48%) but lower sensitivity (72.41% vs 77%). The area under the receiver operating characteristic calculated for miR-154-5p and CA 19-9 were 0.71 and 0.69, respectively.

Carbohydrate Antigen 19-9 Biomarker Shown Useful for Distal CCA Prognosis

miR-154-5p serum levels were negatively correlated with gamma-glutamyl transferase concentration. Also, miR-95-3p serum levels were positively correlated with CA 19-9 levels in patients with dCCA. Both miRNAs seemed to be modulated by diabetes, with a slight decrease in miR-154-5p and a slight increase in miR-95-3p being observed in patients with diabetes. miR-204-5p and miR-200c-3p were positively correlated with patients’ age.

No associations were found between any of the miRNAs evaluated in this study and patients’ gender or liver-related risk factors, including cirrhosis, hepatitis B virus, hepatitis C virus, or alcohol consumption in patients with dCCA.


Tomás AF, Simão AL, Muñoz-Bellvís L, et al. Differential diagnosis of distal cholangiocarcinoma from pancreatic diseases using serum miRNA profiling. Poster presented at: Cholangiocarcinoma Foundation Annual Conference: February 23-25, 2022; Salt Lake City, Utah.