Expression of Integrin Ανβ6 to Differentiate Perihilar Cholangiocarcinoma from Benign Disease: A Pilot Study

Background: Curative treatment for patients with perihilar cholangiocarcinoma (PHC) generally consists of extrahepatic bile duct resection with (extended) hemihepatectomy, an operation that is known for its high morbidity and mortality. Diagnostic tests are often lacking in establishing the diagnosis of PHC preoperatively; as a result, 5-15% of patients resected for presumed PHC have benign disease. Molecular imaging combined with cancer biomarker-specific imaging agents could serve as a novel diagnostic tool. Integrin ανβ6 is a cell surface receptor that is highly upregulated in pancreaticobiliary malignancies. We have developed imaging agents selectively binding integrin ανβ6 for both (preoperative)PET and (intraoperative)fluorescent imaging. We aimed to evaluate the expression of integrin ανβ6 in PHC and in benign disease mimicking PHC using immunohistochemistry in a pilot study.