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MeSH term: Gallbladder Neoplasms
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Evaluation of surgical treatment for incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy: single center results.
BMC Res Notes. 2017; 10(1):56 [PubMed] Free Access to Full Article Related Publications
METHODS: Between January 2008 and January 2015, 352 patients underwent LC at Iwakuni Clinical Center. Among these patients, 8 (2.3%) were diagnosed with IGBC. We evaluated their characteristics, surgical related variables, histopathological findings and surgical outcomes.
RESULTS: Patient median age was 71 (range 49-88) years, and 3 out of 8 were female. All patients with IGBC were Japanese. The grade of cancer was as follows: pT1a (3 cases), pT2 (4 cases) and pT3 (1 case). Two patients with pT2 disease underwent radical surgery. The median follow-up time of these patients was 24 (range 11-80) months. All patients are still alive and two of three patients who refused radical surgery have developed recurrence (liver metastases and recurrence in the peritoneum).
CONCLUSIONS: Although the number of cases was small, the results of this study further support the suggestion that gallbladder carcinoma may be curable if diagnosed as IGBC at an early stage. If the cancer has reached an advanced stage, radical surgery should be performed.
The emerging role of long non-coding RNA in gallbladder cancer pathogenesis.
Biochimie. 2017; 132:152-160 [PubMed] Related Publications
Castleman's disease in carcinoma gall bladder.
BMJ Case Rep. 2016; 2016 [PubMed] Related Publications
Spectrum of gallbladder malignancies on fine-needle aspiration cytology: 5 years retrospective single institutional study with emphasis on uncommon variants.
Diagn Cytopathol. 2017; 45(1):36-42 [PubMed] Related Publications
METHODS: The records of the Department of Cytology, PGIMER were searched from July 2010 to June 2015 and all cases of gallbladder malignancies were analyzed in detail for cytomorphological characteristics. Giemsa and Hematoxylin-Eosin stained slides were evaluated with immunocytochemistry on cell blocks wherever available.
RESULTS: A total of 791 gallbladder FNAC performed in cases of radiologically suspected gallbladder malignancies were evaluated. Gallbladder carcinoma (GBC) was more common in females with a male to female ratio of 1:2.3. Median age was 53.4 years (range 24-85 years); 81 cases (10.2%) were nondiagnostic and 31 (3.9%) were suspicious of malignancy. A total of 645 FNACs were positive for malignancy, out of which there were 619 (96%) adenocarcinoma and 26 cases with unusual malignancies. These included adenosquamous carcinoma (8, 1.2%), squamous cell carcinoma (7, 1.1%), small cell neuroendocrine carcinoma (9, 1.3%), and one case each of undifferentiated carcinoma and Non Hodgkin lymphoma respectively. The unusual malignancies were confirmed on cell block immunocytochemistry.
CONCLUSION: Adenocarcinoma is most common type of gallbladder malignancy; however, other unusual types of carcinomas occur and in such cases, FNAC supplemented by cell block immunocytochemistry is required for an accurate diagnosis. Diagn. Cytopathol. 2017;45:36-42. © 2016 Wiley Periodicals, Inc.
Coexisting cancers: a mixture of neuroendocrine carcinoma and adenocarcinoma in the gallbladder: A case report.
Medicine (Baltimore). 2016; 95(44):e5281 [PubMed] Related Publications
METHODS: Herein, we presented an unusual case of poorly differentiated gallbladder neuroendocrine cell carcinoma coexisting with poorly differentiated adenocarcinoma who survived 20 months after the multimodal treatment (MT) of extended surgery and postoperative chemotherapy.
RESULTS: Our result indicated that for advanced gallbladder neuroendocrine cell carcinoma coexisting with adenocarcinoma, MT including extended surgical approach combined with postoperative chemotherapy may contribute to a relatively good survival outcome.
CONCLUSION: MT may contribute to a relatively good survival outcome for advanced gallbladder neuroendocrine cell carcinoma coexisting with gallbladder adenocarcinoma.
Gallbladder cancer: results achieved and future challenges.
Future Oncol. 2017; 13(3):209-211 [PubMed] Related Publications
A hitherto undescribed benign mesenchymal polyp of the gallbladder: edematous angiomyolipoma-like polyp.
Acta Gastroenterol Belg. 2016 Jul-Sep; 79(3):245-250 [PubMed] Related Publications
Overexpression of LncRNA AFAP1-AS1 predicts poor prognosis and promotes cells proliferation and invasion in gallbladder cancer.
Biomed Pharmacother. 2016; 84:1249-1255 [PubMed] Related Publications
METHODS: We analyzed lncRNA AFAP1-AS1 expression by quantitative real time PCR (qRT-PCR) in 40 gallbladder cancer tissue and adjacent normal tissues, survival plots were generated by Kaplan-Meier analysis and the log-rank test. The expression levels of transcription factor Twist1 and epithelial-to mesenchymal transition (EMT) makers (E-cadherin and Vimentin) were detected by quantitative real time PCR and western blotting analysis after knockdown of lncRNA AFAP1-AS1.
RESULTS: The expression levels of lncRNA AFAP1-AS1 were significantly elevated in GBC tissues and GBC cell lines. In addition, the expression level of lncRNA AFAP1-AS1 was significantly associated with tumor sizes and the higher expression of lncRNA AFAP1-AS1 was correlated with poor prognosis in GBC patients. Knockdown of LncRNA AFAP1-AS1 suppressed cell growth and invasion in NOZ and GBC-SD cells. Furthermore, we found that knockdown of LncRNA AFAP1-AS1 in GBC cells inhibited EMT by down-regulating the transcription factor Twist1 and Vimentin and up-regulated the E-cadherin.
CONCLUSIONS: Our results suggested lncRNA AFAP1-AS1 was correlated with poor prognosis in GBC patients and lncRNA AFAP1-AS1 might be novel therapeutic target in gallbladder cancer.
A let-7 microRNA binding site polymorphism in the KRAS 3'UTR is associated with increased risk and reduced survival for gallbladder cancer in North Indian population.
J Cancer Res Clin Oncol. 2016; 142(12):2577-2583 [PubMed] Related Publications
METHODS: In present case-control study, we enrolled 541 patients with gallbladder malignancy and 307 controls. Genomic DNA was obtained from peripheral blood and genotyping was performed using Taqman allelic discrimination assay.
RESULTS: Heterozygous (TG) individuals are at a significant higher risk for GBC as compared with wild genotype (TT) (p = 0.007, odds ratio = 2.56, 95 % CI 1.27-5.18). At allelic level, allele G has significant higher risk for GBC as compared with T allele (p = 0.008, odds ratio = 2.5, 95 % CI 1.25-5.01). Survival analysis reveals decrease in overall survival for heterozygous genotype (p < 0.0001, hazard ratio = 3.42, 95 % CI 1.21-4.20). Also, significant decrease in overall survival was observed for patient carrying allele G (p < 0.0001, HR = 2.89, 95 % CI 1.21-4.20) as compared with allele C.
CONCLUSIONS: We conclude that KRAS rs61764370 polymorphism is significantly associated with risk and prognosis of gallbladder malignancy in this endemic belt.
Prognostic Significance of HER-2 and p53 Expression in Gallbladder Carcinoma in North Indian Patients.
Oncology. 2016; 91(6):354-360 [PubMed] Related Publications
METHODS: Sixty resectable tumor and control specimens were prospectively collected from December 2012 to January 2016. Immunohistochemical staining was done using monoclonal antibodies to semiquantitatively evaluate HER-2 and p53 protein expression. The criterion for HER-2 positivity was set at >30% tumor cells showing complete, membranous staining while p53 positivity was established at <50% tumor cells showing complete nuclear staining. Clinicopathological correlations were drawn with major clinical outcomes.
RESULTS: It was observed that 36.67% (22/60) tumor cases and 5% (3/60) control cases showed strong HER-2 overexpression significantly correlating with sex, T-stage, nodal spread and distant metastasis (p < 0.05), while 33.3% (20/60) positivity was observed for p53 in tumor cases and 1.7% (1/60) in control cases. Multivariate analysis showed HER-2 (p = 0.04; hazard ratio: 2.36; 95% confidence interval: 1.04-5.33) and p53 (p = 0.03; hazard ratio: 5.63; 95% confidence interval: 1.21-26.26) expression to be independent prognostic factors.
CONCLUSION: Our study thus suggests the plausible role of HER-2 and p53 expression in worse prognosis of GBC in a north Indian population.
Overexpression of LncRNA-ROR predicts a poor outcome in gallbladder cancer patients and promotes the tumor cells proliferation, migration, and invasion.
Tumour Biol. 2016; 37(9):12867-12875 [PubMed] Related Publications
Granulocyte Colony-Stimulating Factor-Producing Gallbladder Cancer.
Acta Med Okayama. 2016; 70(5):393-396 [PubMed] Related Publications
Expression of Human Epidermal Growth Factor Receptor (Her 2/neu) and Proliferative Marker Ki-67: Association with Clinicopathological Parameters in Gallbladder Carcinoma.
Asian Pac J Cancer Prev. 2016; 17(8):3903-9 [PubMed] Related Publications
MATERIALS AND METHODS: A retrospective analysis was conducted on formalin fixed paraffin embedded (FFPE) benign (n=25) and malignant gallbladder (n=25) tissue samples. Hematoxylin and eosin stained slides of each case were reviewed for: type of malignancy (whether adenocarcinoma, squamous cell carcinoma, or any other type); grade (well, moderate, and poor); depth of invasion; and pre-neoplastic changes in adjacent mucosal epithelium like metaplasia and dysplasia. Immunohistochemistry for Her 2 neu and Ki-67 was performed and data analysis was conducted using SPSS 17 software. Chi-square test was used to compare categorical/dichotomous variables. A P value of ≤0.05 was considered significant.
RESULTS: The difference of Her 2 neu expression and Ki67 index between benign and malignant groups was found to be statistically significant. Her2/neu positivity did not have any significant correlation with various clinicopathological parameters other than liver involvement. Five cases of gallbladder cancer showed both Her2/neu and Ki67 positivity. Ten cases were Ki67 positive but Her2/neu negative while one case was Her2/neu positive but Ki67 negative.
CONCLUSIONS: The present study demonstrated overexpression of Her2/neu and Ki67 in gallbladder cancer. A trend of decreasing Her2/neu expression with increasing grade of tumor was observed. Furthermore, greater Ki67 positivity was found in cases with lymph node metastasis and distant metastasis. Future studies with a larger number of patients will be required to precisely define the correlation of Her2/neu expression and Ki67 positivity with clinicopathological parameters. The results however are encouraging and suggest evaluation of Her2/neu as a candidate for targeted therapy.
Preoperative Systemic Inflammation and Complications Affect Long-term Gallbladder Carcinoma Outcomes Following Surgery with Curative Intent.
Anticancer Res. 2016; 36(9):4887-94 [PubMed] Related Publications
PATIENTS AND METHODS: This retrospective study included 54 patients with GBCA resected between 1996 and 2014. Univariate and multivariate analyses were performed to identify prognostic factors associated with overall and recurrence-free survival.
RESULTS: Curative resection (R0) was achieved in 43 patients (79.6%). The median patient age was 74 years (range=25-99 years), and the majority (n=33, 61.1%) were women. Incidental GBCA was detected in 18 patients (33.3%). The overall and recurrence-free survival rates were 63.3% and 55.8% at 3 years and 58.4% and 51.3% at 5 years, respectively. In multivariate analysis, postoperative intra-abdominal complications (p=0.015), non-curative resection (p=0.008), worse histological type (p=0.003), and elevated mGPS (p=0.002) were independent predictors of worse overall survival. Surgical complications (p=0.015), non-curative resection (p=0.005), worse histological type (p=0.002), and elevated mGPS (p=0.022) were also independent predictors of worse recurrence-free survival.
CONCLUSION: Curative resection was important for long-term survival for GBCA. A high preoperative mGPS and occurrence of surgical complications were independent prognostic indicators of poor survival in GBCA.
Global methylation profiling to identify epigenetic signature of gallbladder cancer and gallstone disease.
Tumour Biol. 2016; 37(11):14687-14699 [PubMed] Related Publications
A case of adenosquamous cell carcinoma of the gallbladder with markedly elevated PTHrP and G-CSF levels.
Nihon Shokakibyo Gakkai Zasshi. 2016; 113(9):1564-71 [PubMed] Related Publications
Multiple schwannomas synchronously occurring in the porta hepatis, liver, and gallbladder: first case report.
Medicine (Baltimore). 2016; 95(33):e4378 [PubMed] Related Publications
CASE SUMMARY: A 31-year-old female was referred to our hospital because of repeated abdomen discomfort, slight abdominal distension, and occasional abdominal pain for seven years. Ultrasound and computed tomography and magnetic resonance cholangiopancreatography found multiple intrahepatic and extrahepatic cystic lesions with the dilation of intrahepatic and extrahepatic bile ducts. By exploratory laparotomy, multiple tumors were found in the porta hepatis, liver, and gallbladder, the biggest one was 11 × 6 cm in size. We completely resected these tumors combined with the left lateral liver lobe, gallbladder, and the invaded left and right hepatic arteries, and then severed vessels were reconstructed. Microscopically, the tumor cells were spindle shaped and palisading arrangement. Atypical cells or signs of malignancy were not found. Immunohistochemical investigation showed the protein S-100 was positive, while SMA, CD34, and CD117 negative. Finally, these tumors were diagnosed as schwannomas in the porta hepatis, liver, and gallbladder. The patient is followed-up for 70 months and has been doing well without any complications.
CONCLUSION: We report the first patient with multiple schwannomas synchronously occurring in the porta hepatis, liver, and gallbladder. Accurate preoperative diagnosis of these tumors is difficult. Due to closely adhering to the surrounding important tissues, complete removal is challenging.
Lack of an Apparent Association between Mycotoxin Concentrations in Red Chili Peppers and Incidence of Gallbladder Cancer in India : an Ecological Study.
Asian Pac J Cancer Prev. 2016; 17(7):3499-503 [PubMed] Related Publications
Risk Factors for Gallbladder Cancer in Nepal a Case Control Study.
Asian Pac J Cancer Prev. 2016; 17(7):3447-53 [PubMed] Related Publications
MATERIALS AND METHODS: We conducted a hospitalbased matched case control study on newly diagnosed cases of primary GBC at BP Koirala Institute of Health Sciences and BP Koirala Memorial Cancer Hospital. Controls were healthy nonGBC relatives of cancer patients, matched for age, sex and marital status (in case of females) with cases at a ratio of 1:2. Data were collected between April 2012April 2013 by semi structured interview from both cases and controls. Analyses were carried out with SPSS. Conditional logistic regression was used to find odds ratios and 95% confidence intervals for bivariate and multivariate analysis.
RESULTS: A total of 50 cases and 100 controls were enrolled in this study. On bivariate analysis, factors found to be significantly associated with gallbladder cancer were illiteracy (OR= 3.29, CI= 1.0610.2), history of gallstone disease (OR=27.6, CI=6.57, 115.6), current smoker (OR=2.42, CI=1.005 5.86), early menarche <13 years (OR=2.64, CI=1.096.44), high parity more than 3 (OR=3.12, CI=1.25,7.72), and use of mustard oil (OR=3.63, CI=1.40, 9.40). A significant protective effect was seen with high consumption of fruits at least once a week (OR=0.101, CI=0.030.35). On multivariate analysis, history of gallstone disease, early menarche, current smoker and high consumption of fruits persisted as significant factors.
CONCLUSIONS: History of gallstone disease, cigarette smoking and early menarche were associated with increased risk of gallbladder cancer while high consumption of fruits was found to have a protective effect.
Relationship Between Urinary 8-hydroxydeoxyguanine (8-OHdG) Levels and Clinicopathological Findings in Hepatobiliary Malignancies.
Anticancer Res. 2016; 36(8):3899-903 [PubMed] Related Publications
MATERIALS AND METHODS: Relationships between urinary 8-OHdG levels and clinicopathological factors were analyzed in 101 patients, including 84 with hepatobiliary malignancies, and 18 healthy volunteers. Co-existing biliary inflammation was detected in 8 patients.
RESULTS: Urinary 8-OHdG levels did not correlate with any clinical or liver functional parameters. The existence of inflammation and any tumor-related factor did not correlate with urinary 8-OHdG levels either. Urinary 8-OHdG levels were significantly higher in patients with benign and malignant diseases than in healthy volunteers (p<0.05), but not significantly different between benign and malignant diseases. Among patients with intrahepatic cholangiocarcinoma and gallbladder carcinoma, urinary 8-OHdG levels tended to be higher in patients with lymph node metastasis-positive than in those with lymph node-negative disease (p=0.057).
CONCLUSION: The clinical significance of oxidative DNA damage and increases in its urinary metabolites in patients with hepatobiliary malignancies or inflammatory diseases remain unknown. Further studies are necessary to clarify the relationship between node metastasis and oxidative stress as a prognostic marker.
The risk of malignancy in ultrasound detected gallbladder polyps: A systematic review.
Int J Surg. 2016; 33 Pt A:28-35 [PubMed] Related Publications
METHODS: The keywords: "Gallbladder" AND ("polyp" OR "polypoid lesion") were used to conduct a search in four reference libraries to identify studies which examined the natural history of GBPs diagnosed by US. Twelve studies were eligible for inclusion in this review.
RESULTS: Of the 5482 GBPs reported, malignant GBPs had an incidence of just 0.57%. True GBPs had an incidence of 0.60%. Sixty four patients of adenomatous and malignant polyps were reported. Only in one patient was a malignant GBP reported to be <6mm. Risk factors associated with increased risk of malignancy were GBP >6mm, single GBPs, symptomatic GBPs, age >60 years, Indian ethnicity, gallstones and cholecystitis.
CONCLUSION: With the reported incidence of GBP malignancy at just 0.57%, a management approach based on risk assessment, clear surveillance planning, and multi disciplinary team (MDT) discussion should be adopted. The utilization of endoscopic ultrasound(EUS) should be Only considered on the grounds of its greater sensitivity and specificity when compared to US scans.
Pattern of biliary tract carcinoma at the University College Hospital, Ibadan.
Afr J Med Med Sci. 2015; 44(4):329-34 [PubMed] Related Publications
OBJECTIVE: To determine the pattern and risk factors of biliary tract carcinoma in Ibadan.
METHODOLOGY: This was a retrospective study of histologically confirmed cases of biliary tract carcinoma diagnosed at the University College Hospital, Ibadan between January 1971 and December 20 10. Data was obtained from the records of the Ibadan Cancer Registry, surgical day books and post-mortem records of the Department of Pathology. Histological classification based on the 2010 'WHO classification for tumours of the intrahepatic bile duct, gallbladder and extrahepatic bile duct' was done.
RESULTS: There were 37 cases of biliary tract carcinoma accounting for 0.18% of cancers seen during the period of study. These comprised of 26 (70.3%) females and 11 (29.7%) males. 20 females and 4 males had gallbladder carcinoma, while 6 females and 7 males had cholangiocarcinoma (P = 0.02). The age range was from 37 years to 75 years (mean = 52.5 ± 9.7 years). The peak occurrences of gallbladder carcinoma and cholangiocarcinoma were in the fifth and sixth decades of life respectively. The identified risk factors included female gender (83%), gallstones (33%), and dysplasia (42%).
CONCLUSION: The findings in this study agree with what has been described in the English literature in respect of gender distribution, histological types and some associated risk factors as well as in the fact of its being rare.
Can gallbladder polyps predict colorectal adenoma or even neoplasia? A systematic review.
Int J Surg. 2016; 33 Pt A:23-7 [PubMed] Related Publications
DATA SOURCES: We conducted a systematic review searching the Medline (1966-2016), Scopus (2004-2016), ClinicalTrials.gov (2008-2016) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2016) databases together with reference lists from included studies.
STUDY ELIGIBILITY CRITERIA: All prospective and retrospective observational cohort studies were included.
RESULTS: Four studies were finally included which included 17,437 patients. The association between gallbladder polyps and colorectal adenoma or even neoplasia is not unanimously supported. However, a possible association is clearly depicted. According to one study it seems that this correlation seems to become significant only when the gallbladder polyps exceed the size of 5 mm. However, the impact of size of gallbladder polyps was not investigated in the remaining studies.
CONCLUSION: According to the results of our systematic review there is some evidence to support the hypothesis that gallbladder polyps might adequately predict future risk of colorectal neoplasia. At present, however, current knowledge is very limited and the available data scarce. In this context further studies are necessary to be carried out, before the presence of gallbladder polyps on ultrasound can be recommended as an indication to perform a screening colonoscopy on the same patient.
SHP2 and UGP2 are Biomarkers for Progression and Poor Prognosis of Gallbladder Cancer.
Cancer Invest. 2016; 34(6):255-64 [PubMed] Related Publications
Epigenetic regulation in gallbladder cancer: Promoter methylation profiling as emergent novel biomarkers.
Asia Pac J Clin Oncol. 2016; 12(4):332-348 [PubMed] Related Publications
T2 Gallbladder Cancer-Aggressive Therapy Is Warranted.
Am Surg. 2016; 82(6):518-21 [PubMed] Related Publications
A Solitary Metastasis for a Malignant Schwannoma in the Gallbladder Detected by 18F-FDG PET/CT.
Clin Nucl Med. 2016; 41(8):666-7 [PubMed] Related Publications
Depth of Hepatic Infiltration and Lymph Node Swelling as Factors for Considering Surgery for T2-4 Gallbladder Carcinoma Patients.
Anticancer Res. 2016; 36(6):3075-80 [PubMed] Related Publications
PATIENTS AND METHODS: Fifty consecutive patients with T2-4 GBC who underwent surgery were reviewed retrospectively. We investigated the preoperative information and imaging factors as predictors of survival.
RESULTS: The estimated overall survival in all patients was lower in patients with hepatic infiltration ≥5 mm (n=12) than in those with <5 mm (n=38) (p=0.003). Multivariate analyses demonstrated that liver infiltration ≥5 mm (OR=2.251; 95%CI=0.906-5.596, p=0.081) and lymph node swelling (OR=2.462; 95%CI=1.034-5.859, p=0.042) were risk factors of poor survival.
CONCLUSION: Our results suggested that ≥5 mm liver infiltration and lymph node swelling may serve as deciding factors for surgery consideration in GBC patients.
Impact of Type of Surgery on Survival Outcome in Patients With Early Gallbladder Cancer in the Era of Minimally Invasive Surgery: Oncologic Safety of Laparoscopic Surgery.
Medicine (Baltimore). 2016; 95(22):e3675 [PubMed] Free Access to Full Article Related Publications
Biliary Tract Cancer: Epidemiology, Radiotherapy, and Molecular Profiling.
Am Soc Clin Oncol Educ Book. 2016; 35:e194-203 [PubMed] Related Publications