الفهرس 
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Abstract
Biliary Tract Cancers (BTC) represents the second most common type of hepatobiliary cancer worldwide. Surgical resection provides the best hope of survival when diagnosed at an early stage, but of the 10–30% of cases where surgery is feasible, only a few patients survive beyond three years. In most patients relief of biliary obstruction and palliative chemotherapy are the mainstays of therapy. Pancreatic cancer (PC) is the eighth most common cancer in women and the fourth leading cause of cancer death in men and women. It accounts for 7% of all cancer deaths.
In patients presenting with biliary symptoms, the diagnosis is largely based on the clinical presentation of cholestasis, abdominal pain and weight loss, together with cross-sectional imaging studies, but it is often difficult to differentiate between BTC and benign stricturing conditions. Endobiliary procedures such as forcep biopsy, brush or aspiration cytology have high (95–100%) specificity but are invasive and have a sensitivity of only 40–70% (3). Liver biochemical abnormalities and the standard tumour markers including CA19-9 and carcinoembryonic antigen (CEA) are of limited value.
One such potential biomarker is the pyruvate kinase isoenzyme type M2 (M2-PK). However, as yet the role of M2-PK in bile as marker for BTC has not been investigated. In this study, for the quantification of the dimeric form of M2-PK in bile samples, a sandwich ELISA technique was used which is based on two monoclonal antibodies directed against the dimeric M2-PK.
So, detection of Pyruvate Kinase M2 in bile of patients with BTC may increase the sensitivity and specifity of other tools used in the diagnosis of BTC.