Another study using samples from 62 patients with biliary obstructions, such as PSC or chronic pancreatitis, and 47 patients with malignant biliary obstructions including CCA and head of pancreas tumor demonstrated that patients with malignant obstructions had increased levels of IGF-1 and VEGF in bile but not in serum [65]. The gene discussed is IGF1; the disease is cholangiocarcinoma.