DOI QR코드

DOI QR Code

Clinicopathological Study of Gall Bladder Carcinoma with Special Reference to Gallstones: Our 8-year Experience from Eastern India

  • Hamdani, Nissar Hussain (Department of Surgical Gastroenterology, The Calcutta Medical Research Institute) ;
  • Qadri, Sumyra Khurshid (Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences) ;
  • Aggarwalla, Ramesh (Department of Surgical Gastroenterology, The Calcutta Medical Research Institute) ;
  • Bhartia, Vishnu Kumar (Department of Surgical Gastroenterology, The Calcutta Medical Research Institute) ;
  • Chaudhuri, Sumit (Department of Surgical Gastroenterology, The Calcutta Medical Research Institute) ;
  • Debakshi, Sanjay (Department of Surgical Gastroenterology, The Calcutta Medical Research Institute) ;
  • Baig, Sarfaraz Jalil (Department of Surgical Gastroenterology, The Calcutta Medical Research Institute) ;
  • Pal, N.K. (Department of Surgical Gastroenterology, The Calcutta Medical Research Institute)
  • Published : 2012.11.30

Abstract

Gallbladder carcinoma (GBC) is the commonest cancer of the biliary tree and the most frequent cause of death from biliary malignancies. The incidence of GBC shows prominent geographic, age, race, and gender-related differences and is 4-7 times higher in patients with gallstones. This prompted us to study the clinicopathological aspects of the disease and the incidence of gallstones in gallbladder carcinoma patients, in this part of India. In this, combined retrospective (Jan 2004-March 2010) and prospective study (April 2010-Dec 2011) of eight years, 198 patients of gallbladder carcinoma (50 males and 148 females), (range 28-82 years; mean 55 years) were studied. Most of the patients were poor and presented with abdominal pain and mass, with abnormal lab parameters. Gallstones were present in 86% of patients. Surgical exploration was performed in 130, with gallbladder resection in 60 (including 7 incidental GBC). Adenocarcinoma (87.7%) was the commonest histological type. The study indicates that GBC is common in our scenario. It is a disease of elderly females, has a strong association with gallstones and every cholecystectomy specimen should be examined histopathologically.

References

  1. Beltz WR, Condon RE (1974). Primary carcinoma of the gallbladder. Ann Surg, 180, 180-4. https://doi.org/10.1097/00000658-197408000-00009
  2. Black WC, Key CR, Carmany TB, et al (1977). Cancer of the gallbladder in a population of southwest American Indians. Cancer, 39, 1267-79 https://doi.org/10.1002/1097-0142(197703)39:3<1267::AID-CNCR2820390338>3.0.CO;2-0
  3. Chattopadyay TK, Kapoor VK, Sharma LK, et al (1998). Carcinoma of the gall bladder -can we do anything? Postgrad Med J, 64, 593-5.
  4. Chaudhary A, Dhar P, Tomey S, Sachdev A, Agarwal A (1997). Segment III cholangiojejunostomy for carcinoma of the gallbladder. World J Surg, 21, 866-71. https://doi.org/10.1007/s002689900319
  5. Comfort MW, Gray HK, Wilson JM (1948). The silent gallstones: a 10-20 year follows up. Ann Surg, 128, 931-6. https://doi.org/10.1097/00000658-194811000-00005
  6. De Aretxabla, Rao I, Araya JC, et al (1990). Operative findings in patients with early forms of gall bladder cancer. Br J Surg, 77, 291-3. https://doi.org/10.1002/bjs.1800770316
  7. Gupta S, Udupa KN, Gupta S (1980). Primary carcinoma of the gallbladder: a review of 328 cases. J Surg Oncol, 14, 35-44. https://doi.org/10.1002/jso.2930140106
  8. Gupta SK, Shukla VK (2004). Gall bladder cancer etiopathology and treatment. Hlth Adm, 1052, 134-42.
  9. Hart J, Shani M, Modan B (1972). Epidemiological aspect of gall bladder and biliary tract neoplasm. Am J Pub Hlth, 62, 36-9.
  10. Kapoor VK, Pradeep R, Haribhakti SP, et al (1996). Intrahepatic segment III cholangio-jejunostomy in advanced carcinoma of the gall bladder. Br J Surg, 83, 1709-11. https://doi.org/10.1002/bjs.1800831215
  11. Kapoor VK, Mc Michael AJ (2003). Gallbladder cancer: an 'Indian' disease. Natl Med J Ind, 16, 209-13.
  12. Khan RA, Wahab S, Khan MA, Siddiqui S, Maheshwari V (2010). Advanced presentation of Gallbladder cancer: epidemioclinicopathological study to evaluate the risk factors and assess the outcome. J Pak Med Assoc, 60, 217-9.
  13. Khoo JJ, Misron NA (2008). A clinicopathological study of nine cases of gallbladder carcinoma in 1122 cholecystectomies in Johor, Malaysia. Mal J Pathol, 30, 21-6.
  14. Le MD, Henson D, Young H, Albores-Saavedra J (2011). Is gallbladder cancer decreasing in view of increasing laparoscopic cholecystectomy? Ann Hepatol, 10, 306-14.
  15. Levi F, Lucchini F, Negri E, La Vecchia C (2003). The recent decline in gallbladder cancer mortality in Europe. Eur J Cancer Prev, 12, 265-7. https://doi.org/10.1097/00008469-200308000-00004
  16. Liang JW, Dong SX, Zhou ZX, et al (2008). Surgical management for carcinoma of the gallbladder: a singleinstitution experience in 25 years. Chin Med J, 12, 1900-05.
  17. Malik KA, Jawaid M (2009). Incidental gall bladder carcinoma in patients undergoing cholecystectomy for cholelithiasis. Pak J Surg, 25, 262-5.
  18. Maringhini A, Moreau JA, Melton LJ, et al (1978). Gallstones, gall bladder cancer and other gastrointestinal malignancies. Ann Int Med, 107, 30-5.
  19. Mishra R, Goda C, Arora M, et al (2012). Treatment of Gall Bladder Cancer: a Review. Indo Global J Pharm Sci, 2, 54-62.
  20. Pal A, Sharma SK, Pal A, et al (1990). Ultrasonographic evaluation of carcinoma of the gall bladder. Natl Med J Ind, 3, 167-70.
  21. Pandey M, Pathak AK, Gautam A, Aryya NC, Shukla VK (2001). Carcinoma of the gallbladder: a retrospective review of 99 cases. Digest Dis and Sci, 46, 1145-51. https://doi.org/10.1023/A:1010652105532
  22. Pandey M, Shukla VK (2003). Lifestyle, parity, menstrual and reproductive factors and risk factors of gall bladder cancer. Eur J Cancer Prev, 12, 269. https://doi.org/10.1097/00008469-200308000-00005
  23. Pavlidis TE, Pavlidis ET, Symeonidis NG, Psarras K, Sakantamis AK (2012). Current curative surgical management of gallbladder cancer: a brief review. J Curr Surg, 2, 81-3.
  24. Perpetuo MCMO, Valdivieso M, Heliburn LK, et al (1978). Natural history of gallbladder cancer. Cancer, 42, 330-5. https://doi.org/10.1002/1097-0142(197807)42:1<330::AID-CNCR2820420150>3.0.CO;2-F
  25. Piehler JM, Crichlow RW (1978). Primary carcinoma of the gallbladder. Surg Gynecol Obstet, 147, 929-42.
  26. Prakash AT, Sharma LK, Pandit PN (1975). Primary carcinoma of the gallbladder. Br J Surg, 62, 33-6. https://doi.org/10.1002/bjs.1800620109
  27. Roa JC, Tapia O, Cakir A, et al (2011). Squamous cell and adenosquamous carcinomas of the gallbladder: clinicopathological analysis of 34 cases identified in 606 carcinomas. Mod Pathol, 24, 1069-78. https://doi.org/10.1038/modpathol.2011.68
  28. Shiwani MH (2005). Surgical management of gall bladder carcinoma. Busi breif: Eur Gasteroenterol Rev, 1-5.
  29. Shiwani MH (2007). Surgical management of gall bladder carcinoma. J Pak Med Assoc, 57, 87-90.
  30. Shrestha R, Tiwari M, Ranabhat SK, et al (2010). Incidental gallbladder carcinoma: value of routine histological examination of cholecystectomy specimens. Nepal Med Coll J, 12, 90-4.
  31. Shukla VK, Khandelwal C, Roy SK, Vaidya MP (1985). Primary carcinoma of the gallbladder: a review of a 16 year period at the University hospital. J Surg Oncol, 28, 32-5. https://doi.org/10.1002/jso.2930280109
  32. Shukla VK, Chauhan VS, Mishra RN, Basu S (2008). Lifestyle, reproductive factors and risk of gallbladder cancer. Singapore Med J, 49, 912-5.
  33. Talwar BL, Kanta C, Gupta NM. Biliary carcinoma (1983): an analysis of 209 personal cases. Ind J Cancer, 20, 241-6.
  34. Tyagi BB, Manoharan N, Raina V (2008). Risk factors for gallbladder cancer : a population based case-control study in Delhi. Ind J Med and Paed Oncol, 29, 16-26.
  35. Wenckert A, Robertson B (1966). The natural course of gall stone disease. Gastroenterol, 50, 376-81.
  36. Zargar SA, Khuroo MS, Mahajan R, Jan GM, Shah P (1991). US-guided fine-needle aspiration biopsy of gall bladder masses. Radiol, 179, 275-8. https://doi.org/10.1148/radiology.179.1.2006291

Cited by

  1. Impact of Routine Histopathological Examination of Gall Bladder Specimens on Early Detection of Malignancy - A Study of 4,115 Cholecystectomy Specimens vol.14, pp.5, 2013, https://doi.org/10.7314/APJCP.2013.14.5.3315
  2. Association of adrenergic receptor gene polymorphisms in gallbladder cancer susceptibility in a North Indian population vol.140, pp.5, 2014, https://doi.org/10.1007/s00432-014-1621-7
  3. EphB1 and Ephrin-B, New Potential Biomarkers for Squamous Cell/adenosquamous Carcinomas and Adenocarcinomas of the Gallbladder vol.15, pp.3, 2014, https://doi.org/10.7314/APJCP.2014.15.3.1441
  4. Death Receptor (DR4) Haplotypes Are Associated with Increased Susceptibility of Gallbladder Carcinoma in North Indian Population vol.9, pp.2, 2014, https://doi.org/10.1371/journal.pone.0090264
  5. Platelet Derived Growth Factor-B and Human Epidermal Growth Factor Receptor-2 Polymorphisms in Gall Bladder Cancer vol.16, pp.14, 2015, https://doi.org/10.7314/APJCP.2015.16.14.5647
  6. Is it Necessary to Submit Grossly Normal Looking Gall Bladder Specimens for Histopathological Examination? vol.16, pp.4, 2015, https://doi.org/10.7314/APJCP.2015.16.4.1535
  7. Prognostic Relevance of Human Telomerase Reverse Transcriptase (hTERT) Expression in Patients with Gall Bladder Disease and Carcinoma vol.16, pp.7, 2015, https://doi.org/10.7314/APJCP.2015.16.7.2923
  8. Global epidemiological trends and variations in the burden of gallbladder cancer vol.115, pp.5, 2017, https://doi.org/10.1002/jso.24546
  9. Quantification of Circulating Free DNA as a Diagnostic Marker in Gall Bladder Cancer vol.23, pp.1, 2017, https://doi.org/10.1007/s12253-016-0087-0
  10. Analysis of Carcinogenic Heavy Metals in Gallstones and its Role in Gallbladder Carcinogenesis vol.48, pp.4, 2017, https://doi.org/10.1007/s12029-016-9898-1
  11. Galectin-9: An anticancer molecule for gallbladder carcinoma vol.48, pp.3, 2016, https://doi.org/10.3892/ijo.2016.3347
  12. Detection and quantification of heavy metal elements in gallstones using X-ray fluorescence spectrometry pp.00498246, 2019, https://doi.org/10.1002/xrs.3010