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Molecular Test Doubles Detection Of Bile Duct Cancer
New test provides more accurate diagnosis for patients with bile duct blockages
Mar. 28, 2026 at 1:12am
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Scientists at UPMC Hillman Cancer Center and the University of Pittsburgh School of Medicine developed a molecular test called BiliSeq that detected bile duct cancer with twice the sensitivity of the standard test. The study found BiliSeq increased cancer detection to nearly 90% when combined with pathology, while rarely misclassifying benign disease as malignant. BiliSeq is used for patients with bile duct narrowing or obstructions that need a clearer diagnosis, and it can also identify treatment-relevant genetic information to help personalize care.
Why it matters
Bile duct tumors are often small, difficult to reach, and surrounded by inflammation or scar tissue, making standard biopsy and cytology methods unreliable. BiliSeq addresses this limitation by detecting genetic mutations associated with cancer in bile duct tissue, providing a more accurate diagnosis for patients and informing personalized treatment decisions.
The details
BiliSeq detected approximately 82% of bile duct cancers, compared to 44% with pathology alone. The test functions even when tumor cells are sparse, damaged or indistinguishable from inflammation under the microscope - a key limitation of traditional pathology. BiliSeq also identified treatment-relevant genetic information in about one out of every five patients, leading doctors to change how care was managed in nearly one-third of those cases.
- The study evaluated BiliSeq's performance over six years in more than 2,000 patients across the United States, analyzing nearly 3,000 bile duct specimens.
The players
UPMC Hillman Cancer Center
A comprehensive cancer center and part of the University of Pittsburgh Medical Center (UPMC) health system.
University of Pittsburgh School of Medicine
The medical school of the University of Pittsburgh, a leading academic institution for medical research and education.
Adam Slivka, M.D., Ph.D.
Professor of medicine in the Division of Gastroenterology, Hepatology and Nutrition at the University of Pittsburgh, and director of the gastroenterology service line at UPMC.
Aatur Singhi, M.D., Ph.D.
Associate professor of pathology at the University of Pittsburgh, and director of the UPMC Developmental Laboratory.
What they’re saying
“For decades, in bile duct cancer we've known that a negative biopsy doesn't always rule out cancer. That uncertainty drives repeat testing and sometimes surgery without clear answers.”
— Adam Slivka, Professor of medicine
“With BiliSeq's sister test, PancreaSeq, we learned that changing clinical practice doesn't happen overnight. Today, PancreaSeq is used at more than 100 institutions, and I see BiliSeq following a similar path as a tool developed to improve care for patients.”
— Aatur Singhi, Associate professor of pathology
What’s next
Adoption of BiliSeq is expected to continue growing as more medical centers incorporate the test into their diagnostic practices for patients with bile duct blockages.
The takeaway
BiliSeq represents a significant advancement in the diagnosis of bile duct cancer, providing a more accurate and personalized approach that can lead to earlier treatment decisions and better outcomes for patients.
