1. Funding of Post-doctoral Research Fellow.
2. Laboratory consumables.

I am pleased to be able to report that we have been able to do more than was initially proposed in the original grant application, in that we have been able to analyse bile, urine and blood samples for potential new diagnostic biomarkers for malignant biliary disease. In our first report (October 2010), I reported that we found the level in bile of a protein called Neutrophil Gelatinase-associated Lipocalin (NGAL) was very good at diagnosing malignant cases from benign. This is important as patients with these conditions usually have obstruction to the flow of bile and undergo a procedure called endoscopic retrograde cholangiopancreatography (ERCP), to relieve the obstruction and to collect bile. Thus bile is usually readily available in these patients. There is little research to date on the potential of bile to provide new biomarkers to diagnose cancer, and it is an untapped source of potential new diagnostic markers. Subsequent to our first report, we went on to report that we confirmed our original finding in a second group of patients. Following this validation, our work was selected for oral presentation at the British Society of Gastroenterology Annual Scientific meeting in March 2011 (Birmingham, UK) and has just been selected for publication in the prestigious American Journal of Gastroenterology, one of the highest ranked journals in the field. In the last three months we have completed the proteomic analysis in blood samples. The preliminary results suggest several proteins which can potentially help diagnose biliary cancer. The next studies will use different techniques to fully identify these proteins.

Impact of the research
Although it is still too early for our research to directly impact patient care, we are currently recruiting centres and applying for funding to validate out biomarkers in a large multi-centre clinical trial. If this proves our biomarker is accurate, it could have a major impact on facilitating diagnosis of malignant biliary strictures, enabling patients to receive appropriate therapies as early as possible.