• 제목/요약/키워드: Carcinoma of gall bladder

검색결과 19건 처리시간 0.037초

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

  • Kalita, Dipti;Pant, Leela;Singh, Sompal;Jain, Gaurav;Kudesia, Madhur;Gupta, Kusum;Kaur, Charanjeet
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.3315-3318
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    • 2013
  • 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.

Is it Necessary to Submit Grossly Normal Looking Gall Bladder Specimens for Histopathological Examination?

  • Tayeb, Muhammad;Rauf, Fozia;Ahmad, Khurshid;Khan, Faiz Muhammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1535-1538
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    • 2015
  • Background: The objectives of the study were to: 1) determine the frequency of incidental malignancy in unsuspected/grossly normal looking gall bladders; 2) determine the frequency of malignancy in suspected/grossly abnormal looking gall bladders. Materials and Methods: This prospective, cross sectional study was carried out at a tertiary care hospital in Pakistan, during a four year period (Jan 2009-dec2012). All the cholecystectomy cases performed for gallstone diseases were examined initially by a surgeon and later on by a pathologist for macroscopic abnormalities and accordingly assigned to one of the three categories i.e. grossly normal, suspicious, abnormal/malignant. Frequency of incidental carcinoma in these categories was observed after receiving the final histopathology report. Results: A total of 426 patients underwent cholecystectomy for cholelithiasis, with a 1:4 male: female ratio. Mean age of the patients was 45 years with a range of 17-80 years. The frequency of incidental gallbladder carcinoma was found to be 0.70 %(n=3). All the cases of gallbladder carcinoma were associated with some macroscopic abnormality. Not a single case of incidental carcinoma gallbladder was diagnosed in 383 'macroscopically normal looking' gallbladders. Conclusions: Incidental finding of gall bladder cancer was not observed in any of macroscopically normal looking gall bladders and all the cases reported as carcinoma gallbladder had some gross abnormality that made them suspicious. We suggest histopathologic examination of only those gall bladders with some gross abnormality.

Prognostic Relevance of Human Telomerase Reverse Transcriptase (hTERT) Expression in Patients with Gall Bladder Disease and Carcinoma

  • Deblakshmi, Raj Kumari;Deka, Manab;Saikia, Anjan Kumar;Sharma, Bir Kumar;Singh, Nidhi;Das, NN;Bose, Sujoy
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2923-2928
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    • 2015
  • Background: Gallbladder carcinoma (GBC) has been stated as an Indian disease, with the highest number of cases being reported from certain districts of northeast India, which has an ethnically distinct population. Unfortunately there are no scientific reports on the underlying molecular mechanisms associated with the pathogenesis of the disease from this region. Aim: The present study evaluated the role of differential expression of human telomerase reverse transcriptase (hTERT) in the development of gall bladder anomalies. Materials and Methods: Blood and tissue samples were collected from patients undergoing routine surgical resection for clinically proven cases of gallbladder disease {cholelithiasis (CL, n=50), cholecystitis (CS, n=40) and GBC (n=30) along with adjacent histopathologically proved non-neoplastic controls (n=15)} with informed consent. Whole blood was also collected from age and sex matched healthy controls (n=25) for comparative analysis. Differential hTERT mRNA expression was evaluated by semi-quantitative rt-PCR and real-time PCR based analysis using ${\beta}$-actin as an internal control. Evaluation of differential hTERT protein expression was studied by Western blot analysis and immunoflourescence. Statistical analysis for differential expression and co-relation was performed by SPSSv13.0 software. Results: Gallbladder anomalies were mostly prevalent in females. The hTERT mRNA and protein expression increased gradiently from normal

Histopathological changes in gall bladder mucosa in relation to the number, and size of gallstones, and analysis of the findings in the context of age distribution of the patients: A perspective

  • Sanjeev Sharma;Bhupinder Singh Walia;Mandeep Randhawa;Arjun Sharma;Pankaj Dugg;Jiteshwar Singh Pannu
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.277-286
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    • 2023
  • Backgrounds/Aims: To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population. Methods: One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021. Results: Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; p = 0.043), gallstone number (OR, 9.1; p = 0.050), gallstone size (OR, 17.111; p = 0.013), and duration of symptom (OR, 34.125; p = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom (p = 0.008; OR, 21.118) yielded significant p-value. With histopathological diagnoses, 5% of cases had gallbladder cancer. Conclusions: This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.

위암 환자의 담즙 CEA 농도와 장기 생존율 및 간전이와의 연관성 (Carcinoembryonic Antigen (CEA) in the Gallbladder Bile (b-CEA) of Gastric Carcinoma Patients with Long-term Follow up)

  • 백상현;김현구;강민수;신연명;최경현
    • Journal of Gastric Cancer
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    • 제4권1호
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    • pp.1-6
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    • 2004
  • Purpose: Despite numorous reports on the relationship between the level of carcinoembryonic antigen (CEA) in gall bladder bile and liver metastasis in colorectal cancer, no similar studies have been carried out for gastric carcinomas. We, therefore, undertook the present study to establish the relationship between the gall bladder bile CEA and liver metastasis as well as the post-operative survival rate in gastric carcinoma patients with curative resections. Materials and Methods: In 373 gastric cancer patients (252 males, 121 females, age $21\∼76$ years) operated on at Kosin University Hospital between 1989 1996, the CEA concentration in the gall bladder bile was determined during the operation and the value was related to the rates of post-operative survival and liver metastasis during follow-up period. Results: The overall rate of patient survival decreased gradually with increase in TNM stage. The 13-year postoperative survival rates for stages Ia, Ib, II, IIIa, and IIIb were $95.7\%,\;92.5\%,\;79.9\%,\;50.9\%,\;and\;43.3\$, respectively, and the 10-year survival rate for stage IV was $22.6\%$. The patients with a high ($\geq$10 ng/ml) biliary CEA showed a significantly lower rate of survival than those with a low (<10 ng/ml) biliary CEA. The 13-year cumulative survival rate was $55.4\%$ for the high CEA group and $76.5\%$ for the low CEA group (P<0.01). Also, the patients with a high biliary CEA showed a significantly higher rate ($11.5\%$) of liver metastasis than those with a low biliary CEA ($1.9\%$) (P<0.000). In patients with TNM stages (I and II), the CEA level did not affect the post-operative survival rates ($95.4\%\;and87.7\%$ in the high and low CEA groups, P>0.10), but in those with high TNM stages (III and IV), the survival rate was significantly lower in the high CEA group ($25.9\%$) than in the low CEA group ($57.8\%$) (P<0.05). Conclusion: These result suggest that the gall bladder bile CEA level obtained in an advanced-staged gastric cancer operation may be used in predicting the post-operational survival rate and in sorting out patients with a high risk for cancer recurrence, especially in the liver area.

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Tissue microarray를 이용한 여러 암에서의 thymosin β4, vascular endothelial growth factor, 및 hypoxia-inducible factor-1α 발현양상 연구 (Analysis of the Expression Patterns of Thymosin β4, Vascular Endothelial Growth Factor, and Hypoxia-Inducible Factor-1α in Various Tumors Using Tissue Microarray)

  • 이보영;이승현;안병권;옥미선;차희재
    • 생명과학회지
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    • 제21권3호
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    • pp.417-423
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    • 2011
  • 사이모신 베타 4와 관련 단백질인 HIF-$1{\alpha}$ 및 VEGF의 발현을 여러 인간 암 조직에서 tissue microarray를 사용하여 조사하였다. 사이모신 베타 4는 골육중, 대장 선암, 식도 편평세포암, 신장 및 방광의 이행세포암, 폐암 및 간암에서 많이 발현되었으며 HIF-$1{\alpha}$은 비강 역위성 유두종, 폐암 및 식도 편평세포암에서 강한 발현을 보였으며 대체로 발현되는 양상이나 위치가 사이모신 베타 4와 일치하는 것으로 관찰되었다. VEGF는 암 조직에서보다 암조직에 분포된 혈관내피에서 강하게 발현되는 양상을 나타내었으며 암세포에서는 사이모신 베타 4나 HIF-$1{\alpha}$에 비해 강하게 발현되지 않았다. 위암, 간 혈관육종, 담낭 선암과 자궁 내막 선암에서 적당 수준의 VEGF 발현이 관찰되었으며 VEGF의 발현 양상 및 위치는 위암, 골육종, 지방종, 폐암, 간암, 담낭 선암, 식도 편평세포암, 대장 및 직장암, 신세포암을 포함하는 특정 암에서 사이모신 베타 4 및 HIF-$1{\alpha}$와 일치하는 것으로 관찰되었다.

Platelet Derived Growth Factor-B and Human Epidermal Growth Factor Receptor-2 Polymorphisms in Gall Bladder Cancer

  • Mishra, Kumudesh;Behari, Anu;Kapoor, Vinay Kumar;Khan, M. Salman;Prakash, Swayam;Agrawal, Suraksha
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5647-5654
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    • 2015
  • Gall bladder cancer (GBC) is a gastro-intestinal cancer with high prevalence among north Indian women. Platelet derived growth factor-B (PDGFB) and human epidermal growth factor receptor-2 (HER2) may play roles in the etiology of GBC through the inflammation-hyperplasia-dysplasia-carcinoma pathway. To study the association of PDGFB and HER2 polymorphisms with risk of GBC, 200 cases and 300 controls were considered. PDGFB +286A>G and +1135A>C polymorphisms were investigated with an amplification refractory mutation system and the HER2 $Ile^{655}Val$ polymorphism by restriction fragment length polymorphism. Significant risk associations for PDGFB +286 GG (OR=5.25) and PDGFB +1135 CC (OR=3.19) genotypes were observed for GBC. Gender wise stratification revealed susceptibility for recessive models of PDGFB +1135A>C (OR=3.00) and HER2 $Ile^{655}Val$ (OR=2.52) polymorphisms among female GBC cases. GBC cases with gall stones were predisposed to homozygous +286 GG and +1135 CC genotypes. Significant risk associations were found for ACIle (OR=1.48), GAVal (OR=1.70), GAIle (OR=2.00) haplotypes with GBC cases and GCIle haplotype with female GBC cases (OR=10.37, P=<0.0001). Pair-wise linkage disequilibrium revealed negative associations among variant alleles. On multi-dimensional reduction analysis, a three factor model revealed significant gene-gene interaction for PDGFB +286A>G, PDGFB +1135A>C and HER2 Ile165Val SNPs with GBC. Protein-protein interaction showed significant association of PDGFB and HER2 with the epidermal growth factor receptor signaling pathway.

Association of Cytochrome-17 (MspA1) Gene Polymorphism with Risk of Gall Bladder Stones and Cancer in North India

  • Dwivedi, Shipra;Agrawal, Sarita;Singh, Shraddha;Madeshiya, Amit Kumar;Singh, Devendra;Mahdi, Abbas Ali;Chandra, Abhjeet
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5557-5563
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    • 2015
  • Background: Cholelithiasis is associated in 54%-98% of patients with carcinoma of the gallbladder, and a high incidence among females suggests a role of female hormones in the etiology of the disease. Cytochrome $P450C17{\alpha}$ (CYP-17) is a key enzyme involved in estrogen metabolism and polymorphisms in CYP-17 are associated with altered serum levels of estrogens. Thus, we investigated whether the CYP-17 MspA1 gene polymorphism might impact on risk of gall bladder cancers or gallstones, as well as to determine if this gene polymorphism might be linked with estrogen serum levels and lipid profile among the North Indian gall bladder cancer or gallstone patients. Materials and Methods: CYP-17 gene polymorphisms (MspA1) were genotyped with PCR-RFLP in cancer patients (n=96), stone patients (n=102), cancer + stone patients (n=52) and age/sex matched control subjects (n= 256). Lipid profile was estimated using a commercial kit and serum estrogen was measured using ELISA. Results: The majority of the patients in all groups were females. The lipid profile and estrogen level were significantly higher among the study as compared to control groups. The frequency of mutant allele A2 of CYP17 MspA1 gene polymorphism was higher among cancer (OR=5.13, 95% CI+3.10-8.51, p=0.0001), stone (OR=5.69, 95%CI=3.46-9.37, p=0.0001) and cancer + stone (OR=3.54, 95%CI=1.90-6.60, p=0.0001) when compared with the control group. However there was no significant association between genotypes of CYP17 MspA1 gene polymorphism and circulating serum level of estrogen and lipid profile. Conclusions: A higher frequency of mutant genotype A1A2 as well as mutant allele A2 of CYP-17 gene polymorphism is significantly associated with risk of gallbladder cancer and stones. Elevated levels of estrogen and an altered lipid profile can be used as predictors ofgall bladder stones and cancer in post menopausal females in India.

구강 및 악골에 생긴 전이 암종 (METASTATIC CARCINOMA OF ORAL CAVITY)

  • 김창수;이정훈;안희용;정상철;최홍식
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.142-147
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    • 1990
  • 구강내에 발생하는 암종은 원발성으로 나타나는 것이 보통이지만 신체내 다른 부위의 원발성 암종에 의해 이차적으로 전이되기도 한다. Clausen 과 Poulsen에 의하면 원발성 암종중에서 breast, lung, kidney, thyroid의 순으로 구강내 전이암종을 많이 나타내는 것으로 알려져 있다. 문헌에 의하면 구강 및 악골에 발생한 전이암종 중에서 약 70%가 adenocarcinoma 이며 주로 혈행적(hematogenous) 전이를 하는 것으로 알려져 있다. 이때 전이는 일차적으로 악골내에, 이차적으로 연조직에 전이되며, 이로인해 발생한 악성 전이 암종은 구강내에 발생하는 악성종양의 약 1%에 해당한다. 그러나, 실제로 이의 발견이 어려운 것은 악골에 대한 일상의 검사가 이루어지지 않으며 환자 자신이 특별한 증상을 호소하지 않기 때문이다. 본 교실에서는 문헌상 빈도수가 적은 gall bladder cancer 와 pancreatic tumor 에서 전이된 암종이 특이하게 악골내에서는 나타나지 않고 연조직에만 발생하였기에 이에 보고하는 바이다.

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담낭 및 간외담도계 악성종양의 방사선치료결과 (The Role of Radiotherapy for Carcinomas of the Gall Bladder and Extrahepatic Biliary Duct: Retrospective Analysis)

  • 정현주;이현주;양광모;서현숙;김예회;김성록;김홍용
    • Radiation Oncology Journal
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    • 제16권1호
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    • pp.43-49
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    • 1998
  • 배경 : 담낭 및 간외 담도계 악성종양의 5년 생존율은 $10\%$ 이하로 비교적 예후가 불량한 것으로 알려져 있다. 이러한 질환에서 방사선치료가 증상 완화 및 전체 생존율을 향상시키는 것으로 알려져 있어, 본원의 환자를 대상으로 후향적 분석을 시행하여, 방사선치료의 역할을 알아보고자 하였다. 방법 : 1984년 2월부터 1995년 11월까지 인제대학교 부속 백병원 방사선종양학과에서 담낭 및 간외 담도계 악성종양으로 완치 목적의 방사선 치료를 받은 43명의 환자중 3000cGy 이하의 방사선량 을 조사받은 10명을 제외한 총 33명의 환자(담낭 악성 종양은 21명, 간외 담도계 악성종양 12명)를 대상으로 하였다. 남녀 비는 전체 11명대 22명(담낭 악성종양 4:17, 간외 담도계 악성종양 7:5)이었고, 연령분포는 35-77세(중앙값 61세)이었다. 병기별로는 IV기가 19명으로 가장 많았으며, 재발후 방사선치료를 받은 경우가 3명 포함되었다. 방사선치료는 4MV 선형가속기를 사용하여 총 31.44-54.87Gy(중앙값 44.25Gy)가 조사되었고, 3명의 환자에서는 체외조사 전후로 근접치료가 추가되었다. 방사선조사 단독치료는 6명, 수술 후 방사선 치료는 27명에서 시행되었고, 이 중 16명만이 근치적절제술을 시행받았다. 항암화학요법은 17명에서 병행되었으며 이중 11명이 Mitomycin+5-FU+Leucovorin을 사용하였다. 결과 : 총 추적관찰 기간은 2-97개월(중앙값 8.5개월)이었다. 전체 환자의 2년 생존율은 $29.9\%$, 5년 생존율은 $13.3\%$로 나타났다. 질환별로는 담낭의 경우 2년 생존율이 $34.5\%$, 간외담도계 악성종양은 $27.8\%$이었다. 수술 후 방사선치료를 시행받은 환자들의 2년 생존율은 $30.1\%$이며, 이 중 근치적 절제술을 시행받은 16명의 2년 생존율은 $43.8\%$로, 부분절제 및 우회수술후 방사선치료를 시행받은 17명의 $20.7\%$보다 높게 나타났으나 통계적 유의성은 없었다(p>0.05). 병기별로는 1, II기의 2년 생존율이 $66.6\%$, III, IV기는 $23.6\%$로 통계학적으로 유의한 차이를 나타내었다(p<0.05). ECOG에 의한 임상수행능력정도에 따른 2년 생존율은 2급과 3급이 각각 $41.9\%$, $16.7\%$로 통계학적으로 유의한 차이를 나타내었다(p<0.05). 항암화학요법을 병행한 군의 2년 생존율은 $40.5\%$로 항암화학요법을 병행하지 않은 군의 $22.6\%$ 보다 비교적 높게 나타났으나 통계적 유의성은 없었다(p>0.05). 결론 : 본 연구결과 전체 환자의 2년 생존을과 5년 생존율은 $29.9\%$$13.3\%$로 나타났으며, 병기가 낮고, 임상수행능력이 높을수록 생존율이 향상됨을 알 수 있었다. 또한 근치적 절제술후 방사선 치료를 받은 환자와 항암화학요법을 병행한 군의 치료성적이 비교적 높은 것으로 볼 때, 담낭 및 간외담도계 악성종양환자중 일부에서 적극적인 병합치료요법이 생존율의 향상에 도움을 줄 것으로 기대된다.

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