{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:02:00Z","timestamp":1789624920187,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated the diagnostic performance of serum MUC5AC for predicting malignancy in acute cholangitis patients, comparing it with CA19\u20109 and bilirubin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study included 163 patients hospitalized with acute cholangitis. Serum MUC5AC was measured by ELISA within 24\u2009h of admission. Clinical, laboratory, imaging, and pathological findings were reviewed to categorize patients into benign or malignant groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multivariate analysis identified MUC5AC and total bilirubin as independent predictors of malignant cholangitis. Higher MUC5AC (OR: 1.2385, 95% CI: 1.0906\u20131.4065,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0006) and elevated total bilirubin (OR: 1.2086, 95% CI: 1.1068\u20131.3197,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were independently associated with malignancy. CA19\u20109 was significantly associated with malignant cholangitis in univariate analysis but lost significance in multivariate analysis. Among malignant cases, median MUC5AC levels were significantly higher in metastatic than resectable patients, suggesting an association between elevated MUC5AC and advanced disease stage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MUC5AC is a promising biomarker for predicting malignant etiology in acute cholangitis, offering additional diagnostic value alongside established markers like CA19\u20109 and total bilirubin.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.70187","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:05:32Z","timestamp":1789621532000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Prospective Evaluation of Serum\n                    <scp>MUC5AC<\/scp>\n                    for Predicting Malignancy in Patients With Acute Cholangitis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1868-3079","authenticated-orcid":false,"given":"Merve","family":"Aslan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Health Science University T\u00fcrkiye, Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8469-0907","authenticated-orcid":false,"given":"Muhammed Fatih","family":"Acehan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Health Science University T\u00fcrkiye, Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8252-6975","authenticated-orcid":false,"given":"Fatma Meri\u00e7","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-6229","authenticated-orcid":false,"given":"\u0130hsan","family":"Ate\u015f","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Health Science University T\u00fcrkiye, Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"6","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/S0039-6109(16)45285-0","article-title":"Acute Cholangitis","volume":"70","author":"Lipsett P. A.","year":"1990","journal-title":"Surgical Clinics of North America"},{"issue":"2","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.suc.2018.11.002","article-title":"Cholangitis: Causes, Diagnosis, and Management","volume":"99","author":"Sulzer J. K.","year":"2019","journal-title":"Surgical Clinics of North America"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2015.06.011"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/978-94-017-7215-0_15","article-title":"CA 19\u20109: Biochemical and Clinical Aspects","volume":"867","author":"Scar\u00e0 S.","year":"2015","journal-title":"Advances in Experimental Medicine and Biology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.895040"},{"issue":"3","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1093\/annonc\/mdp332","article-title":"Tumor Markers in Pancreatic Cancer: A European Group on Tumor Markers (EGTM) Status Report","volume":"21","author":"Duffy M. J.","year":"2010","journal-title":"Annals of Oncology"},{"issue":"2","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1007\/BF02946481","article-title":"Are Elevated Levels of the Tumour Marker CA19\u20109 of Any Clinical Significance?","volume":"168","author":"McLaughlin R.","year":"1999","journal-title":"Irish Journal of Medical Science"},{"issue":"31","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"4150","DOI":"10.3748\/wjg.v18.i31.4150","article-title":"Adjusting CA19\u20109 Values to Predict Malignancy in Obstructive Jaundice: Influence of Bilirubin and C\u2010Reactive Protein","volume":"18","author":"La Greca G.","year":"2012","journal-title":"World Journal of Gastroenterology"},{"issue":"4","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/S1072-7515(98)00326-3","article-title":"Diagnostic and Prognostic Values of CA 19\u20109 and CEA in Periampullary Cancers","volume":"188","author":"Kau S. Y.","year":"1999","journal-title":"Journal of the American College of Surgeons"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.bbagen.2014.05.003","article-title":"Mucins: A Biologically Relevant Glycan Barrier in Mucosal Protection","volume":"1850","author":"Corfield A. P.","year":"2015","journal-title":"Biochimica et Biophysica Acta"},{"issue":"4","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1042\/bst0230795","article-title":"Human Mucin Glycoproteins: Varied Structures Predict Diverse Properties and Specific Functions","volume":"23","author":"Gum J. R.","year":"1995","journal-title":"Biochemical Society Transactions"},{"issue":"1","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0304-3835(02)00691-2","article-title":"Serum MUC5AC Mucin as a Potential Marker for Cholangiocarcinoma","volume":"195","author":"Wongkham S.","year":"2003","journal-title":"Cancer Letters"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476\u20104598\u20102\u20109"},{"issue":"4","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/00004347-200210000-00009","article-title":"Cytokeratins 7 and 20, Dpc4, and MUC5AC in the Distinction of Metastatic Mucinous Carcinomas in the Ovary From Primary Ovarian Mucinous Tumors: Dpc4 Assists in Identifying Metastatic Pancreatic Carcinomas","volume":"21","author":"Ji H.","year":"2002","journal-title":"International Journal of Gynecological Pathology"},{"issue":"3","key":"e_1_2_10_16_1","first-page":"649","article-title":"Expression of MUC1, MUC2, MUC5AC and MUC6 in Cholangiocarcinoma: Prognostic Impact","volume":"22","author":"Park S. Y.","year":"2009","journal-title":"Oncology Reports"},{"issue":"1","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1038\/ajg.2016.482","article-title":"A Combination of MUC5AC and CA19\u20109 Improves the Diagnosis of Pancreatic Cancer: A Multicenter Study","volume":"112","author":"Kaur S.","year":"2017","journal-title":"American Journal of Gastroenterology"},{"issue":"1","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00534-006-1152-y","article-title":"Definitions, Pathophysiology, and Epidemiology of Acute Cholangitis and Cholecystitis: Tokyo Guidelines","volume":"14","author":"Kimura Y.","year":"2007","journal-title":"Journal of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12051237"},{"issue":"33","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"5313","DOI":"10.1200\/JCO.2006.08.2644","article-title":"ASCO 2006 Update of Recommendations for the Use of Tumor Markers in Gastrointestinal Cancer","volume":"24","author":"Locker G. Y.","year":"2006","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.109"},{"issue":"1","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1158\/1055-9965.EPI-18-0483","article-title":"Identification of Serum Biomarker Panels for the Early Detection of Pancreatic Cancer","volume":"28","author":"Song J.","year":"2019","journal-title":"Cancer Epidemiology, Biomarkers & Prevention"},{"issue":"5","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/j.1440-1746.1991.tb00896.x","article-title":"Assessment of Serum and Bile Levels of CA19\u20109 and CA125 in Cholangitis and Bile Duct Carcinoma","volume":"6","author":"Ker C. G.","year":"1991","journal-title":"Journal of Gastroenterology and Hepatology"},{"issue":"7","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.2169\/internalmedicine.40.624","article-title":"Heterochronous Development of Intrahepatic Cholangiocellular Carcinoma Following Hepatocellular Carcinoma in a Hepatitis B Virus Carrier","volume":"40","author":"Shiozawa K.","year":"2001","journal-title":"Internal Medicine"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(20010615)91:12<2214::AID\u2010CNCR1255>3.0.CO;2\u2010P"},{"issue":"3","key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.jmb.2004.09.059","article-title":"PMA Induces the MUC5AC Respiratory Mucin in Human Bronchial Epithelial Cells, via PKC, EGF\/TGF\u2010\u03b1, Ras\/Raf, MEK, ERK and Sp1\u2010Dependent Mechanisms","volume":"344","author":"Hewson C. A.","year":"2004","journal-title":"Journal of Molecular Biology"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbps.232"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003462"},{"issue":"7","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1002\/cncr.11652","article-title":"Prognostic Value of Serum MUC5AC Mucin in Patients With Cholangiocarcinoma","volume":"98","author":"Boonla C.","year":"2003","journal-title":"Cancer"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.12.003"}],"container-title":["Journal of Hepato-Biliary-Pancreatic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.70187","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jhbp.70187","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.70187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:05:35Z","timestamp":1789621535000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jhbp.70187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":29,"alternative-id":["10.1002\/jhbp.70187"],"URL":"https:\/\/doi.org\/10.1002\/jhbp.70187","archive":["Portico"],"relation":{},"ISSN":["1868-6974","1868-6982"],"issn-type":[{"value":"1868-6974","type":"print"},{"value":"1868-6982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]},"assertion":[{"value":"2025-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jhbp.70187"}}