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‹ Sun · 16 Aug 2026
Early cancer detection or prevention

Ultra-low-pass whole-genome sequencing of bile cfDNA in patients with biliary strictures.

A new genetic test of bile samples collected during routine procedures detected bile duct and pancreatic cancers an average of 38 days earlier than current methods.

Ultra-low-pass whole-genome sequencing of bile collected at routine ERCP detected biliary malignancy earlier than conventional cytology by 38 days on average and over 100 days in a subset of patients, with 96% specificity in benign cases and a CNA-based CCA/PDAC discriminator with 0.864 accuracy. This scalable, cost-effective approach could complement ERCP workup for biliary malignancy, addressing a major clinical diagnostic challenge.

What the study was

Study design
Prospective exploratory cohort; bile ULP-WGS with ichorCNA tumour-fraction analysis; 50-region CNA classifier; n=95.
Population
95 patients with biliary strictures under radiological suspicion of malignancy (26 malignant, 69 indeterminate at first ERCP).
Sample size
95
Category
Early Detection
Maturity
Exploratory
Journal
eGastroenterology

Why it surfaced

Novel bile ULP-WGS detects biliary malignancy 100+ days before conventional diagnosis with high specificity; CCA/PDAC discriminator clinically actionable. Major unmet need: indeterminate biliary strictures.

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