Somatostatin Receptors 3, 4 and 5 Play Important Roles in Gallbladder Cancer

Guo, Run-Sheng,Shi, Pei-Dong,Zhou, Jie,Chen, Yue-Yu Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.7

Expression changes of somatostatin receptor subtypes (SSTRs) including SSTR1, SSTR2, SSTR3, SSTR4 and SSTR5 in the development of gallbladder cancer were assessed with attention to relationships with clinical pathological characteristics. SSTRs in 29 gallbladder cancer and 25 normal gallbladder tissue specimens were examined by immunohistochemical staining. Differences between SSTRs expressions and clinical pathological parameters were analyzed by chi-square test. The five subtypes of SSTR were all expressed in gallbladder cancer tissues and SSTR3 presented the highest expression. SSTR5 expression was increased significantly in gallbladder cancer (P<0.05) compared with that in normal gallbladder tissue. SSTR3 expression in highly and moderately differentiated gallbladder cancer was significantly higher than that in poorly differentiated lesions (P<0.05). SSTR4 expression was lower in gallbladder cancer with lymph node metastasis than that in gallbladder cancer without lymph node metastasis (P<0.05). Therfore, these results indicated that SSRT5, SSTR3 and SSTR4 may play important roles in the formation and development of gallbladder cancer.

담도계 암의 임상적 고찰

한영철(Young Cheol Han),박성환(Sung Hwan Park),유용운(Young Oon Yoo),허광덕(Kwang Duck Hur) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.4

N/A Sixty five cases of primary carcinoma of the biliary tree, treated in Taegu Catholic Universi- ty Hospital from 1983 to 1992, have b en reviewed. The average age and the ratio of male to female for gallbladder cancer and bile duct cancer were 62.4, 62.5 years and 1:1.2, 1:0.9 respectively. Clinical manifestations in order of frequency were abdominal pain(93% ), indiges- tion(67%), jaundice(58%), nausea/vomiting(53%) in bile duct cancer and gallbladder can- cer. And also, clinical signs in order of frequency were tenderness(62%), jaundice(59%), hepatomegaly(29%) and palpable mass(29%) in bi]e duct and gallbladder cancer. Turnor lo- cations were found to be in the gallbladder in 28 cases(43% ), in the proxirnal bile duct in 15 cases(23%), in the middle bile duct in 3 cases(5%), in the distal bile duct in 15 cases(23%) and in undetermined locations in 4 cases(6%). In the gallbladder cancer, the preoperative di- agnosis was made in 13 cases(46.5%), and CT was the most accurate diagnostic modality(71 % accuracy), In the bile duct cancer, preoperative diagnosis was rnade in 27 cases(73%), and PTC was the most accurate diagnostic modality(91%). In 28 cases of gallbladder cancer, there were 15 cases(54%) with stone. Also, there were 10 cases(27%) in 37 cases of bile duct cancer. Curative operations were performed in 5 cases(17.8%) in gallbladder cancer and 4 cases(12.5%) in bile duct cancer. The histologic examinations of tumor revealed adenocarcinoma(91%), undifferentiatted carcinoma(7%), and severe dysplasia(2%) (clinical- ly malignant). Mean survival time was 5.4 months in gallbladder cancer, 13.2 months in the cases of resection and 5.1 months in the cases of palliative by pass procedure in bile duct can- cer.(Korean J Gastroenterol 1994; 26: 706 715)

농약사용과 암발생과의 관계

설재웅,이상욱,손태용,지선하,남정모,오희철,Sull, Jae-Woong,Yi, Sang-Wook,Sohn, Tae-Yong,Jee, Sun-Ha,Nam, Chung-Mo,Ohrr, Hee-Chul 대한예방의학회 2002 예방의학회지 Vol.35 No.1

Objective : Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. Methods : We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks(RR). Results : At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 140 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95%. CI=1.0-1.9), p for trend=0.041, for digestive organ cancer Incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer, incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0(95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.5-27.9)). Conclusions : This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.

Incidence, Prevalence, and Overall Survival of Bile Duct and Gallbladder Cancer in the Republic of Korea

( Byung Woo Kim ),( Hwa Young Choi ),( Joong-won Park ),( Moran Ki ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Cholangiocarcinoma is relatively more common in Korea compared to other countries. According to the 2014 Korean Cancer Registry database, gallbladder and other biliary cancers (ICD-10: C23-24) ranked ninth, accounting for 2.6% of total cancer cases. Especially, the incidence in Nakdong River basin is reported to be high, and additional epidemiological research is needed. Methods: We conducted the study using the data from National Health Insurance Service-National Sample Cohort (a population of 1 million) between 2002 and 2013. To select new patients, 2002-2003 was utilized as the window period. Therefore, new patients were defined as those first diagnosed in 2004 with cholangiocarcinoma as the main or a secondary disease, namely, intrahepatic bile duct carcinoma (C22.1), malignant neoplasm of gallbladder (C23), and malignant neoplasm of other and unspecified parts of the biliary tract (C24). The 2010 census population was used to calculate the standardized rate. Results: According to the analysis, decreasing trends of incidence were observed between 2004 and 2013; age- and sex-adjusted incidence per 100,000 were 13.1 and 10.4 for intrahepatic bile duct carcinoma, 10.6 and 8.6 for gallbladder cancer, and 18.5 and 11.6 for extrahepatic carcinoma, respectively. The incidence of gallbladder cancer only was higher in females and increased from 9.3 to 9.6 during the study period. Gwangju showed the highest incidence of intraand extra-hepatic bile duct cancer, and Jeonbuk showed the highest incidence of gallbladder cancer. One-year, 3-year, and 5-year overall survival were 42.7%, 25.4%, and 20.8% for C22.1, 52.4%, 40.8%, and 37.7% for C23, and 54.2%, 35.8%, and 30.3% for C24, respectively. The median survivals were 7.3, 10.1, and 11.0 months for C22.1, C23, and C24 respectively. The analysis using the total population of Korea is currently being conducted and will be presented at the meeting. Conclusions: Although the incidence of bile duct and gallbladder cancer has been declining in the last decade, the survival has not improved significantly. There are still significant differences in the incidence by region.

Analysis of gallbladder polypoid lesion size as an indication of the risk of gallbladder cancer

Ji Eun Sung,Chang Woo Nam,Yang Won Nah,Byung Sung Kim 한국간담췌외과학회 2014 한국간담췌외과학회지 Vol.18 No.1

Backgrounds/Aims: Recent advances in ultrasonography have contributed to the early detection of gallbladder cancer. We attempted to predict the progression of the disease by comparing the sizes of polypoid lesions, and we suggest that the size of the lesion would be a useful guideline to determine an appropriate primary surgical approach for polypoid lesions of the gallbladder. Methods: We have retrospectively analyzed 253 patients that, during the operation period from January 2009 to December 2011, had had ultrasonographically detected gallbladder polypoid lesions, and who underwent cholecystectomy at Ulsan university hospital. We have analyzed the demographic data of the patients, the preoperative size of polypoid lesions, and pathologic findings. Results: Of a total of 253 patients, 235 patients had benign lesions, and 18 patients had malignant lesions. Among the malignant polyp patients, 11 had pT1 cancer, 6 had pT2 cancer, and 1 had pT3 cancer. The average size of polypoid lesions was 9.1±3.1 ㎜ and that of malignant lesions was 28.2±16.4 ㎜. The receiver operating characteristic (ROC) curve of the benign and malignant groups shows that 14.5 ㎜ is the optimal point of prediction of the malignancy. Of a total of 18 patients of GB cancer, 11 had pT1 and the average size of their polypoid lesions was 20.5±5.8 ㎜ 7 had pT2 with a size of 39.1±20.7 ㎜. ROC curve analysis of the pT1 and pT2 groups shows that 27 ㎜ would be the optimal point to predict T2 and above cancer. Conclusions: In the case of an early cancer, curative treatment can be achieved through a simple and minimally invasive laparoscopic cholecystectomy. We attempted to predict early cancer occurrence among polypoid lesions of the gallbladder using the simplest standard, size. Although there are some limitations, size can be a simple and easy way to evaluate polypoid lesions of the gallbladder.

Risk Factors for Gallbladder Cancer in Nepal - a Case Control Study

Tamrakar, D,Paudel, IS,Adhikary, S,Rauniyar, B,Pokharel, PK Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.7

Background: Gall bladder cancer (GBC) is highly fatal disease with poor prognosis, with a 5 year survival rate of <10%. It is relatively rare cancer worldwide; however it is the sixth cancer and second most common gastrointestinal tract cancer in Nepalese women. The study focused on associations of certain demographic, lifestyle, dietary, and reproductive factors with gall bladder cancer. Materials and Methods: We conducted a hospital-based 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 non-GBC 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 2012-April 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=1.06-10.2), 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=1.09-6.44), 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=0.03-0.35). 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.

T2 병기의 담낭암에서 간외담도절제를 해야 하는가?

여경준(Kyung-jun Yeu),최종우(Jong-woo Choi),이동식(Dong-sik Lee),김홍진(Hong-jin Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.2

Purpose: The prognosis of advanced gallbladder cancer remains unfortunate. Yet, the prognostic factors and the efficacy of extrahepatic bile duct resection remain unclear. The adequacy for extrahepatic bile duct resection for T2 gallbladder cancer, according to the characteristics of either the clinicopathological factors or the prognostic factors, was evaluated. Methods: One hundred and one patients with gallbladder cancer underwent surgical resection at Yeungnam University Medical Center (YUMC) between January 2001 and July 2008. A retrospective analysis was conducted on 26 patients with pathologic stage T2. Results: 7 of the 26 patients with T2 disease (26.9%) had lymph node metastasis. Of the 7 patients with lymph node metastasis, 3 patients underwent radical cholecystectomy (RC), and 4 patients underwent radical cholecystectomy combined with extrahepatic bile duct resection (RC+BDR). The 1-year and 3-year survival rate of patients that underwent RC was 66.7% and 0% and patients that underwent RC+BDR was 50.0% and 0%, respectively (P=0.433). Even with microscopic vascular invasion or perineural invasion, RC+BDR did not provide any survival advantage compared with RC in T2 gallbladder cancer. Prognostic factors for patients with T2 gallbladder cancer was total bilirubin level, lymph node metastasis, differentiation of tumor, microscopic vascular invasion and perineural invasion. Conclusion: For patients with T2 gallbladder cancer, RC is recommended, even with the presence of lymph node metastasis, microvascular invasion or perineural invasion. Resection of the extrahepatic bile duct is indicated for patients with T2 gallbladder cancer with involvement of the cystic duct or invasion of the hepatoduodenal ligament.

Gallbladder Cancer: a Subtype of Biliary Tract Cancer Which is a Current Challenge in China

Qu, Kai,Liu, Si-Nan,Chang, Hu-Lin,Liu, Chang,Xu, Xin-Sen,Wang, Rui-Tao,Zhou, Lei,Tian, Feng,Wei, Ji-Chao,Tai, Ming-Hui,Meng, Fan-Di Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.4

Biliary tract cancers, broadly described as malignancies that arise from the biliary tract epithelia, are usually divided into two major clinical phenotypes: cholangiocarcinoma and gallbladder cancer, differing in etiopathogenesis, risk factors, and perhaps molecular and genetic signatures. Atypical symptoms and lack of tumor biomarkers make it difficult to diagnose in early stages. At the time of presentation, few patients are candidates for potentially curative surgical resection. We here assessed and compared features of a total of 150 cases divided into extra- and intrahepatic cholangiocarcinomas and gallbladder cancers (GBC). Althought there were no significant differences in serum tumour marker levels, GBC patients had the poorest prognosis. Furthermore, gallbladder cancer respond poorly to chemotherapy or radiation therapy and approximately half of untreated patients died within 10 months. Therefore, treatment for patients with gallbladder cancer is still in challenge. Outcomes and survival of these patients had improved little over the past three decades - a period in which new successful treatments have greatly contributed to the prolonged patient survival for many other cancers.

LC-MS/MS based targeted metabolomics analysis of bile acids from malignant and benign gallbladder cancer patients

송원석,박한규,황철환,김윤곤,김병기 한국공업화학회 2016 한국공업화학회 연구논문 초록집 Vol.2016 No.1

Gallbladder cancers can be difficult to detect because they are located deep inside the body and sometimes they may be no symptoms at all. To find the association between malignant gallbladder cancer and bile acids, this study analyzed the bile acid concentration and composition in bile of malignant and benign gallbladder cancer patients. We quantified major unconjugated bile acids in bile (cholic acid, chenodeoxycholic acid, deoxycholic acid, lithocholic acid and ursodeoxycholic acid) as well as their glycine- and taurine-conjugates by liquid chromatographytandem mass spectrometry (LC-MS/MS). Malignant and benign gallbladder cancer bile could be distinguished by quantification of their major bile acids. Therefore, this diagnostics could be valuable for detecting a malignant gallbladder cancer.

Elevated Expression of Maspin mRNA as a Predictor of Survival in Stage II and III Gallbladder Cancer Cases

Baghel, Kavita,Kazmi, Hasan Raza,Raj, Saloni,Chandra, Abhijit,Srivastava, Rajeshwar Nath Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.1

Background: Maspin expression is a potential prognostic factor for various malignancies but its relation with gallbladder cancer is unknown and needs to be investigated needs to be investigated. We therefore here focused on maspin mRNA expression in normal, gall stone disease and gallbladder cancer subjects, with particular attention to prognostic importance in individuals with malignancies. Materials and Methods: This study was carried out at the Department of Surgical Gastroenterology, King George's Medical University, Lucknow, India. Gallbladder samples from normal (n=25), gall stone disease (n=25) and cancer patients (n=38) were analysed for maspin mRNA expression by semi-quantitative reverse transcriptase PCR and quantitative real time PCR. Statistical analysis was carried out using the Students t test or ANOVA. Survival analysis was conducted according to the Kaplan-Meier method and correlations were assessed using the Pearson correlation method. p<0.05 was considered statistically significant. Results: Significant increase (p=0.028) in expression of maspin mRNA was observed in gallbladder cancer as compared to gall stone disease, whereas no expression was found in normal tissues. Significant correlation (Pearson's coefficient(r)=-0.798, p<0.0001) was observed between relative quantification of maspin mRNA and survival of cancer patients after surgery, with significantly shorter (p=0.002) survival in patients having relative quantification >1.5 as compared to those having relative quantification <1.5. Similarly, significant differences in patient survival for maspin mRNA expression was observed for stage II (p=0.025) and III (p=0.011) cancer. Conclusions: Higher expression of maspin mRNA in gallbladder cancer has prognostic significance for stage II and III cancer, which needs to be investigated further.