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Gall Bladder Cancer (89 unread)

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NatWest bank wouldn't wire dying woman's cash for treatment - Huddersfield Examiner

Posted: August 23rd, 2010, 1:06am CDT

NatWest bank wouldn't wire dying woman's cash for treatment
Huddersfield Examiner
Mrs Southernwood, 61, was diagnosed with gall bladder cancer eight weeks ago, and it has spread to her liver and lungs. On diagnosis her life insurance ...

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Double transplant woman in fighting shape - The Standard

Posted: August 22nd, 2010, 12:42pm CDT

The Standard

Double transplant woman in fighting shape
The Standard
Lo attended entertainment personality Lydia Sum Din-ha when she was admitted to hospital for a liver tumor and gall bladder cancer in 2006. ...

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High exposure to estrogens may cause gall bladder cancer - Biomed Middle East

Posted: August 17th, 2010, 2:43am CDT

Biomed Middle East

High exposure to estrogens may cause gall bladder cancer
Biomed Middle East
A very aggressive disease with a poor prognosis, gallbladder cancer may be connected to higher exposure to estrogens, according to a group of researchers at ...

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Indian doctors isolate gene linked to gall bladder stones - TheMedGuru

Posted: August 13th, 2010, 2:58am CDT

TheMedGuru

Indian doctors isolate gene linked to gall bladder stones
TheMedGuru
... indigestion and abdominal pain but sometimes serious conditions like obstructive jaundice, pancreatitis and even gall bladder cancer can occur. ...

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Hyderabad doctors isolate gallstone gene - istockAnalyst.com (press release)

Posted: August 13th, 2010, 11:54pm CDT

Hyderabad doctors isolate gallstone gene
istockAnalyst.com (press release)
The gene that causes gall stones, which lead to a variety of problems from indigestion to pain in the abdomen to gall bladder cancer, has been discovered by ...

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Judge Orders N.Y. Woman to Set Up Skype Chats Between Ex-Husband, Kids - FOXNews

Posted: August 12th, 2010, 7:14pm CDT

Judge Orders N.Y. Woman to Set Up Skype Chats Between Ex-Husband, Kids
FOXNews
She has been unemployed since December, while her ex-husband, who recently underwent surgery for gall bladder cancer, has been earning a scant $600 a month ...

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Judge Orders NY Woman to Set Up Skype Chats Between Ex-Husband, Kids - FOXNews

Posted: August 12th, 2010, 7:07pm CDT

Judge Orders NY Woman to Set Up Skype Chats Between Ex-Husband, Kids
FOXNews
She has been unemployed since December, while her ex-husband, who recently underwent surgery for gall bladder cancer, has been earning a scant $600 a month ...

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Genetic cause of gall bladder stones found - Sify

Posted: August 12th, 2010, 4:34pm CDT

Genetic cause of gall bladder stones found
Sify
... of problems like indi-gestion and pain in abdomen but also more serious problems like obstructive jaundice, pancreatitis and even gall bladder cancer. ...

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Cause of gallstone disease in Indians found to be genetic - The Hindu

Posted: August 12th, 2010, 12:39pm CDT

The Hindu

Cause of gallstone disease in Indians found to be genetic
The Hindu
... indigestion and abdominal pain but could lead to more serious conditions like obstructive jaundice, pancreatitis and even gall bladder cancer. ...

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Genetic cause of gall bladder stones found - Business Standard

Posted: August 12th, 2010, 11:35am CDT

Genetic cause of gall bladder stones found
Business Standard
... of problems like indi-gestion and pain in abdomen but also more serious problems like obstructive jaundice, pancreatitis and even gall bladder cancer. ...

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Nora Shourd and Iran Mothers of Prisoners of Conscience - Middle East Online

Posted: August 12th, 2010, 2:20am CDT

Nora Shourd and Iran Mothers of Prisoners of Conscience
Middle East Online
Struggling with her own serious condition with advanced gall bladder cancer, on March 20, 2009, Zarganar's admired 83 year old mother, Kyi Oo, died. ...

Nora Shourd and Iran Mothers of Prisoners of Conscienc - Women News Network

Posted: August 10th, 2010, 2:20pm CDT

Nora Shourd and Iran Mothers of Prisoners of Conscienc
Women News Network
Struggling with her own serious condition with advanced gall bladder cancer, on March 20, 2009, Zarganar's admired 83 year old mother, Kyi Oo, died. ...

High fat diet, tobacco are cancer triggers - South Asia Mail

Posted: August 6th, 2010, 12:13am CDT

High fat diet, tobacco are cancer triggers
South Asia Mail
North India, including Delhi, has reported gall bladder cancer cases, but surprisingly, south India has not reported such cancer cases. ...

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High fat diet, tobacco are cancer triggers - Times of India

Posted: August 5th, 2010, 5:51am CDT

High fat diet, tobacco are cancer triggers
Times of India
North India, including Delhi, has reported gall bladder cancer cases, but surprisingly, south India has not reported such cancer cases. ...

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Two-day meet on oncology from Aug 7 - Times of India

Posted: August 3rd, 2010, 2:29pm CDT

Two-day meet on oncology from Aug 7
Times of India
... due to increase in environmental pollution, breast cancer, colo rectal cancer and gall bladder cancer, will be discussed at length at the conference. ...

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Getting richer, lazier - and fatter - Shanghai Daily

Posted: August 3rd, 2010, 11:18pm CDT

Getting richer, lazier - and fatter
Shanghai Daily
... and the risks of breast, colon, prostate, endometrium, kidney and gall bladder cancer increase rapidly as weight gains, according to the report. ...

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A PROMINENT figure who served Queen and county for many years has died aged 76. - Northumberland Gazette

Posted: July 29th, 2010, 4:13pm CDT

A PROMINENT figure who served Queen and county for many years has died aged 76.
Northumberland Gazette
He died on Saturday at Rothbury Community Hospital after a three-month battle with gall bladder cancer. Sir John was educated at Eton and Christchurch ...

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A PROMINENT figure who served Queen and county for many years has died aged 76. - Morpeth Herald

Posted: July 29th, 2010, 2:40am CDT

A PROMINENT figure who served Queen and county for many years has died aged 76.
Morpeth Herald
He died on Saturday at Rothbury Community Hospital after a three-month battle with gall bladder cancer. Sir John was educated at Eton and Christchurch ...

Protect your gall bladder naturally - Sify

Posted: July 5th, 2010, 6:16am CDT

Protect your gall bladder naturally
Sify
Other indications for this procedure include porcelain gall bladder and gall bladder cancer. Gallstones can occur anywhere within the biliary tree, ...
GP exonerated on gall bladder cancer case - 6minutes

Posted: June 29th, 2010, 10:23pm CDT

GP exonerated on gall bladder cancer case
6minutes
A South Australian court has thrown out a negligence case made against a GP over a female patient who died of gall bladder cancer. ...
Jane Jensen - Grand Forks Herald

Posted: June 27th, 2010, 3:44pm CDT

Jane Jensen
Grand Forks Herald
After living with gall bladder cancer for 20 months, Jane Jensen, 60, Stephen, MN left the loving care of her family on June 24. After living with gall ...

Relay for Life team a family affair - Grand Island Independent

Posted: June 17th, 2010, 8:04pm CDT

Relay for Life team a family affair
Grand Island Independent
After losing a co-worker and close friend to lung cancer, his wife lost three grandparents to gall bladder cancer; bladder and throat cancer; and prostrate ...

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Early detection, cure of cancer gains hope - Times of India

Posted: June 17th, 2010, 10:33am CDT

Early detection, cure of cancer gains hope
Times of India
... of cervical cancer, the most prevalent cancer among Indian women apart from gall bladder cancer that has shown increased incidence in North India. ...

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Cancer patient lives 1 day at a time - Peabody Gazette Bulletin

Posted: June 16th, 2010, 9:51am CDT

Cancer patient lives 1 day at a time
Peabody Gazette Bulletin
During the surgery to remove the stomach tumor, doctors made another discovery: Martinez had gall bladder cancer. She travels to Newton every Tuesday for ...

Worcestershire hospital trust 'sorry' for surgery delay - BBC News

Posted: June 10th, 2010, 2:26am CDT

Worcestershire hospital trust 'sorry' for surgery delay
BBC News
Mrs Philpott said she hoped her case would highlight gall bladder cancer. The Trust said: "We would like to offer our sincere apologies to Mrs Philpott. ...

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PubMed - Gall Bladder Cancer

Chemoradiation for Unresectable Gall Bladder Cancer: Time to Review Historic Nihilism?

Fetched: September 1st, 2010, 9:31am CDT

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Chemoradiation for Unresectable Gall Bladder Cancer: Time to Review Historic Nihilism?

J Gastrointest Cancer. 2010 Aug 28;

Authors: Engineer R, Wadasadawala T, Mehta S, Mahantshetty U, Purandare N, Rangarajan V, Kishore Shrivastava S

PURPOSE: Treatment of unresectable locally advanced gallbladder cancers (LAGBC) usually consists of various palliative strategies which provide only a modest survival benefit. Here, we present a series of three patients of LAGBC-treated consecutively at our center with preoperative chemoradiation using tomotherapy and concurrent gemcitabine. METHODS: All three cases were reported to be adenocarcinoma by biopsy or fine-needle aspiration cytology. All the patients underwent positron emission tomography with computerized tomography scan to rule out distant metastasis and also to map the extent of disease for radiotherapy planning. Preoperative chemoradiation consisted of gemcitabine at 300 mg/m(2) weekly and tomotherapy with daily image guidance with MVCT over 5 weeks to a dose of 57 Gy in 25 fractions to the gross tumor and 45 Gy in 25 fractions to the clinical target volume to cover the areas of microscopic spread. RESULTS: Complete metabolic and radiologic response was observed for 2 patients and partial response for 1 patient. Two patients underwent complete surgical excision of which 1 patient had complete pathological response and 1 patient had small residual tumor at the primary and no nodal metastasis. The third patient could not undergo surgery due to medical reasons. CONCLUSIONS: The clinical outcome for unresectable LAGBC with preoperative chemoradiation in terms of feasibility, safety, and survival is encouraging. This treatment strategy has a curative potential for the otherwise fatal disease.

PMID: 20803101 [PubMed - as supplied by publisher]
Analysis of apoptotic effects induced by photodynamic therapy in a human biliary cancer cell line.

Fetched: September 1st, 2010, 9:31am CDT

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Analysis of apoptotic effects induced by photodynamic therapy in a human biliary cancer cell line.

Anticancer Res. 2010 Jun;30(6):2113-8

Authors: Nonaka T, Nanashima A, Nonaka M, Uehara M, Isomoto H, Asahina I, Nagayasu T

BACKGROUND: Photodynamic therapy (PDT) is a relatively new approach for the treatment of biliary tract carcinoma, and its effects have not been investigated in detail to date. This study investigated the mechanisms of human biliary cancer cell death by PDT by focusing on apoptosis induction in vitro and in vivo. MATERIALS AND METHODS: In vitro, NOZ cells were incubated with porfimer sodium (Photofrin) for up to 24 hours before exposure to laser light. Cell viability was assessed using a methyltetrazolium assay after PDT. DNA fragmentation, cell cycle analysis and caspase-3 activity assay were performed to evaluate apoptotic cells induced by PDT. In vivo, DNA fragmentation was detected by TUNEL assay. RESULTS: DNA ladder formation and activation of caspase-3 were observed within 24 hours. The proportion of cells with DNA fragmentation on flow cytometric analysis was increased significantly to 22.2% at 24 hours after PDT. In the in vivo model, TUNEL-positive cells began to increase in the implanted tumour from 6 hours after PDT, and peaked 12 hours later. CONCLUSION: PDT with Photofrin in this human biliary cancer cell line has antitumor effects and induces apoptotic cell death after PDT.

PMID: 20651359 [PubMed - indexed for MEDLINE]
Non-organ-specific preventive effect of long-term administration of Korean red ginseng extract on incidence of human cancers.

Fetched: September 1st, 2010, 9:31am CDT

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Non-organ-specific preventive effect of long-term administration of Korean red ginseng extract on incidence of human cancers.

J Med Food. 2010 Jun;13(3):489-94

Authors: Yun TK, Zheng S, Choi SY, Cai SR, Lee YS, Liu XY, Cho KJ, Park KY

Previously, two case-control studies and a cohort study strongly suggested that Panax ginseng C.A. Meyer exerted non-organ-specific preventive effects against cancer. The purpose of the present study was to evaluate the effects of red ginseng extract on the incidence of human primary cancer. We conducted a randomized, double-blinded, placebo-controlled trial on 643 chronic atrophic gastritis patients in four hospitals in Zhejiang Province, China. Red ginseng extract powder (1 g) was administered orally to each patient per week for 3 years and followed up for 8 years. The development of various cancers in the red ginseng subjects was compared to that of a placebo group. The red ginseng extract powder was specified in terms of its components. Twenty-four cancers of various organs were diagnosed from these subjects during the 11 years: eight lung cancers, six stomach cancers, two liver cancers, two colorectal cancers, and one cancer each of the nasopharynx, esophagus, pancreas, urinary bladder, prostate, and gallbladder. The red ginseng group, which included both genders, demonstrated a relative cancer risk of 0.54 (95% confidence interval, 0.23-1.28; P = .13) compared to the placebo group, which was not statistically significant. Among the 24 cancer patients, 21 were male. The male red ginseng group showed a relative cancer risk of 0.35 (95% confidence interval, 0.13-0.96; P = .03) compared to the male placebo group, which was highly significant statistically. In the present clinical trial on chronic atrophic gastritis patients, administration of red ginseng extract powder for 3 years exerted significant preventive effects on the incidence of non-organ-specific human cancers in males.

PMID: 20521975 [PubMed - indexed for MEDLINE]
Elevated CA 19-9 portends poor prognosis in patients undergoing resection of biliary malignancies.

Fetched: September 1st, 2010, 9:31am CDT

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Elevated CA 19-9 portends poor prognosis in patients undergoing resection of biliary malignancies.

HPB (Oxford). 2010 Mar;12(2):134-8

Authors: Hatzaras I, Schmidt C, Muscarella P, Melvin WS, Ellison EC, Bloomston M

BACKGROUND: Biliary tree malignancies including cholangiocarcinoma and gallbladder cancer are aggressive cancers with a high disease-specific mortality despite resection. The aim of the present study was to identify predictors of survival after resection. METHODS: A retrospective review of all patients that underwent radical resection of biliary malignancies was performed. Demographics, elevated CA19-9 (>35 U/ml), treatment and outcome data were collected and compared according to tumour location. Kaplan-Meier survival curves were created and compared using log-rank analysis. Multivariate analysis was undertaken using Cox proportional hazards regression. RESULTS: Ninety-one patients with biliary malignancies underwent surgical resection between 1992 and 2007. There were 46 (50.5%) extrahepatic cholangiocarcinomas (EHC), 23 (25.2%) intrahepatic cholangiocarcinomas (IHC) and 22 (24.2%) gallbladder carcinomas (GBC). The median (range) age was 64 (24-92) years. An elevated CA19-9 was recorded in 45 (55%) patients (52% of IHC, 63% of EHC, and 41% of GBC). The overall median (range) survival was 22.5 (0.3-153.3) months. All three groups were similar in terms of age, gender, pre-operative CA 19-9 level, completeness of resection and tumour histopathological characteristics. GBC were associated with the shortest median survival (14.3 months) followed by EHC (24.8 months) and IHC (30.4 months); however, this did not meet statistical significance (P= 0.971). Only elevated pre-operative CA 19-9 level (>35 U/ml) was predictive of poor median survival by univariate (P= 0.003) and multivariate analysis (15.1 months vs. 67.4, P= 0.047). CONCLUSIONS: Elevated pre-operative CA 19-9 levels were found to be independent predictors of poor survival after attempted resection for biliary tree malignancies. It is recommended that CA19-9 be routinely measured prior resection.

PMID: 20495658 [PubMed - indexed for MEDLINE]
Novel photodynamic therapy against biliary tract carcinoma using mono-L: -aspartyl chlorine e6: basic evaluation for its feasibility and efficacy.

Fetched: September 1st, 2010, 9:31am CDT

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Novel photodynamic therapy against biliary tract carcinoma using mono-L: -aspartyl chlorine e6: basic evaluation for its feasibility and efficacy.

J Hepatobiliary Pancreat Sci. 2010 May;17(3):313-21

Authors: Kasuya K, Shimazu M, Suzuki M, Kuroiwa Y, Usuda J, Itoi T, Tsuchida A, Aoki T

BACKGROUND: Recently, a second-generation photosensory agent for photodynamic therapy (PDT), mono-L: -aspartyl chlorine e6 (NPe6), which degrades rapidly in vivo, has been developed. We evaluated its feasibility and efficacy for treatment in biliary tract carcinoma. METHODS: A transmittance of semiconductor laser light (664 nm), sensitivity of a human biliary tract carcinoma cell line, and disorder to normal tissue including Glissonian constructs and adjacent hepatocytes were investigated. RESULTS: The transmittance of the laser was 85-91% through yellow clear bile and that of the bile including 50 microg/ml NPe6 was 17-48%. The effective concentration of NPe6 which showed LD50 for a cell line was 12.5 microg/ml, and that of LD95 was 25 microg/ml. NPe6 in the supernatant reduced laser transmissiveness, but it had little influence on the antitumor effect in supernatant with or without NPe6. The NOZ cell-tumor volume was reduced significantly 14 days after irradiation in the PDT group (PDT 69.9 +/- 44.6 mm(3) vs control 296.3 +/- 239.9 mm(3) P < 0.05). No severe hepatic disorder including Glisson components was observed by the histological findings. CONCLUSION: NPe6 PDT was effective in carcinomas even in the presence of bile, and causes no serious complication for the liver and Glisson structure. Therefore, NPe6 PDT will be a useful candidate as a new therapy for biliary tract carcinomas.

PMID: 20464561 [PubMed - indexed for MEDLINE]
Combined large cell neuroendocrine carcinoma and adenocarcinoma of the gallbladder.

Fetched: September 1st, 2010, 9:31am CDT

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Combined large cell neuroendocrine carcinoma and adenocarcinoma of the gallbladder.

Pathol Res Pract. 2010 Jun 15;206(6):397-400

Authors: Sato K, Imai T, Shirota Y, Ueda Y, Katsuda S

Large cell neuroendocrine carcinoma (LCNEC) is a high-grade malignant neuroendocrine tumor that was first defined in the lungs. There are six previous reports on LCNEC in the gallbladder, comprising three cases combined with another tumor and three pure LCNECs. We describe a tumor combined with LCNEC and adenocarcinoma elements arising in the gallbladder and give a review of the literature. A 68-year-old woman was diagnosed as having gallbladder wall thickening and a hepatic mass. The surgically resected tumor had a dumbbell shape with gallbladder and liver elements. Histological examination revealed LCNEC in the liver and a deep infiltrative portion of the gallbladder, as well as a well-differentiated tubular adenocarcinoma in the mucosa of the gallbladder. The pseudoglandular structures of LCNEC were marked in the transitional area. Immunoreactivities for carcinoembryonic antigen and CA19-9 as well as for chromogranin A and synaptophysin were detected in the LCNEC element. High p53-protein expression and high proliferative activity estimated by Ki-67 positivity were observed in both elements. The results suggest a close relationship between LCNEC and adenocarcinoma, and support the theory that these elements originate from common cancer stem cells.

PMID: 19945229 [PubMed - indexed for MEDLINE]
Percutaneous transcholecystic placement of an ePTFE/FEP-covered stent in the common bile duct.

Fetched: September 1st, 2010, 9:31am CDT

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Percutaneous transcholecystic placement of an ePTFE/FEP-covered stent in the common bile duct.

Cardiovasc Intervent Radiol. 2010 Jun;33(3):639-42

Authors: Krokidis ME, Hatzidakis AA

We report the case of a 78-year-old male patient with obstructive jaundice due to a pancreatic head neoplasm. The patient's general condition did not permit an endoscopic approach and the presence of diffuse liver metastases prohibited hepatic puncture for percutaneous biliary drainage, therefore the transcolecystic transperitoneal approach was decided to be the safest decompression route. Through a gallbladder access, a Viabil-covered stent with a mesh extension was placed in the distal common bile duct, without complications. The patient died 8 months later without signs of stent dysfunction or necessity of reintervention. Transcholecystic transperitoneal access is a safe option when diffuse liver metastases prohibit the transhepatic approach, even in cases where placement of a covered stent is considered necessary.

PMID: 19434448 [PubMed - indexed for MEDLINE]
Facing the challenge of treating gallbladder carcinoma. Review of the literature.

Fetched: August 17th, 2010, 9:13am CDT

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Facing the challenge of treating gallbladder carcinoma. Review of the literature.

Hepatogastroenterology. 2010 Mar-Apr;57(98):215-9

Authors: Mastoraki A, Papanikolaou IS, Konstandiadou I, Sakorafas G, Safioleas M

Gallbladder carcinoma (GBC) remains the most common biliary tract malignancy and is characterized as an aggressive and highly lethal disease. There is also a wide discrepancy among sources regarding the epidemiology of the tumor. Despite recent research on the therapeutic strategies against gallbladder neoplastic disorders, surgical resection appears the only potentially curative approach. Unfortunately, a mere minority of patients is eligible to undergo surgical intervention. In addition, surgical removal of gallbladder tumor does not necessarily guarantee patient's long-term recovery. Alternative therapies, such as radio and chemotherapy proved insufficient. The aim of this review was to evaluate the results of surgical treatment for GBC with special reference to the extent of its histological spread and to present the recent literature in order to provide an update on the current concepts of surgical management of the disease.

PMID: 20583415 [PubMed - indexed for MEDLINE]
Expression of LAPTM4B in gallbladder carcinoma cells: the role in invasive potential.

Fetched: August 17th, 2010, 9:13am CDT

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Expression of LAPTM4B in gallbladder carcinoma cells: the role in invasive potential.

Hepatogastroenterology. 2010 Mar-Apr;57(98):207-11

Authors: Zhou L, He XD, Yu JC, Zhou RL, Xiong FX, Qu Q, Rui JA

BACKGROUND/AIMS: It was previously established that LAPTM4B-35 highly expressed in gallbladder carcinoma and being of clinicopathological and prognostic significances. However, expression of LAPTM4B gene in gallbladder carcinoma (GBC-SD), a gallbladder carcinoma cell line, and its role in invasive potential remain unclear. METHODOLOGY: Expression of LAPTM4B in GBC-SD cells was first detected. Plasmids, pcDNA3-AE (containing complete open reading frame of LAPTM4B) and Mock (pcDNA3), were transiently transfected into GBC-SD cells. Invasive phenotypes (migration and invasion) and relative molecules were then shown by transwell assay, crossing river test and Western blot analysis. RESULTS: Immunocytochemical staining revealed that LAPTM4B-35 positively expressed in cytoplasm of GBC-SD cells. But LAPTM4B-35 expression was obviously weaker in GBC-SD cells than that in BEL-7402 cells (positive control). Besides, cells transfected with pcDNA3-AE presented shorter crossing river time, less migrated and invaded cell numbers, compared with cells transfected with the Mock plasmid and parent cells. Finally, increased expressions of active uPA, MMP-9, pro MMP-2 and active MMP-2 were also observed in cells transfected with pcDNA3-AE. CONCLUSIONS: Our data suggested that LAPTM4B expressed in GBC-SD cells at a relatively low level. Forced overexpression of LAPTM4B increased invasive potential of GBC-SD cells, through modulating molecules associated with degradation of extracellular matrix.

PMID: 20583413 [PubMed - indexed for MEDLINE]
Expression of growth factor receptors and targeting of EGFR in cholangiocarcinoma cell lines.

Fetched: August 17th, 2010, 9:13am CDT

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Expression of growth factor receptors and targeting of EGFR in cholangiocarcinoma cell lines.

BMC Cancer. 2010;10:302

Authors: Xu L, Hausmann M, Dietmaier W, Kellermeier S, Pesch T, Stieber-Gunckel M, Lippert E, Klebl F, Rogler G

BACKGROUND: Cholangiocarcinoma (CC) is a malignant neoplasm of the bile ducts or the gallbladder. Targeting of growth factor receptors showed therapeutic potential in palliative settings for many solid tumors. The aim of this study was to determine the expression of seven growth factor receptors in CC cell lines and to assess the effect of blocking the EGFR receptor in vitro. METHODS: Expression of EGFR (epithelial growth factor receptor), HGFR (hepatocyte growth factor receptor) IGF1R (insulin-like growth factor 1 receptor), IGF2R (insulin-like growth factor 2 receptor) and VEGFR1-3 (vascular endothelial growth factor receptor 1-3) were examined in four human CC cell lines (EGI-1, HuH28, OZ and TFK-1). The effect of the anti-EGFR-antibody cetuximab on cell growth and apoptosis was studied and cell lines were examined for KRAS mutations. RESULTS: EGFR, HGFR and IGFR1 were present in all four cell lines tested. IGFR2 expression was confirmed in EGI-1 and TFK-1. No growth-inhibitory effect was found in EGI-1 cells after incubation with cetuximab. Cetuximab dose-dependently inhibited growth in TFK-1. Increased apoptosis was only seen in TFK-1 cells at the highest cetuximab dose tested (1 mg/ml), with no dose-response-relationship at lower concentrations. In EGI-1 a heterozygous KRAS mutation was found in codon 12 (c.35G>A; p.G12D). HuH28, OZ and TFK-1 lacked KRAS mutation. CONCLUSION: CC cell lines express a pattern of different growth receptors in vitro. Growth factor inhibitor treatment could be affected from the KRAS genotype in CC. The expression of EGFR itself does not allow prognoses on growth inhibition by cetuximab.

PMID: 20565817 [PubMed - indexed for MEDLINE]
False positive diagnosis of metastatic esophageal carcinoma on positron emission tomography: a case report of cholecystitis simulating a hepatic lesion.

Fetched: August 17th, 2010, 9:13am CDT

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False positive diagnosis of metastatic esophageal carcinoma on positron emission tomography: a case report of cholecystitis simulating a hepatic lesion.

Clin Nucl Med. 2010 Jun;35(6):409-12

Authors: Hansen N, Brown RK, Khan A, Frey KA, Orringer M

Esophageal cancer has been increasing in incidence for the last several decades. The current staging evaluation includes computed tomography, endoscopic ultrasonography, and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), which influences the treatment options. PET/CT is limited in its ability to differentiate hypermetabolic metastatic disease from acute/chronic inflammatory conditions, and this must be considered during interpretation. This is the case report of a 77-year-old man with esophageal cancer whose PET/CT demonstrated increased F-18 FDG uptake in the right lobe of the liver. This was originally interpreted at an outside institution as suspicious for metastatic disease, which would have precluded potential surgical cure. Subsequent reinterpretation and additional imaging including magnetic resonance imaging suggested that the uptake in the liver was likely due to adjacent gallbladder inflammation. On the basis of this interpretation, an abdominal exploration, liver biopsy, cholecystectomy, and transhiatal esophagectomy were performed. Final pathology of the gallbladder revealed perforated cholecystitis and a pericholecystic abscess (related to a prior septic episode), which were responsible for the increased radiotracer uptake. This case is presented to illustrate the importance of considering benign etiologies that may mimic metastatic disease when interpreting PET/CT scans.

PMID: 20479586 [PubMed - indexed for MEDLINE]
Migration of a covered metallic stent following endoscopic ultrasound-guided hepaticogastrostomy: fatal complication.

Fetched: August 17th, 2010, 9:13am CDT

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Migration of a covered metallic stent following endoscopic ultrasound-guided hepaticogastrostomy: fatal complication.

Endoscopy. 2010;42 Suppl 2:E126-7

Authors: Martins FP, Rossini LG, Ferrari AP

PMID: 20405376 [PubMed - indexed for MEDLINE]
Calreticulin is a B cell molecular target in some gastrointestinal malignancies.

Fetched: August 17th, 2010, 9:13am CDT

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Calreticulin is a B cell molecular target in some gastrointestinal malignancies.

Clin Exp Immunol. 2010 May;160(2):215-22

Authors: PekÃ¡rikovÃ¡ A, SÃ¡nchez D, PalovÃ¡-JelÃnkovÃ¡ L, SimsovÃ¡ M, Benes Z, HoffmanovÃ¡ I, Drastich P, JanatkovÃ¡ I, Mothes T, TlaskalovÃ¡-HogenovÃ¡ H, TuckovÃ¡ L

Calreticulin, upon translocation to the cell surface, plays a critical role in the recognition of tumour cells and in experimentally induced cellular anti-tumour immunity. However, less is known about anti-calreticulin antibodies and their role in malignancies. Using enzyme-linked immunosorbent assay (ELISA), we found immunoglobulin (Ig)A and/or IgG anti-calreticulin antibodies in sera of approximately 63% of patients with hepatocellular carcinoma (HCC), 57% of patients with colorectal adenocarcinoma (CRA) and 47% of patients with pancreatic adenocarcinoma (PACA), while healthy controls, patients with viral hepatitis C and with chronic pancreatitis reached only 2%, 20% and 31% seropositivity, respectively. We found significantly elevated mean levels of IgA anti-calreticulin antibodies (P < 0.001) in patients with HCC (78.7 +/- 52.3 AU, mean +/- standard deviation), PACA (66.5 +/- 30.9 AU) and CRA (61.8 +/- 25.8 AU) when compared to healthy controls (41.4 +/- 19.2 AU). Significantly elevated mean levels of IgG anti-calreticulin antibodies (P < 0.001) were detected in patients with HCC (121.9 +/- 94.2 AU), gall bladder adenocarcinoma (118.4 +/- 80.0 AU) and PACA (88.7 +/- 55.6 AU) when compared to healthy controls (56.7 +/- 22.9 AU). Pepscan analysis revealed a large number of antigenic epitopes of calreticulin recognized by both IgA and IgG antibodies of patients with HCC and PACA, indicating robust systemic immune response. Moreover, significantly elevated levels of antibodies against peptide KGEWKPRQIDNP (P < 0.001) in these patients, tested by ELISA, confirmed the distinct character of antibody reactivity against calreticulin. The high occurrence and specificity of serum anti-calreticulin autoantibodies in the majority of patients with some gastrointestinal malignancies provide the evidence for their possible clinical relevance.

PMID: 20030668 [PubMed - indexed for MEDLINE]
[A case of cholangiocarcinoma suspected by continuous elevation of CA 19-9 after surgery of xanthogranulomatous cholecystitis]

Fetched: August 13th, 2010, 9:16pm CDT

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[A case of cholangiocarcinoma suspected by continuous elevation of CA 19-9 after surgery of xanthogranulomatous cholecystitis]

Korean J Gastroenterol. 2010 Jun;55(6):404-9

Authors: Hwang SY, Kim JS, Jeong JB, Kim JW, Kim BG, Lee KL, Ahn YJ, Chang MS

Xanthogranulomatous cholecystitis (XGC) is an unusual and destructive inflammatory process that is characterized by thickening of the gallbladder (GB) wall with a tendency to adhere to neighboring organs. XGC is often mistaken for GB carcinoma, and the frequency of the coexistence of these two lesions is approximately 10%. Therefore, in case of severe XGC, there is chance of either overlooking the carcinoma or other significant lesions. CA 19-9 is commonly measured in the serum of patients with hepatobiliary malignancies. Although CA 19-9 can be elevated in benign conditions such as cholestasis, pancreatitis, tuberculosis, thyroid disease etc., malignancy should be considered at first in setting of its significant and persistent elevation. We report a case of a 62-year-old man who showed continuously rising level of CA19-9 over 2000 U/mL after cholecystectomy for xanthogranulomatous cholecystitis and finally was diagnosed as cholangiocarcinoma by short-term follow up.

PMID: 20571310 [PubMed - indexed for MEDLINE]
Massive hemobilia and papillomatosis of the gallbladder in metachromatic leukodystrophy: a life-threatening condition.

Fetched: August 13th, 2010, 9:16pm CDT

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Massive hemobilia and papillomatosis of the gallbladder in metachromatic leukodystrophy: a life-threatening condition.

Neuropediatrics. 2009 Dec;40(6):284-6

Authors: Garavelli L, Rosato S, Mele A, Wischmeijer A, Rivieri F, Gelmini C, SandonÃ F, Sassatelli R, Carlinfante G, Giovanardi F, Gemmi M, Della Giustina E, Amarri S, Banchini G, Bedogni G

Polyposis of the gallbladder is rare during childhood. This condition can be associated with three other conditions: metachromatic leukodystrophy, Peutz-Jeghers' syndrome, and pancreaticobiliary maljunction. We report the case of a child with hemobilia in metachromatic leukodystrophy, which rendered cholecystectomy necessary. Macroscopically, the gallbladder measured 4.6 cm in length and showed an opaque serous surface and focal brown petechiae. Moreover, a yellow polypoid lesion of 2 cm in diameter and a diffuse thickening of the fundus wall were observed. Many reports describe the importance of the association of gallbladder papillomatosis with metachromatic leukodystrophy, but only three cases presented with massive intestinal bleeding, such as our young patient had. It is thus imperative that this life-threatening condition should be well known.

PMID: 20446223 [PubMed - indexed for MEDLINE]
[Management of incidental gallbladder carcinoma]

Fetched: August 13th, 2010, 9:16pm CDT

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[Management of incidental gallbladder carcinoma]

Cir Esp. 2010 Apr;87(4):265; author reply 266

Authors: Barriga SÃ¡nchez R, Cruz Cidoncha A, GonzÃ¡lez E, GarcÃa UreÃ±a MA

PMID: 20080231 [PubMed - indexed for MEDLINE]
New prognostic factor influencing long-term survival of patients with advanced gallbladder carcinoma.

Fetched: August 10th, 2010, 6:32pm CDT

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New prognostic factor influencing long-term survival of patients with advanced gallbladder carcinoma.

Surgery. 2010 Aug;148(2):271-7

Authors: Miura F, Asano T, Amano H, Toyota N, Wada K, Kato K, Takada T, Takami H, Ohira G, Matsubara H

BACKGROUND: Although the safety of operations has generally improved in recent years, the mortality of extended operations for advanced gallbladder carcinoma (GBC) remains high, and the outcomes of patients with advanced GBC requiring major surgery are poor. In this study, a newly formulated original stage classification of advanced GBC was evaluated to clarify prognostic factors affecting long-term survival. METHODS: A total of 149 patients with resected GBC infiltrating beyond the propria muscle layer were analyzed retrospectively. These patients were classified into F0 (n = 50), F1 (n = 38), F2 (n = 38), and F3 (n = 23) according to the number of positive histopathologic factors, consisting of direct invasion to the liver, invasion to the hepatoduodenal ligament, and lymph node metastasis. Overall survival rates were compared with the Union Internationale Contre le Cancer TNM classification (6th edition). RESULTS: Overall 5-year survival rates of patients with F0, F1, F2, and F3 were 60%, 35%, 5%, and 0%, respectively. Significant differences were observed, except between F2 and F3. In 38 patients with F1, there were no significant differences between 13 patients with direct invasion to the liver, 4 patients with invasion to the hepatoduodenal ligament, and 21 patients with lymph node metastasis. Multivariate analysis revealed that F classification was the most important independent risk factor to predict survival. CONCLUSION: Patients with advanced GBC are expected to survive long if only 1 of hepatic invasion, hepatoduodenal ligament invasion, or lymph node metastasis is positive.

PMID: 20570306 [PubMed - indexed for MEDLINE]
Genetics of biliary tract cancers and emerging targeted therapies.

Fetched: August 10th, 2010, 6:32pm CDT

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Genetics of biliary tract cancers and emerging targeted therapies.

J Clin Oncol. 2010 Jul 20;28(21):3531-40

Authors: Hezel AF, Deshpande V, Zhu AX

Biliary tract cancers (BTC), which encompass intra- and extrahepatic cholangiocarcinomas and gallbladder carcinomas, are a genetically diverse collection of cancers. Evidence suggests distinct models of molecular and pathologic progression, and a growing body of genetics data points to a heterogeneous collection of underlying mutations in key oncogenes and tumor suppressor genes. Although tumor genetics have been used to tailor individual treatment regimens and guide clinical decision making in other cancers, these principles have not been applied in BTC. Recent clinical trials with targeted therapies seem promising, although the relationships between subsets of patients with positive responses to therapy and tumor genetics remain unexplored. Here, we summarize the molecular pathogenesis and genetics of BTCs and animal modeling and relate these to recent and ongoing clinical trials with targeted agents.

PMID: 20547994 [PubMed - indexed for MEDLINE]
Report of a multicenter phase II trial testing a combination of biweekly bevacizumab and daily erlotinib in patients with unresectable biliary cancer: a phase II Consortium study.

Fetched: August 10th, 2010, 6:32pm CDT

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Report of a multicenter phase II trial testing a combination of biweekly bevacizumab and daily erlotinib in patients with unresectable biliary cancer: a phase II Consortium study.

J Clin Oncol. 2010 Jul 20;28(21):3491-7

Authors: Lubner SJ, Mahoney MR, Kolesar JL, Loconte NK, Kim GP, Pitot HC, Philip PA, Picus J, Yong WP, Horvath L, Van Hazel G, Erlichman CE, Holen KD

PURPOSE: Biliary cancers overexpress epidermal growth factor receptor (EGFR), and angiogenesis has been correlated with poor outcome. Erlotinib, an EGFR tyrosine kinase inhibitor, and bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor have each been shown to have activity in biliary cancer. The primary objective of this study was to evaluate the response rate by Response Evaluation Criteria in Solid Tumors (RECIST). Secondary end points included overall survival (OS), time to progression (TTP), VEGF levels, and molecular studies of EGFR and k-ras. PATIENTS AND METHODS: Eligible patients had advanced cholangiocarcinoma or gallbladder cancer. Patients were treated with bevacizumab 5 mg/kg intravenously on days 1 and 15 and erlotinib 150 mg by mouth daily on days 1 through 28. Responses were evaluated by RECIST. VEGF levels were collected, and samples were analyzed for EGFR mutation by polymerase chain reaction. RESULTS: Fifty-three eligible patients were enrolled at eight sites. Of 49 evaluable patients, six (12%; 95% CI, 6% to 27%) had a confirmed partial response. Stable disease was documented in another 25 patients (51%). Rash was the most common grade 3 toxicity. Four patients had grade 4 toxicities. Median OS was 9.9 months, and TTP was 4.4 months. Low repeats (< 16) in EGFR intron 1 polymorphism and G>G k-ras Q38 genotype (wild type) were associated with improved outcomes. CONCLUSION: Combination chemotherapy with bevacizumab and erlotinib showed clinical activity with infrequent grade 3 and 4 adverse effects in patients with advanced biliary cancers. On the basis of preliminary molecular analysis, presence of a k-ras mutation may alter erlotinib efficacy. The combination of bevacizumab and erlotinib may be a therapeutic alternative in patients with advanced biliary cancer.

PMID: 20530271 [PubMed - indexed for MEDLINE]
Gallbladder perforation associated with carcinoma of the duodenal papilla: a case report.

Fetched: August 10th, 2010, 6:32pm CDT

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Gallbladder perforation associated with carcinoma of the duodenal papilla: a case report.

World J Surg Oncol. 2010;8:41

Authors: Hosaka A, Nagayoshi M, Sugizaki K, Masaki Y

BACKGROUND: Gallbladder perforation is a rare clinical condition, which mostly occurs following acute cholecystitis associated with cholelithiasis. A tumor of the ampulla of Vater causes gradually progressive symptoms, and is rarely associated with perforation of the gallbladder. CASE PRESENTATION: A 56-year-old man with carcinoma of the ampulla of Vater presented with spontaneous gallbladder perforation and localized bile peritonitis. He complained of right upper abdominal pain, and laparotomy revealed perforation of the gallbladder with no gallstones. Postoperative upper gastrointestinal endoscopy demonstrated a slightly enlarged duodenal papilla, and biopsy revealed adenocarcinoma of the ampulla. Pylorus-preserving pancreaticoduodenectomy was performed subsequently. CONCLUSION: Ampullary carcinoma can be associated with gallbladder perforation and present with acute manifestations. Immediate surgical treatment is required for this condition.

PMID: 20487525 [PubMed - indexed for MEDLINE]
[Portal vein thrombosis]

Fetched: August 10th, 2010, 6:32pm CDT

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[Portal vein thrombosis]

Gastroenterol Hepatol. 2010 Mar;33(3):179-90

Authors: Seijo-RÃos S, GarcÃa-PagÃ¡n JC

Thrombosis of the splenoportal axis not associated with liver cirrhosis or tumoral disease is the second cause of portal hypertension in the western world. In up to 60% of cases, an underlying systemic prothrombotic disorder can be identified as an etiological factor. One third of cases are caused by local factors and the coexistence of several entities is not unusual. Therefore, an etiologic diagnosis is essential in these patients. Early anticoagulation therapy in the acute phase of thrombosis of the splenoportal axis significantly affects the probability of recanalization and consequently the prognosis of these patients. In the chronic phase of splenoportal thrombosis (or portal cavernoma), the symptoms are caused by the complications of established portal hypertension. To date, anticoagulation therapy is limited to patients in whom an underlying prothrombotic disorder has been demonstrated.

PMID: 19733938 [PubMed - indexed for MEDLINE]
Gall Bladder and Extrahepatic Bile Duct Lymphomas: Clinicopathological Observations and Biological Implications.

Fetched: August 4th, 2010, 9:26am CDT

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Gall Bladder and Extrahepatic Bile Duct Lymphomas: Clinicopathological Observations and Biological Implications.

Am J Surg Pathol. 2010 Jul 31;

Authors: Mani H, Climent F, Colomo L, Pittaluga S, Raffeld M, Jaffe ES

Lymphomas of the gall bladder and extrahepatic bile ducts are exceedingly rare. We present the clinicopathological features of 19 cases from our files; 14 patients had primary lymphoma (13 involving gall bladder and 1 involving common hepatic duct), while 5 had systemic lymphoma on further work-up. Most patients presented with symptoms mimicking cholecystitis. The most common primary lymphoma types were diffuse large B-cell lymphoma, extranodal marginal zone lymphoma, B-lymphoblastic lymphoma, and follicular lymphoma. Two cases had features of lymphomatous polyposis, one a case of follicular lymphoma and the second a case of mantle cell lymphoma, with disease limited to the mantle zones, so-called in situ mantle cell lymphoma. Other rare lymphoma subtypes not described earlier in this site included the extracavitary variant of primary effusion lymphoma and plasmablastic lymphoma. Patients with diffuse large B-cell lymphoma and extranodal marginal zone lymphoma were older (mean age 75.8 y) than those with other subtypes (mean age 47 y) and more likely to have gallstones (60% vs. 12.5%). A comprehensive literature review revealed 36 primary gall bladder and 16 primary extrahepatic bile duct lymphomas. When compared with primary gall bladder lymphomas, those involving the extrahepatic bile ducts present at a younger age (47 y vs. 63 y) usually with obstructive jaundice, and are less often associated with gallstones (17% vs. 50%) or regional lymph node involvement (6% vs. 31%). In conclusion, primary lymphomas of the gall bladder and extrahepatic bile ducts show a broad spectrum of disease types, but in many respects mirror the spectrum of primary lymphomas of the gastrointestinal tract.

PMID: 20679881 [PubMed - as supplied by publisher]
Clinical determinants of suppurative cholangitis in malignant biliary tract obstruction.

Fetched: August 4th, 2010, 9:26am CDT

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Clinical determinants of suppurative cholangitis in malignant biliary tract obstruction.

Bratisl Lek Listy. 2010;111(6):336-9

Authors: Doganay M, Yuksek YN, Daglar G, Gozalan U, Tutuncu T, Kama NA

BACKGROUND: The purpose of this study was to find the factors predicting the supurative cholangitis in malignant biliary tract obstruction. METHODS: During the period of 1992-2003, 107 patients were operated on for malignant obstruction of the biliary tract. Obstructions were due to gall bladder cancer (n = 4), cholangiocarcinoma (n = 21) or periampullary tumor (n = 82). Sixteen patients were found to have suppurative cholangitis at laparotomy. Among the patients with suppurative cholangitis, eight were males and eight were females with a mean age of 62 (range 42-85) years. The chi-square analysis and student-t test were employed for correlation of individual risk factors with cholangitis. Stepwise logistic regression analysis was then used to identify independent risk factors. RESULTS: Only seven patients with supurative cholangitis (43.8 %) had the Charcot's triad of symptoms and one had the Reynold's pentad. Six of 16 patients survived postoperatively and were discharged from hospital while nine patients died during the first hospital admission. There were five cases of death due to biliary sepsis, two cases of anastomotic leakage, one acute renal failure, and one case of intra-abdominal hemorrhage and sepsis. Multivariate logistic regression analysis showed that a number of variables can serve as independent predictors of suppurative cholangitis, namely the fever, leukocytosis, high bilirubin level and ERCP performed in preoperative period. CONCLUSION: Identification of these risk factors may be worthwhile in the early diagnosis and treatment of the disease. Fever, high bilirubin level, leukocytosis and ERCP performed in the preoperative period were independently associated with suppurative cholangitis (Tab. 3, Ref. 20).

PMID: 20635678 [PubMed - in process]
[Gallbladder adenomyomatosis]

Fetched: August 4th, 2010, 9:26am CDT

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[Gallbladder adenomyomatosis]

Eksp Klin Gastroenterol. 2010;(4):86-91

Authors:

THE AIM: to familiarize with the main clinical aspects of the adenomyomatosis gallbladder. Recent literature data show that adenomyomatosis of the gallbladder is not a rare disease and its frequency in cholecystectomy is 2-8.7%. It is more common after the age of 35-40 years and among women. Course of the disease is complicated by cholecystolithiasis, and localization in the bottom of the gall bladder-malignization. The main method of diagnosis is ultrasonography. For the differential diagnosis of cancer of the gall bladder used under the MRIs. Cholecystectomy is indicated for complications of cholecystolithiasis and suspected malignancy in the gallbladder.

PMID: 20626106 [PubMed - in process]
Intraluminal polypoid metastasis of renal cell carcinoma in gallbladder mimicking gallbladder polyp.

Fetched: August 4th, 2010, 9:26am CDT

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Intraluminal polypoid metastasis of renal cell carcinoma in gallbladder mimicking gallbladder polyp.

Arch Pathol Lab Med. 2010 Jul;134(7):1003-9

Authors: Fang X, Gupta N, Shen SS, Tamboli P, Charnsangavej C, Rashid A, Wang H

CONTEXT: Metastatic renal cell carcinoma (RCC) in gallbladder is rare with only 18 cases published in the English literature. OBJECTIVES: To review the clinicopathologic characteristics of metastatic RCC in gallbladder and to correlate the findings with clinical outcomes. DESIGN: We report 4 additional cases of intraluminal polypoid metastasis of RCC in gallbladder and reviewed all reported cases, to our knowledge, of metastatic RCC in gallbladder in the English literature. RESULTS: Most of the patients (19 of 22; 86%) were men. The ages at presentation ranged from 39 to 84 years with a median age of 61.5 years. All cases showed an intraluminal polypoid/pedunculated mucosal mass mimicking a gallbladder polyp. Histologically, all cases were clear cell RCC with most of the tumors either confined to gallbladder mucosa (67%) or involved both mucosa and muscular layer (27%). The longest interval between nephrectomy and the development of gallbladder metastasis was 27 years. CONCLUSIONS: Metastatic clear cell RCC should be considered in the differential diagnosis of polypoid lesion of the gallbladder with clear cell morphology. Solitary metastasis of RCC in gallbladder correlated with better survival, and simple cholecystectomy for solitary metastatic RCC may provide patients with favorable long-term survival.

PMID: 20586628 [PubMed - indexed for MEDLINE]
[Rare tumors of the gallbladder and bile ducts. A case review]

Fetched: August 4th, 2010, 9:26am CDT

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[Rare tumors of the gallbladder and bile ducts. A case review]

Rozhl Chir. 2010 Apr;89(4):250-2

Authors: Kalac J, VeverkovÃ¡ L, Wechsler J, Piskac P, Zambo I

The authors deal with the problem of benigh tumours of the bile duct which might occur as a very suprising intraoperative finding instead of preoperatively diagnosed "gallstones". This situation can happen because of possible mistakes that might accompany today's modern practical investigative techniques. The presented report is an example of the pre-operatirely assumed choledocholithiasis which was not confirmed during the operation. Instead a rare bile duct tumour was found.

PMID: 20586163 [PubMed - indexed for MEDLINE]
Adjuvant chemoradiation therapy in gallbladder cancer.

Fetched: August 4th, 2010, 9:26am CDT

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Adjuvant chemoradiation therapy in gallbladder cancer.

J Surg Oncol. 2010 Jul 1;102(1):87-93

Authors: Cho SY, Kim SH, Park SJ, Han SS, Kim YK, Lee KW, Lee WJ, Woo SM, Kim TH

BACKGROUND AND OBJECTIVES: Gallbladder cancer is a relatively uncommon gastrointestinal malignancy. Indications for adjuvant chemoradiation therapy after surgical resection have not yet been determined. We aimed this study to elucidate the effectiveness of adjuvant chemoradiation therapy according to TNM stage for gallbladder cancer. METHODS: Between March 2001 and March 2009, 100 patients with gallbladder cancer underwent surgical resection. We divided the patients according to TNM stage, and subdivided further according to whether adjuvant chemoradiation therapy was added or not. The clinicopathologic factors, recurrence and survival were retrospectively analyzed. RESULTS: Patients with gallbladder cancer at T2N0M0, T2N1M0, T3N0M0, and T3N1M0 stages were enrolled in this study. Among the four stages, the two lymph node-negative stages (T2N0M0 and T3N0M0) did not show any gain in survival by adding adjuvant chemoradiation therapy. Conversely, the remaining lymph node-positive stages (T2N1M0 and T3N1M0) showed gain in disease-free survival, and the lymph node-positive T2 stage (T2N1M0) showed gain in disease-specific survival. In patients with lymph node-positive T2/T3 GB cancers, adjuvant chemoradiation therapy was an independent prognostic factor for survival. CONCLUSIONS: Adjuvant chemoradiation therapy is recommended for lymph node-positive T2/T3 gallbladder cancer following surgical resection.

PMID: 20578085 [PubMed - indexed for MEDLINE]
Polymorphisms in ERCC2, MSH2, and OGG1 DNA repair genes and gallbladder cancer risk in a population of Northern India.

Fetched: August 4th, 2010, 9:26am CDT

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Polymorphisms in ERCC2, MSH2, and OGG1 DNA repair genes and gallbladder cancer risk in a population of Northern India.

Cancer. 2010 Jul 1;116(13):3160-9

Authors: Srivastava K, Srivastava A, Mittal B

BACKGROUND: Genetic variants of DNA repair enzymes may lead to genetic instability and contribute to gallbladder (GB) carcinogenesis. METHODS: A case-control study (230 GB carcinogenesis patients and 230 controls) was undertaken to evaluate whether genetic variations in 3 DNA repair genes ERCC2 (Asp312Asn [rs1799793] and Lys751Gln [rs13181]), MSH2 (-118T > C [rs2303425] and IVS1 + 9G>C [rs2303426]), and OGG1 (Ser326Cys [rs1052133] and 748-15C > G [rs2072668]) are associated with GB carcinogenesis risk in a North Indian population. RESULTS: The authors found that the ERCC2 Asp312Asn AA, MSH2 IVS1 + 9G > C CC, OGG1 Ser326Cys GG and CG + GG, and OGG1 748-15C > G GG and CG + GG genotypes were significantly associated with an increased risk of GB carcinogenesis (odds ratio [OR], 2.1, 1.8, 2.5, 1.8, 2.0, and 1.6, respectively). In contrast, ERCC2 Lys751Gln, and MSH2 -118T > C markers showed no significant associations with GB carcinogenesis risk, although because of the small sample size their effects cannot be ruled out. Female GB carcinogenesis patients with the OGG1 748-15C > G GG, OGG1 Ser326Cys GG, and ERCC2 Asp312Asn genotypes had a greater risk for developing the disease (OR, 3.6, 7.7, and 2.7, respectively). There was a significant interaction between MSH2 IVS1 + 9G > C and OGG1 748-15C > G polymorphisms (P = .001). Furthermore, individuals with > 6 variant alleles of the studied polymorphisms were at 4-fold increased risk for developing GB carcinogenesis. Classification and Regression Tree analysis revealed potential higher-order gene-gene interactions and categorized a few higher-risk subgroups for GB carcinogenesis. CONCLUSIONS: These results suggest that genetic variants in the DNA repair pathways may be involved in GB carcinogenesis etiology.

PMID: 20564624 [PubMed - indexed for MEDLINE]
Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause!

Fetched: August 4th, 2010, 9:26am CDT

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Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause!

Eur J Surg Oncol. 2010 Jun;36(6):514-9

Authors: Shrikhande SV, Barreto SG, Singh S, Udwadia TE, Agarwal AK

BACKGROUND: While gallstones are associated with cancers of the gallbladder, the actual nature of their relationship needs to be clarified. This would aid the recommendations on the need for prophylactic cholecystectomy. METHODS: A systematic search of the scientific literature was carried out using the Medline, the Embase, and the Cochrane Central Register of Controlled Trials for the years 1891-2009 to obtain access to all publications involving gallstones in gallbladder cancer. RESULTS: While some epidemiological evidence supports a causal relationship for gallstones in gallbladder cancer, other studies have demonstrated a relatively low incidence of gallbladder cancer in countries reporting a high incidence of gallstones as a whole. In those studies where gallstones appear to have a causative role for cancer, the risk increases with increasing size, volume and weight, and number of the stones. The impact of duration of the stone or its composition is not clear. Experimental evidence from studies examining the impact of artificially introducing gallstones in the gallbladder has failed to lead to carcinogenesis. CONCLUSIONS: The evidence at the current time indicates that gallstones are a cofactor in the causation of gallbladder cancer. Absolute proof of their role as a cause for gallbladder cancer is lacking. The recommendation for prophylactic cholecystectomy in countries reporting a high incidence of gallbladder cancer and associated gallstones needs to be tailored to the epidemiological profile of the place.

PMID: 20537839 [PubMed - indexed for MEDLINE]
Diabetes in relation to biliary tract cancer and stones: a population-based study in Shanghai, China.

Fetched: August 4th, 2010, 9:26am CDT

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Diabetes in relation to biliary tract cancer and stones: a population-based study in Shanghai, China.

Br J Cancer. 2010 Jun 29;103(1):115-9

Authors: Shebl FM, Andreotti G, Rashid A, Gao YT, Yu K, Shen MC, Wang BS, Li Q, Han TQ, Zhang BH, Fraumeni JF, Hsing AW

BACKGROUND: Biliary tract cancers are rare but fatal malignancies. Diabetes has been related to biliary stones, but its association with biliary tract cancers is less conclusive. METHODS: In a population-based case-control study of 627 cancers, 1037 stones, and 959 controls in Shanghai, China, we examined the association between diabetes and the risks of biliary tract cancer and stones, as well as the effect of potential mediating factors, including serum lipids and biliary stones (for cancer), contributing to the causal pathway from diabetes to biliary diseases. RESULTS: Independent of body mass index (BMI), diabetes was significantly associated with gallbladder cancer and biliary stones ((odds ratio (OR) (95% confidence interval)=2.6 (1.5-4.7) and 2.0 (1.2-3.3), respectively). Biliary stones and low serum levels of high-density lipoprotein (HDL) were significant mediators of the diabetes effect on gallbladder cancer risk, accounting for 60 and 17% of the diabetes effect, respectively. High-density lipoprotein was also a significant mediator of the diabetes effect on biliary stones, accounting for 18% of the diabetes effect. CONCLUSIONS: Independent of BMI, diabetes is a risk factor for gallbladder cancer, but its effect is mediated in part by biliary stones and serum HDL levels, suggesting that gallbladder cancer risk may be reduced by controlling diabetes, stones, and HDL levels.

PMID: 20517308 [PubMed - indexed for MEDLINE]
Trends in survival of patients diagnosed with cancer of the digestive organs in the Nordic countries 1964-2003 followed up to the end of 2006.

Fetched: August 4th, 2010, 9:26am CDT

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Trends in survival of patients diagnosed with cancer of the digestive organs in the Nordic countries 1964-2003 followed up to the end of 2006.

Acta Oncol. 2010 Jun;49(5):578-607

Authors: Klint A, Engholm G, Storm HH, TryggvadÃ³ttir L, Gislum M, Hakulinen T, Bray F

Cancers of the digestive organs (including the oesophagus, stomach, small intestine, colon, rectum and anus, liver, gallbladder, and pancreas) constitute one-fifth of all cancer cases in the Nordic countries and is a group of diseases with diverse time trends and varying consequences for public health. In this study we examine trends in relative survival in relation to the corresponding incidence and mortality rates in the Nordic countries during the period 1964-2003. MATERIAL AND METHODS: Data were retrieved from the NORDCAN database for the period 1964 to 2003, grouped into eight 5-year periods of diagnosis. The patients were followed up until the end of 2006. Analysis comprised trends in 5-year relative survival, excess mortality and age-specific relative survival. RESULTS: Survival following cancers of the colon and rectum has increased continuously over the observed period, yet Danish patients fall behind those in the other Nordic countries. The largest inter-country variation is seen for the rare cancers in the small intestine. There has been little increase in prognosis for patients diagnosed with cancers of the liver, gallbladder or pancreas; 5-year survival is generally below 15%. Survival also remains consistently low for patients with oesophageal cancer, while minor increases in survival are seen among stomach cancer patients in all countries except Denmark. The concomitant incidence and mortality rates of stomach cancer have steadily decreased in each Nordic country at least since 1964. CONCLUSION: While the site-specific variations in mortality and survival largely reflect the extent of changing and improving diagnostic and clinical practices, the incidence trends highlight the importance of risk factor modification. Alongside the ongoing clinical advances, effective primary prevention measures, including the control of alcohol and tobacco consumption as well as changing dietary pattern, will reduce the incidence and mortality burden of digestive cancers in the Nordic countries.

PMID: 20491524 [PubMed - indexed for MEDLINE]
Expression of the extracellular matrix protein periostin in liver tumours and bile duct carcinomas.

Fetched: August 4th, 2010, 9:26am CDT

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Expression of the extracellular matrix protein periostin in liver tumours and bile duct carcinomas.

Histopathology. 2010 Apr;56(5):600-6

Authors: Riener MO, Fritzsche FR, Soll C, Pestalozzi BC, Probst-Hensch N, Clavien PA, Jochum W, Soltermann A, Moch H, Kristiansen G

AIMS: To study the relevance of periostin, known to be involved in epithelial-mesenchymal transition (EMT), in hepatocellular and bile duct cancer. METHODS AND RESULTS: Immunohistochemical periostin expression was semiquantitatively analysed in normal liver tissue (n = 20), hepatocellular carcinoma (HCC; n = 91), liver-cell adenoma (n = 9), focal nodular hyperplasia (n = 13) and bile duct carcinomas (BDC; n = 116) using tissue microarrays. Normal bile ducts, gallbladder epithelium and hepatocytes showed weak cytoplasmic periostin expression. In HCC, there was strong epithelial periostin expression in 19/91 (20.9%) and strong stromal periostin expression in 10/91 cases (11%). Epithelial expression in tumour cells was significantly associated with a higher tumour grade (P < 0.05) and hepatitis B virus infection (P = 0.007). Importantly, there was no strong periostin expression in benign liver tumours. Strong stromal periostin expression was detected in 78/116 (67.2%) BDC and strong epithelial expression in 39/116 (33.6%) BDC. pT stage, differentiation grade and proliferation rate in primary BDC were independent of periostin expression. Epithelial periostin expression was associated with reduced overall survival on univariate and multivariate analysis. CONCLUSIONS: The EMT protein periostin is expressed in the stroma and epithelium of a subset of BDC and HCC. Epithelial periostin expression is a marker for malignant transformation of hepatocytes and a novel prognostic marker in BDC.

PMID: 20459570 [PubMed - indexed for MEDLINE]
Mesopancreas: myth or reality?

Fetched: August 4th, 2010, 9:26am CDT

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Mesopancreas: myth or reality?

JOP. 2010;11(3):230-3

Authors: Agrawal MK, Thakur DS, Somashekar U, Chandrakar SK, Sharma D

CONTEXT: A recently published study hypothesized the concept of 'mesopancreas', defining it as a firm, well-vascularized structure extending from the posterior surface of the pancreatic head to behind the mesenteric vessels. OBJECTIVE: To verify and define mesopancreas from resection specimens obtained from fresh cadavers. DESIGN: Postmortem anatomical-pathological study. SETTING: Department of Surgery in conjunction with the Departments of Forensic Medicine and Pathology, Government Medical College and Hospital, Jabalpur, MP, India. PARTICIPANTS: Twenty fresh adult cadavers without any intra-abdominal injury or gross intra-abdominal pathology. INTERVENTIONS: Specimens containing the entire duodenum, pancreatic head and neck, gallbladder, cystic duct, common bile duct, superior mesenteric vessels, inferior vena cava and aorta were removed en-bloc. Gross and histopathological examinations of the specimens were carried out. MAIN OUTCOME MEASURES: To look for a fibrous sheath or fascia around the retropancreatic structure purported to be a mesopancreas. RESULTS: Loose areolar tissue, adipose tissue, peripheral nerve, nerve plexus, lymphatic and capillaries were found in the retropancreatic tissue, extending from the head, neck and uncinate process of pancreas to the aorto-caval groove but no fibrous sheath or fascia was found around these structures. CONCLUSIONS: The concept of 'mesopancreas' is anatomically unfounded.

PMID: 20442517 [PubMed - indexed for MEDLINE]
Comparison of sclerosing cholangitis with autoimmune pancreatitis and infiltrative extrahepatic cholangiocarcinoma: multidetector-row computed tomography findings.

Fetched: August 4th, 2010, 9:26am CDT

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Comparison of sclerosing cholangitis with autoimmune pancreatitis and infiltrative extrahepatic cholangiocarcinoma: multidetector-row computed tomography findings.

Jpn J Radiol. 2010 Apr;28(3):205-13

Authors: Arikawa S, Uchida M, Kunou Y, Uozumi J, Abe T, Hayabuchi N, Ishida Y, Kaji R, Okabe Y, Murotani K

PURPOSE: The aim of this study was to compare multidetector-row computed tomography (MDCT) findings between cases of sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and infiltrative extrahepatic cholangiocarcinoma (IEC). MATERIALS AND METHODS: We retrospectively assessed MDCT findings from 16 IEC cases and 13 SC-AIP cases. MDCT findings were analyzed with regard to location, length, wall thickness, contour, stricture wall enhancement pattern, proximal duct diameter, and the presence of diffuse concentric thickening in the proximal duct and gallbladder wall thickness. RESULTS: Stricture length, stricture wall thickness, and proximal duct diameter were significantly smaller for SC-AIP than for IEC: 19.3 +/- 8.7 vs. 31.8 +/- 12.0 mm (P = 0.004), 2.1 +/- 1.3 vs. 4.1 +/- 1.3 mm (P < 0.001), and 9.2 +/- 3.9 vs. 13.3 +/- 5.0 mm (P = 0.012), respectively. SC-AIP was correlated with stricture location in both the intrapancreatic and hilar hepatic bile ducts, concentric stricture contour (P < 0.001), and diffuse concentric thickening of the proximal bile duct (P = 0.010). Overall values of sensitivity, specificity, and accuracy used to distinguish between SC-AIP and IEC for stricture wall thickness of <3.0 mm and concentric contour were 76.9%, 93.8%, and 86.2%, respectively, and 100%, 87.5%, 93.1%, respectively. CONCLUSION: Concentric contour and stricture wall thicknesses of <3.0 mm may help distinguish between SC-AIP and IEC.

PMID: 20437131 [PubMed - indexed for MEDLINE]
Expression of p16 protein in gallbladder carcinoma and its precancerous conditions.

Fetched: August 4th, 2010, 9:26am CDT

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Expression of p16 protein in gallbladder carcinoma and its precancerous conditions.

Hepatogastroenterology. 2010 Jan-Feb;57(97):18-21

Authors: Choi HJ, Yun SS, Kim HJ, Choi JH

BACKGROUND/AIMS: Adenocarcinoma of the gallbladder is a highly malignant neoplasm. p16 is a tumor suppressor gene protein, which is a cyclin-dependent kinase inhibitor that regulates the G1-S phase of the cell cycle. The purpose of the present study was to investigate the expression of p16 in gallbladder carcinoma and its precancerous conditions and to examine the relationship between p16 expression and clinicopathological parameters. METHODOLOGY: Formalin-fixed, paraffin-embedded tissue sections from 20 cases of normal gallbladder, 20 cases of chronic cholecystitis, 20 cases of gallbladder adenoma, 20 cases of dysplasia, and 58 cases of adenocarcinoma were examined. The expression of p16 was evaluated by immunohistochemical analysis. RESULTS: In normal gallbladder, no expression of p16 was found. In chronic cholecystitis, expression of p16 was not found. In gallbladder adenomas, expression of p16 was found in 20% (4/20). In low grade dyspalsias, expression of p16 was not found. In high grade dysplasias, p16 expression was present in 45.0% (9/20). In gallbladder adenocarcinomas, p16 expression was found in 27.6% (16/58). Expression of p16 correlated significantly with histologic grade (p < 0.05). No correlation was found between p16 expression and age, gender, tumor size, gross type, location, vascular invasion, lymph node metastasis, and TNM stage, respectively. CONCLUSIONS: P16 protein overexpression is an early and relatively common event in carcinogenesis of gallbladder carcinoma. Expression of p16 protein is absent in normal or chronic cholecystitis. Expression of p16 may be an ancillary diagnostic marker of gallbladder carcinoma and its precancerous conditions.

PMID: 20422865 [PubMed - indexed for MEDLINE]
[Gallbladder chloroma: a case report]

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[Gallbladder chloroma: a case report]

J Radiol. 2010 Feb;91(2):239-40

Authors: Ukkola-Pons E, Weber-Donat G, Minvielle F, Bonardel G, Baccialone J, Jeanbourquin D, Teriitehau C

PMID: 20389274 [PubMed - indexed for MEDLINE]
Cystadenoma originating from the gallbladder.

Fetched: August 4th, 2010, 9:26am CDT

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Cystadenoma originating from the gallbladder.

J Ultrasound Med. 2010 Apr;29(4):663-6

Authors: Gokalp G, Dusak A, Topal NB, Aker S

PMID: 20375388 [PubMed - indexed for MEDLINE]
Color Doppler twinkling artifacts in various conditions during abdominal and pelvic sonography.

Fetched: August 4th, 2010, 9:26am CDT

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Color Doppler twinkling artifacts in various conditions during abdominal and pelvic sonography.

J Ultrasound Med. 2010 Apr;29(4):621-32

Authors: Kim HC, Yang DM, Jin W, Ryu JK, Shin HC

OBJECTIVE: The aims of this study were to describe the mechanisms likely to be responsible for color Doppler twinkling artifacts and their associated machine factors and to illustrate the various conditions that cause twinkling artifacts and those pitfalls. METHODS: We evaluated various sonographic machine-associated factors that influence artifact appearance and identified various conditions that display twinkling artifacts during abdominal and pelvic sonography. RESULTS: The presence of twinkling artifacts was found to be dependent on focal zones, gray scale gains, color write priorities, and pulse repetition frequencies. Twinkling artifacts were found to be associated with calcified lesions in the liver, gallbladder adenomyomatosis, hepatic bile duct hamartoma, gallstones and choledocholithiasis, chronic pancreatitis, urinary stones, encrusted indwelling urinary stents, bowel gas, and metallic foreign bodies. However, some of the twinkling artifacts were found to be associated with false-negative and -positive results. CONCLUSIONS: Color Doppler twinkling artifacts are additional useful sonographic signs in the diagnosis of calcified lesions, urinary and biliary stones, gallbladder adenomyomatosis, and some miscellaneous conditions.

PMID: 20375381 [PubMed - indexed for MEDLINE]
Selective histopathology in cholecystectomy for gallstone disease.

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Selective histopathology in cholecystectomy for gallstone disease.

Indian J Gastroenterol. 2010 Jan;29(1):26-30

Authors: Mittal R, Jesudason MR, Nayak S

BACKGROUND: Incidental gallbladder cancer is found in upto 1% of cholecystectomy specimens for gallstone disease. Currently, in our institution, all gallbladder specimens are sent for routine histopathology, to rule out incidental gallbladder carcinoma. This study was aimed at assessing the need for routine histopathology of gallbladder specimens after cholecystectomy for gallstone disease. METHODS: Hospital records of all patients undergoing cholecystectomy for gallstone disease over a ten-year period, between 1998 and 2007, in a single surgical unit were reviewed. RESULTS: A total of 1312 patients underwent cholecystectomy for gallstone disease. Gallbladder carcinoma was detected in 13 patients. Macroscopic abnormalities of the gallbladder were found in all the 13 patients. In patients with a macroscopically normal gallbladder, there were no cases of gallbladder carcinoma. CONCLUSION: Gallbladder carcinoma is associated with macroscopic abnormalities in all cases. Therefore histopathology should be restricted to only those specimens which reveal a macroscopic abnormality. This would identify all cases of incidental gallbladder carcinoma, at the same time decreasing cost and pathological work load.

PMID: 20373083 [PubMed - indexed for MEDLINE]
Does gallbladder cancer divide India?

Fetched: August 4th, 2010, 9:26am CDT

Does gallbladder cancer divide India?

Indian J Gastroenterol. 2010 Jan;29(1):3-7

Authors: Behari A, Kapoor VK

PMID: 20373078 [PubMed - indexed for MEDLINE]
Reactive oxygen species-mediated endoplasmic reticulum stress and mitochondrial dysfunction contribute to cirsimaritin-induced apoptosis in human gallbladder carcinoma GBC-SD cells.

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Reactive oxygen species-mediated endoplasmic reticulum stress and mitochondrial dysfunction contribute to cirsimaritin-induced apoptosis in human gallbladder carcinoma GBC-SD cells.

Cancer Lett. 2010 Sep 28;295(2):252-9

Authors: Quan Z, Gu J, Dong P, Lu J, Wu X, Wu W, Fei X, Li S, Wang Y, Wang J, Liu Y

In this study, the anticancer effect of cirsimaritin, a natural flavonoid, against human gallbladder carcinoma cell line GBC-SD and the underlying mechanisms were investigated. Cirsimaritin inhibited the growth of tumor cells and induced mitochondrial apoptosis in GBC-SD cells. In addition, cirsimaritin triggered endoplasmic reticulum (ER) stress and down-regulated the phosphorylation of Akt, while knock-down of CHOP dramatically abrogated the inactivation of Akt and reversed the pro-apoptotic effect of cirsimaritin. Furthermore, cirsimaritin provoked the generation of reactive oxygen species in GBC-SD cells, while the antioxidant N-acetyl cysteine almost completely blocked the activation of ER stress and apoptosis, suggesting cirsimaritin-induced reactive oxygen species is an early event that triggers ER stress mitochondrial apoptotic pathways in GBC-SD cells.

PMID: 20359814 [PubMed - indexed for MEDLINE]
Human gallbladder carcinoma: Role of neurotrophins, MIB-1, CD34 and CA15-3.

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Human gallbladder carcinoma: Role of neurotrophins, MIB-1, CD34 and CA15-3.

Eur J Histochem. 2010 Jan-Mar;54(1):e10

Authors: Artico M, Bronzetti E, Alicino V, Ionta B, Bosco S, Grande C, Bruno M, Tranquilli Leali FM, Ionta G, Fumagalli L

Gallbladder carcinoma is the most common biliary tract tumor and the fifth most common gastrointestinal tract cancer .The prognosis of gallbladder carcinoma is poor and less than 5% of the patients are still alive five years postoperatively. Gallbladder specimens were obtained during surgical operations performed in eleven patients for resection of a gallbladder carcinoma, and during five autopsies (control cases selected among patients who died from for other causes, excluding those suffering from biliary or hepatic diseases). Immunohistochemical characterization and distribution of neurotrophins, with their respective receptors, were analyzed. The actual role played by these neurotrophic factors in the general regulation, vascular permeability, algic responsiveness, release of locally active substances and potential tumorigenesis in the gallbladder and biliary ducts compartment remains controversial. Our study revealed an increased immunohistochemical expression of NGF and TrKA in the epithelium and in the epithelial glands of the gallbladder carcinoma together with an evident immunoreactivity for BDNF in the same neoplastic areas. An evident immunoreactivity for NGF, TrKA and BDNF was observed in control specimens of gallbladder obtained during autopsies, whereas a weak or quite absent immunoreactivity was observed in the same specimens for NT4, TrKC and p75. On the contrary an appreciable immunoreactivity for p75 was observed in the specimens harvested from patients with gallbladder carcinoma. We also investigated the expression of some known tumor markers such as MIB-1 (anti Ki-67), CD34 and CA15-3, to identify a possible correlation between the expression of these molecular factors and the prognosis of gallbladder carcinoma. They resulted highly expressed in the stroma (CD34 and CA 15-3) and in the epithelium/epithelial glands (MIB-1) of the neoplastic areas and appeared to be almost absent in the control cases, suggesting that these markers, taken together, could be adopted as a panel of prognostic factors in the evaluation of the gallbladder carcinoma.

PMID: 20353905 [PubMed - indexed for MEDLINE]
Hormones and gallbladder cancer in women.

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Hormones and gallbladder cancer in women.

Indian J Gastroenterol. 2009 Jul-Aug;28(4):126-30

Authors: Barreto SG, Haga H, Shukla PJ

Epidemiological evidence suggests that the incidence of gallstone disease and gallbladder cancer is higher in women. We analyzed the literature on estrogen and progesterone receptor expression in gallbladder cancer in women. A systematic search was done using Medline, Embase, and Cochrane Central Register of Controlled Trials for the years 1983-2009. The search terms used included 'gallbladder', 'gallstone', 'oestrogen/estrogen', 'progesterone', 'cancer', 'cholelithiasis', 'hormone,' and 'motility'. Hormone receptor expression in gallbladder cancer was analyzed in 11 studies of which immunohistochemistry was used in 10 and enzyme immunoassay in one study. Sample sizes varied 141. Estrogen and/or progesterone receptor expression was detectable in gallbladder cancer tissue samples in nine studies, whereas four studies failed to confirm these findings. The data on the association of hormone receptor expression to tumor differentiation is contradictory and needs further evaluation.

PMID: 19937419 [PubMed - indexed for MEDLINE]
[p53 and p27 gene expression in subserosal gallbladder carcinoma]

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[p53 and p27 gene expression in subserosal gallbladder carcinoma]

Rev Med Chil. 2009 Aug;137(8):1017-22

Authors: Roa E I, Lantadilla H S, Ibacache S G, de Aretxabala U X

BACKGROUND: Subserosal carcinoma is the stage that presents the greatest difficulty in the diagnosis therapeutic handling and prognosis evaluation. AIM: To study the expression of p53 and p27 genes in subserosal gallbladder cancer. MATERIAL AND METHODS: One hundred twenty seven tissue samples of subserosal gallbladder cancer (coming from 112 females aged 62+/-13 years and 15 men aged 67+/-17 years) and 50 control samples were selected to construct tissue arrays. p53 and p27 genes were determined by immunohistochemistry. RESULTS: Thirty eight percent of tumors were not detected at the macroscopic examination, 52% and 17% had lymph node and blood vessel involvement, respectively. Fifty six and 46% were positive for p53 and p27, respectively. No association between the expression of both genes and gender, degree of differentiation, lymph node or blood vessel involvement, was observed. Overall five years actuarial survival was 32%. Patients with positive or negative p53 expression had a 22% and 53% survival, respectively (p=0.05). No association between survival and p27 expression was observed. CONCLUSIONS: p53 gene expression is a prognostic factor for subserosal gallbladder cancer.

PMID: 19915764 [PubMed - indexed for MEDLINE]
Gallbladder stent placement for prevention of cholecystitis in patients receiving covered metal stent for malignant obstructive jaundice: a feasibility study.

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Gallbladder stent placement for prevention of cholecystitis in patients receiving covered metal stent for malignant obstructive jaundice: a feasibility study.

Dig Dis Sci. 2010 Aug;55(8):2406-11

Authors: Gosain S, Bonatti H, Smith L, Rehan ME, Brock A, Mahajan A, Phillips M, Ho HC, Ellen K, Shami VM, Kahaleh M

PURPOSE: Covered self-expanding metal stents (CSEMS) have been used for palliation of malignant distal biliary strictures. Occlusion of the cystic duct by CSEMS may be complicated by cholecystitis. This potentially could be prevented by placement of a transpapillary gallbladder stent (GBS). PATIENTS AND METHODS: Between 11/2006 and 10/2007, a total of 73 patients (50 male) aged 65 +/- 14 years underwent CSEMS placement for palliation of malignant obstructive jaundice. In cases where CSEMS placement caused occlusion of the cystic duct, a 7 French transpapillary pigtail gallbladder stent (GBS) was inserted to prevent cholecystitis. RESULTS: Of the 73 patients, 18 had a prior cholecystectomy; 34 had the CSEMS placed below the cystic duct insertion. In 19 out of the 21 patients who had a CSEMS covering the cystic duct ostium, GBS placement was attempted, which was successful in 11 individuals (58%). An attempt to access the gallbladder was complicated by wire perforation of the cystic duct in three patients; one patient requiring emergent cholecystostomy tube placement. None of the patients who underwent successful GBS placement developed cholecystitis. One GBS dislodged and was repositioned. Cholecystitis occurred in two (20%) of the ten patients without transpapillary gallbladder decompression who had a CSEMS covering the cystic duct. CONCLUSIONS: The ideal placement of a CSEMS is below the cystic duct insertion. Should the cystic duct ostium be occluded, placement of a GBS should be considered to minimize the risk of cholecystitis.

PMID: 19888656 [PubMed - indexed for MEDLINE]
Caspase-8 polymorphisms and risk of gallbladder cancer in a northern Indian population.

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Caspase-8 polymorphisms and risk of gallbladder cancer in a northern Indian population.

Mol Carcinog. 2010 Jul;49(7):684-92

Authors: Srivastava K, Srivastava A, Mittal B

Caspase-8 (CASP8) is a key controller of apoptosis, and its deregulation plays an important role in carcinogenesis. To evaluate the role of CASP8 polymorphisms in gallbladder cancer (GBC), we examined the risk associated with three single-nucleotide polymorphisms (SNPs) in a case-control study in North Indian population. Genotypes and haplotypes of the CASP8 polymorphisms (-652 6N ins/del; rs3834129, Ex13 + 51G > C; rs1045485 and IVS12-19 G > A; rs3769818) were determined for 230 GBC patients and 230 cancer-free controls randomly selected from the population. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated in multivariate logistic regression analysis for the association of individual SNPs and haplotypes with GBC. Carriers for the "del" allele of rs3834129 SNP were associated with a 0.60-fold decreased risk for GBC (95% CI = 0.42-0.88; P(trend) = 0.005). In the combined analysis of the three CASP8 variants, we found that the individuals with the diplotypes carrying two copies of the common CASP8 del-G-G haplotype had 0.35-fold reduced risk (95% CI = 0.14-0.85) when compared with the diplotype containing 0-1 copy. The false-positive report probability (FPRP) approach advocated that these results were noteworthy (FPRP < 0.5). The molecular modeling results of rs1045485 polymorphism indicated that the overall configuration of both wild-type and polymorphic CASP8 protein were similar, with negligible deviation at the site of the polymorphism itself. In summary, low penetrance variants in CASP8 gene may alter the susceptibility toward GBC.

PMID: 20564345 [PubMed - indexed for MEDLINE]
[Mitral regurgitation associated with essential thrombocythemia and gallbladder cancer]

Fetched: July 11th, 2010, 1:35pm CDT

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[Mitral regurgitation associated with essential thrombocythemia and gallbladder cancer]

Kyobu Geka. 2010 Jun;63(6):462-5

Authors: Osawa H, Sakurada T, Sasaki J, Araki E, Nobuoka A, Konno A

A 64-year-old man with essential thrombocythemia was admitted to our hospital because of cardiac failure. Echocardiography revealed severe mitral regurgitation and a gallbladder tumor was detected incidentally by ultrasonography. Although the gallbladder tumor was strongly suspected to be malignant, we considered that the radical operation would be possible because of its early stage. After treatment of cardiac failure, cholecystectomy was performed. Pathological examination proved that the gallbladder tumor was malignant in T1N0M0 stage I. Afterwards, mitral valve plasty and maze operation were performed concomitantly. During the operation, activated coagulation time was kept over 400 sec with heparin. The operation was completed without major problems and the postoperative course was uneventful. The patient has not suffered from the recurrence of a gallbladder carcinoma or mitral regurgitation for 2 years.

PMID: 20533737 [PubMed - indexed for MEDLINE]
Solitary skeletal metastasis in carcinoma gallbladder: two case reports.

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Solitary skeletal metastasis in carcinoma gallbladder: two case reports.

Cancer Imaging. 2010;10:121-3

Authors: Prakash M, Aiyappan SK, Kumar A, Sreenivasan R, Yadav TD, Khandelwal N

We report 2 cases of carcinoma gallbladder with only solitary skeletal metastasis. To the best of our knowledge there are only 3 case reports of carcinoma gallbladder with skeletal metastasis in the English literature.

PMID: 20529758 [PubMed - indexed for MEDLINE]
Ovarian metastasis following gallbladder carcinoma: a case report.

Fetched: July 11th, 2010, 1:35pm CDT

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Ovarian metastasis following gallbladder carcinoma: a case report.

Eur J Gynaecol Oncol. 2010;31(2):219-21

Authors: Carlomagno C, Insabato L, Bifulco G, De Placido S, Lauria R

BACKGROUND: Mucinous ovarian cancer raises problems of differential diagnoses because it is often difficult to distinguish the primary from the metastatic form. Most metastatic ovarian tumors originate from the gastrointestinal tract, mainly colorectal, gastric, pancreatic; the gallbladder is a very rare source of ovarian metastases. CASE: We report a case of ovarian metastases from a gallbladder cancer, incidentally diagnosed more than 2.5 years earlier during a laparoscopic intervention for biliary lithiasis. CONCLUSION: The interest of this case lies in the long progression-free survival, the venous thromboembolism syndrome that preceded by a few months the diagnosis of the ovarian mass and the discrepancy between the radiologic and the laparoscopic stage assessment.

PMID: 20527247 [PubMed - indexed for MEDLINE]
[Radiation exposure and cancer mortality among nuclear power plant workers: a meta-analysis]

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[Radiation exposure and cancer mortality among nuclear power plant workers: a meta-analysis]

J Prev Med Public Health. 2010 Mar;43(2):185-92

Authors: Park ES, Moon K, Kim HN, Lee WJ, Jin YW

OBJECTIVES: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

PMID: 20383052 [PubMed - indexed for MEDLINE]
Surgical therapy and prognosis of sarcomatoid carcinoma of the gallbladder.

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Surgical therapy and prognosis of sarcomatoid carcinoma of the gallbladder.

Hepatobiliary Pancreat Dis Int. 2010 Apr;9(2):175-9

Authors: Hu ZH, Li ZW, Shen L, Zhang M, Zheng SS

BACKGROUND: Sarcomatoid carcinoma of the gallbladder is rare and its characteristics are poorly understood. This study aimed to understand the behavior and prognosis of sarcomatoid carcinoma of the gallbladder as well as its clinical manifestations and survival rate of patients after radical or palliative surgery, and to review the reported data worldwide and our 10 patients. METHODS: From 2004 to 2009, ten patients were pathologically diagnosed with sarcomatoid carcinoma of the gallbladder and underwent operation at our center. These characteristics, clinical presentations, tumor-node-metastasis (TNM) staging, surgical modes, and prognosis were reviewed, retrospectively. We collected the data of 46 patients reported in the English-language literature worldwide and analyzed the survival with ours. The survival rate was estimated using the Kaplan-Meier method, and was compared using the log-rank test. RESULTS: The median age of the 10 patients was 67 years (inter-quartile range 59-74 years), and the size of tumor inter-quartile ranged from 3.1 to 7.9 cm. In this series, 9 patients received radical surgery, and one undewent palliative surgery. There was no surgical mortality, and one patient underwent a second operation because of liver metastasis. The median survival time of the patients was 9 months (inter-quartile range 6-12 months), with 3 patients still being alive until follow-up; however, two patients had tumor recurrence. The data from the 56 patients (10 patients in our series and 46 reported elsewhere) statistically indicated that the median age was 66 years (inter-quartile range 61-74.5 years) and the overall median survival was 5.5 months (inter-quartile range 2.5-10 months). The survival time in the patients undergoing radical surgery (n=42) was significantly longer than that in the patients undergoing palliative surgery (n=14)(P=0.031). CONCLUSIONS: The survival of the patients with sarcomatoid carcinoma of the gallbladder is poor. Some patients may die shortly after the surgery because of recurrence or metastasis. However, radical surgery is still necessary if possible.

PMID: 20382590 [PubMed - indexed for MEDLINE]
Helicobacter species and pathogenesis of gallbladder cancer.

Fetched: July 11th, 2010, 1:35pm CDT

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Helicobacter species and pathogenesis of gallbladder cancer.

Hepatobiliary Pancreat Dis Int. 2010 Apr;9(2):129-34

Authors: Mishra RR, Tewari M, Shukla HS

BACKGROUND: Gallbladder cancer (GBC) is a rare disease but a leading cause of cancer-related death worldwide. A number of etiological factors have been implicated in the causation of GBC and pathogenic infection by bacteria is one of these. DATA SOURCES: A PubMed search on "helicobacter", "gallbladder cancer", and "biliary tract malignancies" was done on the topic, and the relevant data were collected, reviewed, and analyzed. RESULTS: Helicobacter is an epsilon proteobacterium that infects the mucosal lining of the human gastrobiliary system. Infection with helicobacter is an important risk factor for the development of cancer and the bacterium has been categorized as a group-I carcinogen by the International Agency for Research on Cancer (IARC). These microbes enter the human body by means of contaminated food and water. Thereby they invade the tissues and produce chemical carcinogens that lead to DNA damage and subsequently a series of gene mutations transform normal cells into cancer cells. In this review, we focus our attention on the role of helicobacter in the causation of biliary tract malignancies. CONCLUSIONS: The review attempts to summarize the current available data on the role of helicobacter in the causation of GBC. There are accountable data available to suggest the role of helicobacter species in the causation of GBC although larger studies are urgently required for confirmation.

PMID: 20382581 [PubMed - indexed for MEDLINE]
[Immunohistochemical expression of Ki-67 as a marker of proliferation in gallbladder mucosa samples with or without cancer]

Fetched: July 11th, 2010, 1:35pm CDT

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[Immunohistochemical expression of Ki-67 as a marker of proliferation in gallbladder mucosa samples with or without cancer]

Rev Med Chil. 2009 Jul;137(7):881-7

Authors: Roa E I, Elorza D X, Lantadilla H S, Ibacache S G, Aretxabala U X

BACKGROUND: There is paucity of knowledge on the proliferative features of normal or chronically inflamed gallbladder and the mechanisms of development of gallbladder cancer. AIM: To study the proliferation features of non tumoral gallbladder mucosa through the expression of Ki-67 antigen in tissue micro array analysis. MATERIAL AND METHODS: The immunohystochemical expression of Ki-67 in tissue micro array was studied in 96 samples of non tumoral gallbladder mucosa (coming from 74 females aged 45+/-16 years and 22 males aged 53+/-16 years) and 102 samples of gallbladder cancer (coming from 84 females aged 62+/- 14 years and 18 males aged 70+/- 13 years). RESULTS: The staining index of Ki-67 expression was 19+/-25% (range 096-8996) in samples of non tumoral mucosa and 46+/-29% (range 396-9896) in gallbladder cancer (p <0.01). Ki-67 was expressed in less than 10% of epithelial cells in 55% of non tumoral mucosa samples and 6% of gallbladder cancer samples. Seventy five percent of gallbladder cancer samples had a staining index of more than 20%. An expression of Ki-67 over 20% or 50% was observed in 25% and 15% of non tumoral mucosa samples, respectively. CONCLUSIONS: Non tumoral gallbladder mucosa samples have a high proliferation index, measured using Ki-67 immunohystochemical expression. There is a group of samples with cellular hyper-proliferation that maybe related to the pathogenesis of gallbladder cancer.

PMID: 19802414 [PubMed - indexed for MEDLINE]
[Natural history of gallbladder cancer. Analysis of biopsy specimens]

Fetched: July 11th, 2010, 1:35pm CDT

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[Natural history of gallbladder cancer. Analysis of biopsy specimens]

Rev Med Chil. 2009 Jul;137(7):873-80

Authors: Roa E I, MuÃ±oz N S, Ibacache S G, Aretxabala U X

BACKGROUND: There is scarcity of knowledge about the development of gallbladder cancer. AIM: To study the features of development and progression of gallbladder cancer. MATERIAL AND METHODS: Review of histopathological studies of gallbladder obtained in 25,971 cholecytectomies performed in patients aged 45+/- 16 years, 79% females, between 1993 and 2004. Among these, 210 had a dysplasia not associated to cancer and 1,039 had a gallbladder cancer Clinical and morphological parameters of preneoplastic and neoplastic lesions were analyzed. Ninety five percent of patients were followed. RESULTS: All cases of dysplasia were incidental findings. Metaplasia, dysplasia and carcinoma in situ were present in the adjacent mucosa in 66%, 81% y 69% of gallbladder carcinomas, respectively. Twenty five percent of gallbladders studied were carcinomas (mucous carcinoma in 18% and muscular carcinoma in 7%). Ninety two percent of cases had chronic inflammation in the gallbladder wall. Seventy two percent of mucous carcinomas were not detected macroscopically Five years survival of mucous carcinoma was 92%. There was an association between the intensity of the lesion and the age of the patients. The age difference between chronic cholecystitis and gallbladder cancer was 11 years for women and nine for men. CONCLUSIONS: From a morphological standpoint, the period in which a dysplasia becomes a carcinoma is approximately 10 years.

PMID: 19802413 [PubMed - indexed for MEDLINE]
[Lymphoplasmocytic (IGG4-associated) cholecystitis developed in a case of prolonged gallbladder adenomyomatosis]

Fetched: July 11th, 2010, 1:35pm CDT

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[Lymphoplasmocytic (IGG4-associated) cholecystitis developed in a case of prolonged gallbladder adenomyomatosis]

Eksp Klin Gastroenterol. 2009;(8):114-22

Authors: Il'chenko AA, Bystrovskaia EV, Orlova IuN, Tsaregorodtseva TM, Khomeriki SG, Vasnev OS, Dolgasheva GM

The article presented a rare clinical observation of 55 years old patient, long-suffering from gall bladder adenomiomatosis, for which the subsequent development was complicated by lymphocytoplasmocytic cholecystitis.

PMID: 20469688 [PubMed - indexed for MEDLINE]
Gall bladder cancer and Mirizzi syndrome: alternative explanation to the common belief.

Fetched: June 26th, 2010, 9:50am CDT

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Gall bladder cancer and Mirizzi syndrome: alternative explanation to the common belief.

ANZ J Surg. 2010 Jan;80(1-2):116-7

Authors: Wijesuriya SR, Delriviere L, Mitchell A

PMID: 20575902 [PubMed - in process]
Benign and malignant tumors in Down syndrome: analysis of the 1514 autopsied cases in Japan.

Fetched: June 26th, 2010, 9:50am CDT

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Benign and malignant tumors in Down syndrome: analysis of the 1514 autopsied cases in Japan.

Pediatr Int. 2010 Jun 21;

Authors: Ehara H, Ohno K, Ito H

Abstract Background: Down syndrome is known for the association with neoplasms. Methods: We surveyed the association with benign and malignant neoplasms in Down syndrome patients registered in the Annual of the Pathological Autopsy Cases of Japan (1974-2000), a database of autopsied cases operated by the Japanese Society of Pathology. Results: In a total of 1514 cases with Down syndrome, 8 cases with 10 benign tumors (4 males and 4 females) and 104 cases with malignant disorders (61 males, 42 females and 1 case with unrecorded gender), in which 87 cases with hematopoietic malignancies (83.7%) and 17 cases with solid tumors (16.3%), were identified. The association of gallbladder adenocarcinoma with a benign tumor of the colon was noted in one case, while further two cases with double benign tumors were confirmed as well. No case with a double malgnancy was found. Hematopoietic malignancies (87 cases) included 31 cases (35.6%) with acute myelocytic leukemia, 10 (11.4%) with acute lymphocytic leukemia and 2 (2.3%) with chronic myelocytic leukemia. The ratio of acute myelocytic leukemia to acute lymphocytic leukemia was 3.1 in the present study. A peak in the age distribution was at 0 year in our data in contrast to the previous data (at 1 year) for myelocytic leukemia. The 17 solid tumors identified included 3 hepatocellular carcinomas, 3 extrahepatic cholangiocarcinomas, 2 gallbladder adenocarcinomas, 3 brain tumors, 3 seminomas, etc. Conclusion: We present new associations of benign and malignant tumors with Down syndrome.

PMID: 20573041 [PubMed - as supplied by publisher]
[Estimation of the effects of centralization of cancer treatment on mortality reduction by in Fukui prefecture]

Fetched: June 26th, 2010, 9:50am CDT

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[Estimation of the effects of centralization of cancer treatment on mortality reduction by in Fukui prefecture]

Nippon Koshu Eisei Zasshi. 2010 Apr;57(4):263-70

Authors: Hattori M, Fujita M, Nakamura Y, Ioka A

PURPOSE: This study was conducted to clarify the efficacy of centralization of cancer treatment using population-based cancer registry data in Fukui prefecture, Japan. METHOD: Associations between hospital procedure volume and cancer survival were analyzed using the population-based cancer registry survival data for Fukui prefecture between 1994 and 1998. Firstly the cancer patients who received primary treatments for each target sites such as esophagus, stomach, colon, liver, gall bladder, pancreas, lung, breast, uterus, ovary, prostate, urinary bladder, and lymphoid tissue were totaled. Then, hospitals were divided into 4 categories according to the number of patients by each site; high, medium, low and very low volume. Stage-matched 5-year relative survival rates for each site were then calculated for each categorized hospital volume, and that most desirable for medical treatment for each target site was decided with reference to age-, sex-, and cancer stage-adjusted hazard ratios. Age-adjusted morality reduction was estimated by the expected survival rate after centralization when all cancer patients had received treatments. RESULTS: The 5-year relative survival rates were higher in hospitals with large numbers of patients. With some target sites, such as the stomach, colon, and breast, the mortality was similar between high and low volume hospitals, whereas the other target sites showed higher mortality in line with decrease in number of patients treated. It was estimated that a 2.06% reduction in the mortality rate might be achieved if each case were treated at the most desirable category of hospital in Fukui prefecture. CONCLUSION: Cancer treatment at hospitals have appropriate procedure volumes is an effective way to increase cancer survival and lower the mortality rate.

PMID: 20560408 [PubMed - in process]
Ectopic thyroid presenting as a gallbladder mass.

Fetched: June 26th, 2010, 9:50am CDT

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Ectopic thyroid presenting as a gallbladder mass.

Ann R Coll Surg Engl. 2010 May;92(4):W4-6

Authors: Liang K, Liu JF, Wang YH, Tang GC, Teng LH, Li F

The ectopic thyroid tissue is the result of abnormality in embryological development and migration. Ectopic thyroid tissue located in or adjacent to the gallbladder wall is extremely rare with only two cases reported since 1969. These cases were all identified incidentally by pathological examination after cholecystectomy for acute or chronic cholecystitis. We here report a case of ectopic thyroid tissue presenting as a gallbladder mass in a 60-year-old woman who underwent cholecystectomy. Ectopic thyroid tissue in the gallbladder wall was confirmed by histopathology.

PMID: 20500998 [PubMed - indexed for MEDLINE]
[Changes of electrical property of the twelve source-points in encephaloma patients before and after surgery]

Fetched: June 26th, 2010, 9:50am CDT

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[Changes of electrical property of the twelve source-points in encephaloma patients before and after surgery]

Zhen Ci Yan Jiu. 2010 Feb;35(1):52-5

Authors: Liu LL, Zhao BX, Xie ZH, Fan YP

OBJECTIVE: To observe the changes of electrical property of the 12 Source-points in encephaloma patients undergoing surgery. METHODS: A total of 116 encephaloma patients and 60 healthy people who signed the informed consent were enlisted in the present study. The regional cutaneous electric resistance (CER) of the bilateral 12 Yuan (Source)-points was measured in the afternoon (14:00-16:00) before and one week after surgery under room temperature [(22 +/- 3) degrees C, (55 +/- 10)% in humidity] by using "Meridian Energy Analysis Device". RESULTS: In comparison with normal subjects, CER values of the 12 Source-points on both sides of the body in encephaloma patients were significantly lower (P < 0.01). Before surgery, CER values of Wangu (SI 4), Taibai (SP 3), Taichong (LR 3) and Chongyang (ST 42) on the left side were significantly higher than those of the isonym points on the right side (P < 0.01, P < 0.05), suggesting an imbalance of the bilateral Small Intestine, Spleen, Liver and Stomach Meridians. After surgery, CER values of Shenmen (HT 7), Wangu (SI 4), Yangchi (SJ 4) and Taibai (SP 3) on the left side were markedly higher than those of the isonym points on the right side (P < 0.05, P < 0.01), suggesting an imbalance of the bilateral Heart, Small Intestine, Trienergizer and Spleen Meridians. Comparison between pre- and post-surgery showed that CER values of Taiyuan (LU 9), Daling (PC 7), Taibai (SP 3), Taichong (LR 3), Taixi (KI 3), Jinggu (BL 64), Qiuxu (GB 40) and Chongyang (ST 42) on both sides, and Wangu (SI 4) on the right side lessened obviously post-surgery (P < 0.01, P < 0.05), suggesting an imbalance of the bilateral meridians found in more meridians, including yang meridians entering the brain as the Bladder, Gallbladder, Stomach Meridians. CONCLUSION: In encephaloma patients, the CER values of some Source-points on the left side are significantly higher than those on the right side, suggesting an imbalance of the bilateral meridians in functional activities.

PMID: 20458908 [PubMed - indexed for MEDLINE]
Preliminary experience of cetuximab in the treatment of advanced-stage biliary tract cancer.

Fetched: June 26th, 2010, 9:50am CDT

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Preliminary experience of cetuximab in the treatment of advanced-stage biliary tract cancer.

Onkologie. 2010;33(1-2):45-7

Authors: Chang PY, Cheng MF, Lee HS, Hsieh CB, Yao NS

BACKGROUND: Cetuximab has been proved to be effective alone or in combination with other chemotherapeutic agents in the treatment of various malignancies. The aim of this report was to describe our experience of using cetuximab with chemotherapeutics agents to treat advanced-stage biliary tract cancer. CASE REPORTS: We retrospectively analyzed the outcomes of 5 biliary tract cancer patients receiving cetuximab-containing therapy. Four of them had stage IV disease, and 1 patient had incomplete resection at the time of diagnosis. Epidermal growth factor receptor (EGFR) expression and K-ras status were assessed when a specimen was available. After cetuximab treatment, complete response was achieved in 1 patient, partial response in 3 patients, and stable disease in 1 patient. Three surgical specimens were available, and all revealed positive EGFR expression. Only 1 surgical specimen was adequate for K-ras mutation test, and the wild type was confirmed. Complete response was found in the patient who had wild type K-ras. The progression-free survival of these patients varied from 4 to 16 months. CONCLUSIONS: Cetuximab-containing therapy might be an effective treatment for advanced biliary tract cancer.

PMID: 20164661 [PubMed - indexed for MEDLINE]
Time to move to targeted drugs in biliary tract cancer?

Fetched: June 26th, 2010, 9:50am CDT

Time to move to targeted drugs in biliary tract cancer?

Onkologie. 2010;33(1-2):10-1

Authors: Louvet C, Tournigand C

PMID: 20164655 [PubMed - indexed for MEDLINE]
Can the growth rate of a gallbladder polyp predict a neoplastic polyp?

Fetched: June 26th, 2010, 9:50am CDT

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Can the growth rate of a gallbladder polyp predict a neoplastic polyp?

J Clin Gastroenterol. 2009 Oct;43(9):865-8

Authors: Shin SR, Lee JK, Lee KH, Lee KT, Rhee JC, Jang KT, Kim SH, Choi DW

GOALS: The aim of this study was to evaluate whether the growth rate of a gallbladder (GB) polyp is a predictive indicator for neoplastic polyps. BACKGROUND: Cholecystectomy for GB polyps that are larger than 10 mm is generally recommended because of the high probability of neoplasm. In contrast, a follow-up strategy is preferred for GB polyps smaller than 10 mm. However, there are no treatment guidelines for polyps that grow in size during the follow-up period. STUDY: We retrospectively investigated 145 patients with GB polyps who underwent at least 1 ultrasonographic follow-up examination over an interval greater than 6 months, before cholecystectomy at Samsung medical center, South Korea, from 1994 to 2007. The growth rate was determined based on the change in size per time interval between 2 ultrasonographic examinations (mm/mo). RESULTS: The median age of the patients was 48 years (range: 25 to 75). One hundred twenty-five non-neoplastic polyps and 20 neoplastic polyps were found. Neoplastic polyps were more frequently found in patients older than 60 years, those with hypertension, a polyp size greater than 10 mm, and a rapid growth rate greater than 0.6 mm/mo. On multivariate analysis, however, the growth rate was not related to the neoplastic nature of a polyp, but older age (>60 y) and large size (>10 mm) were significantly associated with neoplastic polyps. CONCLUSIONS: Patient's age (>60 y) and large polyp size (>10 mm) were significant predictive factors for neoplastic GB polyps. GB polyps less than 10 mm in diameter do not require surgical intervention simply because they grow.

PMID: 19398929 [PubMed - indexed for MEDLINE]

Trials - Gall Bladder Cancer

PII of SBRT & Chemo for Unresectable Cholangiocarcinoma Followed by Liver Transplantation

Posted: June 15th, 2010, 9:00am CDT

Conditions: Cholangiocarcinoma; Hepatobiliary Cancers; Hepatobiliary Cancers Liver; Hepatobiliary Cancers Bile Duct; Bile Duct Cancer (Cholangiocarcinoma); Hepatobiliary Cancers Gallbladder; Hepatobiliary Cancers Hepatocellular Carcinoma (Hepatoma)
Interventions: Procedure: Stereotactic Body Radiotherapy; External photon radiation; Procedure: Systemic chemotherapy; Intravenous route; Procedure: Liver transplant
Sponsor: Stanford University
Recruiting - verified July 2010

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