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Impact of Routine Histopathological Examination of Gall Bladder Specimens on Early Detection of Malignancy - A Study of 4,115 Cholecystectomy Specimens

  • Published : 2013.05.30

Abstract

Gall bladder carcinoma is the most common cancer of biliary tree, characterized by rapid progression and a very high mortality rate. Detection at an early stage, however, is indicative of a very good prognosis and prolonged survival. The practice of histopathological examination of gall bladder specimens removed for clinically benign conditions and its usefulness has been a subject of controversy. The present prospective study was carried out over a period of four years in order to find out the incidence of unsuspected gallbladder carcinoma in cholecystectomy specimens received in our histopathology laboratory and to analyze their clinico-pathological features. A total of 4,115 cases were examined. Incidentally detected cases comprised 0.44%, which accounted for 72% of all gall bladder carcinomas detected. The majority were in an early, surgically resectable stage. From the results of this study we recommend that in India and other countries with relatively high incidences of gall bladder carcinoma, all cholecystectomy specimens should be submitted to histopathology laboratory, as this is the only means by which malignancies can be detected at an early, potentially curable stage.

Keywords

References

  1. Bartlett DL (2000). Gallbladder cancer. Semin Surg Oncol, 19, 145-55. https://doi.org/10.1002/1098-2388(200009)19:2<145::AID-SSU7>3.0.CO;2-6
  2. Chin KF, Mohammad AA, Khoo YY, Krishnasamy T (2012). The impact of routine histopathological examination on cholecystectomy specimens from an Asian demographic. Ann R Coll Surg Engl, 94, 165-9. https://doi.org/10.1308/003588412X13171221501708
  3. Darmas B, Mahmud S, Abbas A, Baker AL (2007). Is there any justification for the routine histological examination of straightforward cholecystectomy specimens? Ann R Coll Surg Engl, 89, 238-41. https://doi.org/10.1308/003588407X168361
  4. De Zoysa MI, De Silva SK, Illeperuma A (2010). Is routine histological examination of gall bladder specimens justifiable? Ceylon Med J, 55, 13-6.
  5. Dix FP, Bruce IA, Krypcyzk A, Ravi S (2003). A selective approach to histopathology of the gallbladder is justifiable. Surgeon, 1, 233-5. https://doi.org/10.1016/S1479-666X(03)80023-9
  6. Ghimire P, Yogi N, Shrestha BB (2011). Incidence of incidental carcinoma gall bladder in cases of routine cholecystectomy. Kathmandu Univ Med J (KUMJ), 9, 3-6.
  7. Giang TH, Ngoc TT, Hassell LA (2012). Carcinoma involving the gallbladder: a retrospective review of 23 cases - pitfalls in diagnosis of gallbladder carcinoma. Diagnostic Pathology, 27, 7-10.
  8. Hamdani NH, Qadri SK, Aggarwalla R, et al (2012). Clinicopathological Study of Gall Bladder Carcinoma with Special Reference to Gallstones: Our 8-year Experience from Eastern India. Asian Pac J Cancer Prev, 13, 5613-7. https://doi.org/10.7314/APJCP.2012.13.11.5613
  9. Kapoor VK, Mc Michael AJ (2003). Gallbladder cancer: an 'Indian' disease. Natl Med J Ind, 16, 209-13.
  10. Lam CM, Yuen AW, Wai AC, et al (2005). Gallbladder cancer presenting with acute cholecystitis. A population-based study. Surg Endosc, 19, 697-701. https://doi.org/10.1007/s00464-004-9116-2
  11. Lazcano-Ponce EC, Miquel JF, Munoz N, et al (2001). Epidemiology and molecular pathology of gallbladder cancer. Cancer J Clin, 51, 349-64. https://doi.org/10.3322/canjclin.51.6.349
  12. Lee SH, Lee DS, You IY, et al (2010) Histopathologic analysis of adenoma and adenoma-related lesions of the gallbladder. Korean J Gastroenterol, 55, 119-26. https://doi.org/10.4166/kjg.2010.55.2.119
  13. Levy AD, Murakata LA, Rohrmann CA Jr (2001). Gallbladder carcinoma: radiologic-pathologic correlation. Radiographics. 21, 295-314. https://doi.org/10.1148/radiographics.21.2.g01mr16295
  14. Mazer LM, Losada HF, Chaudhry RM, et al (2012). Tumor characteristics and survival analysis of incidental versus suspected gallbladder carcinoma. J Gastrointest Surg, 16, 1311-7. https://doi.org/10.1007/s11605-012-1901-y
  15. Meirelles-Costa AL, Bresciani CJ, Perez RO, et al (2010). Are histological alterations observed in the gallbladder precancerous lesions? Clinics (Sao Paulo), 65, 143-50.
  16. Mishra S, Chaturvedi A, Misra NC (2006). Gallbladder cancer. Curr Treat Options Gastroenterologist, 9, 95-106. https://doi.org/10.1007/s11938-006-0028-1
  17. Mitrovic F, Krdzalic G, Musanovic N, Osmic H (2010). Incidental gallbladder carcinoma in regional clinical centre. Acta Chir Iugosl, 57, 95-7.
  18. Mittal R, Jesudason MR, Nayak S (2010). Selective histopathology in cholecystectomy for gallstone disease. Indian J Gastroenterol, 29, 26-30.
  19. 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
  20. Randi G, Franceschi S, La Vecchia C (2006). Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer, 118, 1591-602. https://doi.org/10.1002/ijc.21683
  21. Samad A, Kumar B, Khanzada TW (2009). Practice of surgeons regarding examination of pathological specimens in operating room. J Ayub Med Coll Abbottabad, 21, 137-42.
  22. Shih SP, Schulick RD, Cameron JL, et al (2007). Gallbladder cancer: the role of laparoscopy and radical resection. Ann Surg, 245, 893-901. https://doi.org/10.1097/SLA.0b013e31806beec2
  23. 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.
  24. Stephen AE, Berger DL (2001). Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery, 129, 699-703. https://doi.org/10.1067/msy.2001.113888
  25. Sun CD, Zhang BY, Wu LQ, Lee WJ (2005). Laparoscopic cholecystectomy for treatment of unexpected early-stage gallbladder cancer. J Surg Oncol, 91, 253-7. https://doi.org/10.1002/jso.20318
  26. Tantia O, Jain M, Khanna S, Sen B (2009). Incidental carcinoma gall bladder during laparoscopic cholecystectomy for symptomatic gall stone disease. Surg Endosc, 23, 2041-6. https://doi.org/10.1007/s00464-008-9950-8
  27. 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.
  28. Wakai T, Ajioka Y, Nagino N, et al (2012). Morphological features of early gallbladder carcinoma. Hepatogastroenterology, 59, 1013-7.
  29. Wang RT, Xu XS, Liu J, Liu C (2012).Gallbladder carcinoma: analysis of prognostic factors in 132 cases. Asian Pac J Cancer Prev, 13, 2511-4. https://doi.org/10.7314/APJCP.2012.13.6.2511
  30. Yamagiwa H, Tomiyama H (1986). Intestinal metaplasiadysplasia-carcinoma sequence of the gallbladder. Acta Pathol Jpn, 36, 989-97.
  31. Yi X, Long X, Zai H, et al (2013). Unsuspected gallbladder carcinoma discovered during or after cholecystectomy: focus on appropriate radical re-resection according to the T-stage. Clin Transl Oncol (Epub ahead of print).

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