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Acinar Cell Carcinoma
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Adrenal Gland Cancer
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Ampulla Of Vater
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Angiosarcoma
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Google - Gall Bladder Cancer
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Man's mission after 'brilliant' sister, 33, died weeks after diagnosis - Liverpool Echo
Posted: January 17th, 2022, 3:00am GMT
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Digestyl Reviews 2022 – Negative Customer Complaints or Positive Feedback? - Inter Press Service
Posted: January 17th, 2022, 2:35am GMT
Digestyl Reviews 2022 – Negative Customer Complaints or Positive Feedback? Inter Press Service -
Life is what you make it: A decade later a transplant survivor makes it sweet - Lincoln Journal Star
Posted: January 17th, 2022, 10:15pm GMT
Life is what you make it: A decade later a transplant survivor makes it sweet Lincoln Journal Star -
Pancreatic And Biliary Stents Market Size, Type, Application, Growth, Opportunity And Forecast. – Hunter Women's Chronicle - Hunter Women's Chronicle
Posted: January 15th, 2022, 4:39am GMT
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SynoGut Reviews 2022 [USA, CA, UK, IE, Australia, NZ]- Improve Your Guts, Digestion & Immunity - Inter Press Service
Posted: January 15th, 2022, 3:00am GMT
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What Is Wegovy Weight-Loss Drug? - POPSUGAR
Posted: January 14th, 2022, 6:25pm GMT
What Is Wegovy Weight-Loss Drug? POPSUGAR -
Injectable Drug Wegovy Can Help People Lose 35 Pounds in Over a Year - POPSUGAR
Posted: January 14th, 2022, 6:25pm GMT
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Woman rushed to A&E after two years attempting to see GP in person - Bristol Live
Posted: January 14th, 2022, 7:56am GMT
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50-Year-Old Woman Weighing 117 Kgs Saved By Doctors; Underwent Redo Bariatric Surgery - TheHealthSite
Posted: January 14th, 2022, 3:58am GMT
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Gallbladder Cancer Treatment Market Size 2022 Analysis of Present Sales, Major Developments, Opportunities, And Future Forecasts till 2028| Key Players : 4SC AG, Halozyme Therapeutics Inc, Aslan Ph… – Industrial IT - Industrial IT
Posted: January 13th, 2022, 9:42pm GMT
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Stainless Steel Surgical Scalpel Market 2022 Analysis by Top Keyplayers | Swann-Morton,KAI Group,Feather,BD – Industrial IT - Industrial IT
Posted: January 13th, 2022, 9:42pm GMT
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OPINION: COVID is here to stay, so let's start dealing with it - The Richmond Observer
Posted: January 13th, 2022, 8:04pm GMT
OPINION: COVID is here to stay, so let's start dealing with it The Richmond Observer -
County mayor proclaims February 'Cholangiocarcinoma Awareness Month' | Local News | williamsonherald.com - williamsonherald.com
Posted: January 13th, 2022, 5:36pm GMT
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The worst pandemic facing America right now isn't COVID-19. It's obesity. Why that matters - Courier Journal
Posted: January 13th, 2022, 8:09am GMT
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Hazardous Wastewater Causes Health Issues for Delaware Residents - Delaware Today
Posted: January 13th, 2022, 6:06am GMT
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Andrew David "Andy" Dickson Obituary (1939 - 2022) Southern Rhode Island Newspapers - Legacy.com
Posted: January 12th, 2022, 9:39pm GMT
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Legal community remembers Kelly as friend, mentor - Delaware Business Times
Posted: January 12th, 2022, 9:13pm GMT
Legal community remembers Kelly as friend, mentor Delaware Business Times -
Best dog food - what fruits and vegetables can dogs eat? - AZ Big Media
Posted: January 12th, 2022, 9:08pm GMT
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Family Assumed 61-Year-Old Mother’s Sudden Weight Loss Was Due To Dieting; It Turned Out To Be Pancreatic Cancer - SurvivorNet
Posted: January 11th, 2022, 6:30pm GMT
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Receiving Complex Care from a Multidisciplinary Team: Carol Goodermote's Patient Story - Massachusetts General Hospital
Posted: January 11th, 2022, 4:51pm GMT
Receiving Complex Care from a Multidisciplinary Team: Carol Goodermote's Patient Story Massachusetts General Hospital -
Handheld Imaging Devices Market is Estimated to Hit at a 13.1% CAGR by 2028 | General Electric, Smith Nephew, - EIN News
Posted: January 11th, 2022, 12:34pm GMT
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Olive Oil and Lemon Juice: Myths, Benefits, and Downsides - Healthline
Posted: January 11th, 2022, 12:32pm GMT
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We thought mum’s weight loss was down to dieting but it was cancer – it was heartbreaking... - The Sun
Posted: January 11th, 2022, 8:47am GMT
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California weighs order canceling elective surgeries as COVID surges - ABC10.com KXTV
Posted: January 11th, 2022, 3:14am GMT
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What is the keto diet and is it safe? Everything you need to know about popular weightloss method - 7NEWS
Posted: January 11th, 2022, 2:22am GMT
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Andrew David “Andy” Dickson Dies at 82 - GoLocalProv
Posted: January 11th, 2022, 10:28pm GMT
Andrew David “Andy” Dickson Dies at 82 GoLocalProv -
Shirley Aubertine Obituary (1930 - 2022) - Eugene, OR - Legacy.com
Posted: January 10th, 2022, 9:51pm GMT
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Elevation Oncology Highlights 2021 Achievements and Outlines Expected 2022 Milestones - PRNewswire
Posted: January 10th, 2022, 10:00am GMT
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From the 'mother of all surgeries' to 50 miles for Maggie's Centres - In Your Area
Posted: January 10th, 2022, 8:43am GMT
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Surgical Robots Market to Register CAGR 17.6 % Growth in Revenue During the Forecast 2021-2027 | INTUITIVE SURGICAL, STRYKER CORPORATION, MEDTRONIC - Digital Journal
Posted: January 10th, 2022, 4:43am GMT
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Don’t Ignore Obesity; It Could Lead To Unmanageable Health Conditions | TheHealthSite.com - TheHealthSite
Posted: January 10th, 2022, 3:56am GMT
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California weighs order canceling elective surgeries as COVID surges - CalMatters
Posted: January 9th, 2022, 3:31pm GMT
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Don’t Ignore Obesity; It Could Lead To Unmanageable Health Conditions | TheHealthSite.com - TheHealthSite
Posted: January 9th, 2022, 4:00am GMT
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DR ELLIE CANNON: Is stress caring for my ill wife giving me muscle twitches? - Daily Mail
Posted: January 8th, 2022, 8:00pm GMT
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Mum, 33, dies on Boxing Day 4 weeks after being diagnosed with breast cancer when she complained of ‘pain i... - The Sun
Posted: January 8th, 2022, 5:13pm GMT
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1.8 million excess deaths attributable to urban air pollution in 2019 - The Daily Star
Posted: January 8th, 2022, 4:00pm GMT
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EXPLAINER: Where are the COVID-19 tests that Biden promised? - newsconcerns
Posted: January 8th, 2022, 3:43am GMT
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Dry January 2022: Benefits include better sleep and eye health - newsconcerns
Posted: January 8th, 2022, 3:29am GMT
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Mum, 33, complained of pain in her side five weeks before Boxing Day death - Liverpool Echo
Posted: January 8th, 2022, 3:00am GMT
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McLeod Health Welcomes These New Physicians - McLeod Health
Posted: January 7th, 2022, 7:29pm GMT
McLeod Health Welcomes These New Physicians McLeod Health -
70 Indian Americans among Regeneron Science Talent Search... - The American Bazaar
Posted: January 7th, 2022, 3:16pm GMT
70 Indian Americans among Regeneron Science Talent Search... The American Bazaar -
70 Indian Americans among Regeneron Science Talent Search... - The American Bazaar
Posted: January 7th, 2022, 3:16pm GMT
70 Indian Americans among Regeneron Science Talent Search... The American Bazaar -
Exosome Research Products Market Analysis, Trends and Forecast 2028 l QIAGEN, Thermo Fisher Scientific Inc., Bio-Techne., System Biosciences – Industrial IT - Industrial IT
Posted: January 7th, 2022, 1:11pm GMT
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Digital Pills Market Growth Rate Forecast and End User Application to 2028 – Industrial IT - Industrial IT
Posted: January 7th, 2022, 1:11pm GMT
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Endoscopy Devices Market 2021-2024: Growth Drivers, Business Statistics, Top Region with Share, and Revenue Analysis – Industrial IT - Industrial IT
Posted: January 7th, 2022, 10:53am GMT
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Exclusive Insights on Gallbladder Cancer Treatment Market 2021-2026: Latest Trends, Drivers, Strategies and Competitive Landscape – Industrial IT - Industrial IT
Posted: January 7th, 2022, 7:02am GMT
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Matt Goss opens up about his late mother’s influence on new album... - The US Sun
Posted: January 7th, 2022, 10:05pm GMT
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Matt Goss opens up about his late mother’s influence on new album... - The Sun
Posted: January 7th, 2022, 10:05pm GMT
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Canceled Visa Hinders Novak Djokovic's Australian Open Appearance After COVID Medical Exemption - POPSUGAR
Posted: January 6th, 2022, 1:45pm GMT
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79 Indian-American including some South Asian teens named 'Nation's Top Scientists' - newsindiatimes.com
Posted: January 6th, 2022, 11:54am GMT
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Endoscopic treatment of solitary gastric neurofibroma | IJGM - Dove Medical Press
Posted: January 6th, 2022, 5:50am GMT
Endoscopic treatment of solitary gastric neurofibroma | IJGM Dove Medical Press -
Omicron found in Delhis 65 per cent samples between January 1 and 3; city sees significant jump in... - The Hans India
Posted: January 6th, 2022, 2:40am GMT
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Omicron found in Delhi's 65 per cent samples between January 1 and 3; city sees significant jump in deaths, hospitalisations - The New Indian Express
Posted: January 6th, 2022, 12:12am GMT
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Citing record COVID spread, Peoria hospitals start delaying elective procedures - Peoria Journal Star
Posted: January 6th, 2022, 10:52pm GMT
Citing record COVID spread, Peoria hospitals start delaying elective procedures Peoria Journal Star -
Names to Know: Cornerstone VNA, Wentworth-Douglass updates - Seacoastonline.com
Posted: January 5th, 2022, 9:15pm GMT
Names to Know: Cornerstone VNA, Wentworth-Douglass updates Seacoastonline.com -
Dangerous Conditions a Simple Blood Test Can Help Detect - 24/7 Wall St.
Posted: January 5th, 2022, 9:00pm GMT
Dangerous Conditions a Simple Blood Test Can Help Detect 24/7 Wall St. -
Citing record COVID spread, both Peoria hospitals start delaying elective procedures - Pekin Daily Times
Posted: January 5th, 2022, 8:39pm GMT
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Rotorua Daily Post Year in Review: December 2021 - New Zealand Herald
Posted: January 5th, 2022, 7:00pm GMT
Rotorua Daily Post Year in Review: December 2021 New Zealand Herald -
14 New Beauty Buys You Need From Sephora to Kick Off 2022 - POPSUGAR
Posted: January 5th, 2022, 6:35pm GMT
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August’s Sturgeon Moon Gives Every Zodiac Sign an Opportunity For Gratitude - POPSUGAR
Posted: January 5th, 2022, 6:00pm GMT
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July's Buck Moon Is All About Reflection — Here's How It'll Affect Your Zodiac Sign - POPSUGAR
Posted: January 5th, 2022, 5:20pm GMT
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The Weeknd Beats Up an Older Version of Himself in Dawn FM Tracklist Reveal — Watch - POPSUGAR
Posted: January 5th, 2022, 5:10pm GMT
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Chanel Iman and Sterling Shepard Are Divorcing After Nearly 4 Years of Marriage - POPSUGAR
Posted: January 5th, 2022, 4:47pm GMT
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Get Ready to See Checker-Print Nails on the Fingers of Every Cool Person You Know - POPSUGAR
Posted: January 5th, 2022, 4:45pm GMT
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Emily in Paris: I Can't Be the Only One Who Has Mindy and Benoît's Song on Repeat - POPSUGAR
Posted: January 5th, 2022, 4:40pm GMT
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Emily in Paris: I Can't Be the Only One Who Has Mindy and Benoît's Song on Repeat - POPSUGAR
Posted: January 5th, 2022, 4:40pm GMT
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Here's What We Know About Jamie Lynn Spears's Involvement in Sweet Magnolias Season 2 - POPSUGAR
Posted: January 5th, 2022, 4:15pm GMT
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Naomi Osaka Teaches Muppets About Melanin in a New Episode of Sesame Street - POPSUGAR
Posted: January 5th, 2022, 4:15pm GMT
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Four out of five Covid deaths reported at LNJP had co-morbid conditions: Hospital official - ThePrint
Posted: January 5th, 2022, 4:00pm GMT
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100+ Creative Contact Names For Your Partner, Friends, and Family - POPSUGAR
Posted: January 5th, 2022, 3:45pm GMT
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Our Shopping Editor's Top Home Picks For 2022 So Far - POPSUGAR
Posted: January 5th, 2022, 3:40pm GMT
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Our Shopping Editor's Top Home Picks For 2022 So Far - POPSUGAR
Posted: January 5th, 2022, 3:40pm GMT
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The 355 May Not Be Based on Real Events, but It Was Still Inspired by a True Story - POPSUGAR
Posted: January 5th, 2022, 3:25pm GMT
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Go Ahead, Snap a Pic — Charlotte Tilbury's New Foundation Has Me Fully Camera Ready - POPSUGAR
Posted: January 5th, 2022, 3:00pm GMT
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Chanel's Latest Beauty Collection Isn't Just Chic — It's Eco-Conscious, Too - POPSUGAR
Posted: January 5th, 2022, 2:15pm GMT
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Prediction of early recurrence after R0 resection for gallbladder carcinoma of stage T1b–T3 - MD Linx
Posted: January 5th, 2022, 12:04pm GMT
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Gallbladder Cancer Therapeutics Market – Find out the Latest Useful Insights, Trends and Other Reasons for the Industry Growth, Key Players -Sanofi F. Hoffmann-La Roche – Industrial IT - Industrial IT
Posted: January 5th, 2022, 11:36am GMT
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Helicobacter pylori pathogenicity islands | IDR - Dove Medical Press
Posted: January 5th, 2022, 10:23am GMT
Helicobacter pylori pathogenicity islands | IDR Dove Medical Press -
How Do You Design a Better Hospital? Start With the Light - WIRED
Posted: January 5th, 2022, 10:00am GMT
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Liquid Biopsy Market to Be at Forefront by 2029| Analysis by CareDx, Inc., Eurofins Scientific, MDxHealth., Cardiff Oncology., Immucor – Industrial IT - Industrial IT
Posted: January 5th, 2022, 6:45am GMT
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Dr. Ira Sharp Benefits from Clinical Trial - Pancreatic Cancer News & Stories
Posted: January 5th, 2022, 6:00am GMT
Dr. Ira Sharp Benefits from Clinical Trial Pancreatic Cancer News & Stories -
How New Drug Leqvio May Help Lower Cholesterol - Healthline
Posted: January 5th, 2022, 6:00am GMT
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The 6 Best Home Elliptical Machines to Help You Conquer Your Fitness Goals Are Here - POPSUGAR
Posted: January 5th, 2022, 11:35pm GMT
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Miley Cyrus and Pete Davidson Confess Their Biggest Secrets During New Year's Eve Special - POPSUGAR
Posted: January 5th, 2022, 10:35pm GMT
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Welp, Keto Is Officially the Least-Healthy Diet of 2022, According to an Expert Panel - POPSUGAR
Posted: January 5th, 2022, 10:15pm GMT
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The French-Roll Hairstyle Was a '90s Staple For Black Women, and It's Getting a 2022 Upgrade - POPSUGAR
Posted: January 5th, 2022, 10:10pm GMT
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Kulture Matches Mom Cardi B in Chanel, Solidifying Her Status as the Chicest 3-Year-Old - POPSUGAR
Posted: January 4th, 2022, 9:40pm GMT
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White Eyelash Extensions: The Surprising Yet Subtle Makeup Trend You'll Want to Try in 2022 - POPSUGAR
Posted: January 4th, 2022, 9:25pm GMT
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Shopbop's Newest Activewear Drop Will Have You Ready to Move Your Body - POPSUGAR
Posted: January 4th, 2022, 9:20pm GMT
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Jonathan Van Ness Is Transforming Their Getting Curious Podcast Into a New Netflix Series - POPSUGAR
Posted: January 4th, 2022, 9:18pm GMT
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Think Fast! These Are the Best ESPN 30 For 30 Documentaries, Ranked - POPSUGAR
Posted: January 4th, 2022, 9:10pm GMT
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Suni Lee Addresses Racist Criticism Over Her New Relationship With Boyfriend Jaylin Smith - POPSUGAR
Posted: January 4th, 2022, 9:00pm GMT
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We’re Calling It: The Bachelor Contestant Who Self-Eliminated Will Return to Clayton Echard’s... - POPSUGAR
Posted: January 4th, 2022, 8:30pm GMT
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Everything We Know About Janet Jackson's Documentary: "This Is My Story, Told by Me" - POPSUGAR
Posted: January 4th, 2022, 8:01pm GMT
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Lust, Love, and Heartbreak Play Out in the Through My Window Trailer - POPSUGAR
Posted: January 4th, 2022, 7:40pm GMT
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One Size Beauty’s Powder Foundation Went Viral on TikTok, So I Put it to the Hype Test - POPSUGAR
Posted: January 4th, 2022, 7:35pm GMT
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Mom's 2-Year-Old Son Thought Encanto Character Was Him: "It Was the Impact of Feeling Seen" - POPSUGAR
Posted: January 4th, 2022, 7:33pm GMT
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11 Essential — and Chic! — Cookware Sets Beginners and Seasoned Chefs Alike Will Adore - POPSUGAR
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22 Organizing Bins That Will Help You Keep All Parts of Your Home Neat and Tidy - POPSUGAR
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Alessia Cara and Chance the Rapper Get Soaked For Forgetting the Lyrics During Karaoke – Watch! - POPSUGAR
Posted: January 4th, 2022, 6:55pm GMT
PubMed - Gall Bladder Cancer
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Axillary nodal metastasis of operated gallbladder carcinoma: remote site of aggression-a case report
Fetched: January 17th, 2022, 5:01am GMT by Manu Vats
BMC Surg. 2022 Jan 15;22(1):16. doi: 10.1186/s12893-022-01477-3.
ABSTRACT
BACKGROUND: Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer.
CASE PRESENTATION: A 63-year-old gentleman presented with the complaint of a non-healing ulcer at upper abdomen for the last 1 month. He had undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed isolated bilateral axillary metastasis and the patient underwent a bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later.
CONCLUSION: Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of isolated bilateral axillary lymph nodes as a distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.
PMID:35033032 | DOI:10.1186/s12893-022-01477-3
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KIF15 knockdown suppresses gallbladder cancer development
Fetched: January 14th, 2022, 5:01am GMT by Jun Wang
Eur J Cell Biol. 2021 Sep-Nov;100(7-8):151182. doi: 10.1016/j.ejcb.2021.151182. Epub 2021 Nov 5.
ABSTRACT
Gallbladder cancer (GBC) is commonly regarded as one of the most lethal malignant tumor types with poor prognosis. Kinesin family member 15 (KIF15) is reported to be tightly related with progression of multiple cancer types which, however, has not been clarified in GBC so far. KIF15 was significantly up-regulated in clinical GBC tissues compared with that in para-carcinoma tissues and the expression level was also correlated with tumor malignancies. In addition to tissues, GBC cells also exhibited a high expression abundance of KIF15. After down-regulating KIF15 via lentiviral transfection, GBC cell proliferation and migration were both inhibited, while cell apoptosis was promoted markedly. Likewise, silencing KIF15 significantly interfered the growth of nude mouse xenografts. Our experiments in GBC cell lines also demonstrated that KIF15 overexpression accelerated cell proliferation but lessened cell apoptosis in both GBC-SD and SGC-996 cells. Further investigation of the mechanism occurring in GBC inhibition mediated by KIF15 knockdown revealed that KIF15 deficiency led to decreased activity of several signaling pathways (TNF, PI3K/AKT and MAPK), a reduction of CDK6 expression regulated by enhanced p21, and HSP60 absence. Following the treatment of shCtrl- and shKIF15-transfected cells with AKT activator, we found that anti-tumor effects resulting from KIF15 deficiency could be relieved by AKT activator in both experimental cells. Overall, for the first time, we demonstrated that KIF15 was overexpressed in GBC and displayed a close relationship between KIF15 levels and GBC clinical stages. Furthermore, low expression of KIF15 resulted in obvious anti-tumor effects.
PMID:34781077 | DOI:10.1016/j.ejcb.2021.151182
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Genomic alterations in biliary tract cancer predict prognosis and immunotherapy outcomes
Fetched: January 12th, 2022, 5:01am GMT by Xiaofeng Chen
J Immunother Cancer. 2021 Nov;9(11):e003214. doi: 10.1136/jitc-2021-003214.
ABSTRACT
BACKGROUND: Recently, immunotherapy with immune checkpoint inhibitors (ICIs) has shown promising efficacy in biliary tract cancer (BTC), which includes gallbladder cancer (GBC) and cholangiocarcinoma (CHOL). Understanding the association between immunotherapy outcomes and the genomic profile of advanced BTC may further improve the clinical benefits from immunotherapy.
METHODS: Genomic tumor DNA was isolated from 98 Chinese patients with advanced BTC and used for targeted next-generation sequencing of 416 cancer-related genes to identify the genomic alterations common to advanced BTC. Thirty-four patients had received ICI camrelizumab plus gemcitabine and oxaliplatin (from the NCT03486678 trial) as a first-line treatment. Tumor-infiltrating immune cells were evaluated using immunofluorescence staining.
RESULTS: KRAS and TP53 mutations were much more frequent in the advanced-stage BTC cohort than in other cohorts with mostly early stage disease. Specifically, KRAS-TP53 co-mutations were favored in advanced CHOL, with a favorable response to immunotherapy, while single KRAS mutations predicted poor prognosis and immunotherapy outcomes for CHOL. Compared with GBC, CHOL had more mutations in genes involved in KRAS signaling; a high mutation load in these genes correlated with poor immunotherapy outcomes and may subsequently cause inferior immunotherapy outcomes for CHOL relative to GBC. Furthermore, a genomic signature including 11 genes was developed; their mutated subtype was associated with poor prognosis and immunotherapy outcomes in both CHOL and GBC. Transcriptome analyses suggested immune dysfunction in the signature mutated subtype, which was validated by tumor microenvironment (TME) evaluation based on detection of immune cell infiltration. Importantly, the signature wild-type subtype with favorable TME may be an advantageous population of immunotherapy.
CONCLUSIONS: Genomic alterations in advanced BTC were associated with specific prognosis and immunotherapy outcomes. Combining genomic classification with TME evaluation further improved the stratification of immunotherapy outcomes.
PMID:34795005 | PMC:PMC8603283 | DOI:10.1136/jitc-2021-003214
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Segnet Network Algorithm-Based Ultrasound Images in the Diagnosis of Gallbladder Stones Complicated with Gallbladder Carcinoma and the Relationship between P16 Expression with Gallbladder Carcinoma
Fetched: January 8th, 2022, 5:01am GMT by Liang Xue
J Healthc Eng. 2021 Dec 21;2021:2819986. doi: 10.1155/2021/2819986. eCollection 2021.
ABSTRACT
The study focused on how to improve the diagnostic coincidence rate of patients with gallbladder stones and gallbladder cancer based on an optimized Segnet network algorithm and the relationship of gallbladder cancer with multiple tumor suppressor 1 (P16). 300 patients diagnosed with gallbladder cancer in the hospital were selected as the research subjects. The pyramid pooling operation was incorporated into the original Segnet network algorithm, and its performance was evaluated, factoring into the intersection of union (IoU), algorithm precision (Pre), and recall rate (Recall). After 8 hours of fasting, conventional ultrasound and contrast-enhanced ultrasound examinations were performed, and the images were evaluated by three experienced ultrasound diagnosticians. The positive signal of P16 immunohistochemical staining was brownish yellow, which was generally concentrated in the nucleus, and a small part was located in the cytoplasm. In each slice, ten visual fields were selected. Then, they were observed under a high-power mirror, and the number was counted. It was found that the optimized Segnet network algorithm increased the IoU by 7.3%, the precision by 8.2%, and the recall rate by 11.1%. The diagnostic coincidence rates of conventional ultrasound and contrast-enhanced ultrasound examinations for gallbladder cancer were 78.13% (25/32) and 87.5% (25/32), respectively. The positive expression rate of P16 in gallbladder adenocarcinoma (47.06%) was significantly lower than that of acute cholecystitis with gallbladder stones (84.38%) and gallbladder polyps (67.16%) (P < 0.05). The positive expression rate of P16 in patients with stage III and stage IV (33.33% and 40%) was significantly lower than that in patients with stages I and II (87.5% and 80%) (P < 0.05). The positive expression rate of P16 in high differentiation (86.67%) was significantly higher than that of moderate differentiation (40%) and poor differentiation (28.57%) (P < 0.05). In short, contrast-enhanced ultrasound can effectively improve the diagnostic coincidence rate of gallbladder cancer, and the expression of P16 in gallbladder cancer is closely related to tumor staging and differentiation.
PMID:34970422 | PMC:PMC8714339 | DOI:10.1155/2021/2819986
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Grayscale and Spectral Doppler Ultrasound in the Diagnosis of Hepatic Veno-occlusive Disease/Sinusoidal Obstruction Syndrome After Hematopoietic Stem Cell Transplantation in Children
Fetched: January 6th, 2022, 5:01am GMT by Nusabe Kaya
J Pediatr Hematol Oncol. 2021 Nov 1;43(8):e1105-e1110. doi: 10.1097/MPH.0000000000002334.
ABSTRACT
The aim of this study is to determine the ultrasound criteria in the diagnosis of hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) after hematopoietic stem cell transplantation (HSCT) in children. A total of 158 pediatric patients underwent HSCT between January 2016 and January 2018. In all, 71 patients with clinically suspicious hepatic VOD/SOS have been followed with serial ultrasound examinations. Hepatomegaly, gallbladder wall thickening, ascites, pleural effusion, reverse flow in the portal vein, and diameter and peak systolic velocity of the hepatic artery were evaluated. Patients were divided into 2 groups retrospectively: VOD/SOS and non-VOD/SOS. The predictive value of all findings was determined, respectively. Gallbladder wall thickening, increase of diameter and peak systolic velocity of the hepatic artery, and the presence of ascites are highly predictive for VOD/SOS (P=0.001 and < 0.05). The reversed portal venous flow was developed in 3 patients in the VOD/SOS group, no significant difference was found between the 2 groups (P>0.05). Hepatomegaly was recorded in 29 (70.7%) patients in the VOD/SOS group, 13 of them was presented related to a primary disease. Pleural effusion is not associated with the diagnosis of VOD/SOS (P>0.05). Gallbladder wall edema, an increase of peak systolic velocity of the hepatic artery, and the presence of ascites are highly related to the diagnosis of VOD/SOS in children after HSCT. Ultrasound findings must be correlated with clinical criteria.
PMID:34673713 | DOI:10.1097/MPH.0000000000002334
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The Association Between Cholecystectomy and Colorectal Cancer in the Female Gender
Fetched: January 6th, 2022, 5:01am GMT by Fahad Aurif
Cureus. 2021 Dec 2;13(12):e20113. doi: 10.7759/cureus.20113. eCollection 2021 Dec.
ABSTRACT
Colorectal carcinoma (CRC) has been of great interest among researchers, and multiple causes have been proposed and accepted; however, cholecystectomy (CMY) as a potential cause for CRC, particularly in the female gender has not been studied in detail, despite multiple evidence suggesting a positive association. This review is directed at investigating the association between CMY and CRC in the female gender and aims at finding a potential cause for this association. CRC involves cancer of the sigmoid and rectum. The composition of the bile acids is altered in patients after CMY, and the resultant secondary bile acids (BA) without a functioning gall bladder are exposed directly to the intestines, which could lead to cancer. An increase in fecal secondary bile acids is also described as high in the CMY population and has been linked to cancer. Right-sided GI cancers were attributed to CMY, although many earlier studies did not find this to be true. It is interesting to note a strong association between CRC and CMY in the female western population.
PMID:34984153 | PMC:PMC8720289 | DOI:10.7759/cureus.20113
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Determinative Structural Features Identified With Probe-based Confocal Endomicroscopy for the Accurate Diagnosis of Gallbladder Malignancy
Fetched: January 5th, 2022, 5:01am GMT by Tomotake Koizumi
Anticancer Res. 2022 Jan;42(1):67-73. doi: 10.21873/anticanres.15458.
ABSTRACT
BACKGROUND: Probe-based confocal laser endomicroscopy (pCLE) can visualize microscopic structures at high resolution but has not yet yielded definitive diagnostic features of gallbladder malignancy, as opposed to benign changes.
PATIENTS AND METHODS: A total of 73 patients had their gallbladder evaluated with pCLE performed on resected benign and malignant gallbladder surgical specimens, which were sprayed with fluorescein. Malignant and benign features of pCLE findings were identified on the basis of Miami and Paris Classifications. Standard histopathological diagnoses and individual patient pCLE findings of gallbladder lesions were correlated.
RESULTS: Of the 73 consecutive patients that had their gallbladder evaluated ex vivo with pCLE, 11 were identified with gallbladder malignancy. pCLE identified features of gallbladders examined ex vivo, including the presence of thick dark bands and dark clumps, which together correlated with histopathologically-determined biliary malignancy at 100% sensitivity. Thick white bands and visualized epithelium, also identified with pCLE, together correlated with histopathologically-determined malignancy at 100% specificity.
CONCLUSION: pCLE can be used for real-time differentiation of cancerous/non-cancerous regions in the gallbladder using the diagnostic criteria identified in the present study.
PMID:34969710 | DOI:10.21873/anticanres.15458
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Risk of Hepatobiliary-Gastrointestinal Malignancies and Appropriate Cancer Surveillance in Patients With Primary Sclerosing Cholangitis
Fetched: January 4th, 2022, 5:01am GMT by Sujani Yadlapati
Cureus. 2021 Nov 26;13(11):e19922. doi: 10.7759/cureus.19922. eCollection 2021 Nov.
ABSTRACT
Patients with primary sclerosing cholangitis (PSC) are at risk of hepatobiliary and gastrointestinal cancers. Increased risk of cancer is a result of the chronic, progressive fibro-inflammatory state which ultimately results in the destruction of biliary ducts. PSC is often associated with inflammatory bowel disease (IBD). Patients with PSC are at significant risk of cholangiocarcinoma (CCA), gall bladder malignancy and those with IBD are at increased risk of colorectal cancer. It is important to implement cancer surveillance protocols in these patients. The aim of these protocols is the prevention or early detection of cancerous or pre-cancerous lesions. Given that PSC is rare, large prospective studies evaluating the risk of malignancy in these patients are not available. A great deal of uncertainty exists regarding how to best implement cancer surveillance in these patients. About 50% of deaths in PSC patients are due to malignancy and many patients eventually progress to end-stage liver disease and succumb to hepatic failure. In this review, we cover cancer surveillance strategies in PSC patients based on existing literature and expert opinions.
PMID:34976523 | PMC:PMC8712253 | DOI:10.7759/cureus.19922
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Clinical presentation of gastric Burkitt lymphoma presenting with paraplegia and acute pancreatitis: A case report
Fetched: December 31st, 2021, 5:01am GMT by Ying Lin
World J Gastroenterol. 2021 Dec 7;27(45):7844-7854. doi: 10.3748/wjg.v27.i45.7844.
ABSTRACT
BACKGROUND: The incidence of gastric Burkitt lymphoma (BL), presenting as paraplegia and acute pancreatitis, is extremely low. BL is a great masquerader that presents in varied forms and in atypical locations, and it is prone to misdiagnosis and missed diagnosis. The prognosis of BL remains poor because of the difficulty in early diagnosis and the limited advances in chemotherapy.
CASE SUMMARY: A 53-year-old man was referred to our hospital from the local county hospital due to abdominal pain for two weeks and weakness in the lower extremities for one day. Magnetic resonance imaging of the abdomen and lumbar spine showed a swollen pancreas and gallbladder, with peripancreatic exudation and liquid collection, indicating acute pancreatitis and acute cholecystitis. Additionally, we observed abnormally thickened lesions of the gastric wall, multiple enlarged retroperitoneal lymph nodes and a well-demarcated, posterolateral extradural mass lesion between T9 and T12, with extension through the spinal foramen and definite bony destruction, suggesting metastasis in gastric malignancy. Subsequent whole-body positron emission tomography/computed tomography examination showed multifocal malignant lesions in the stomach, pancreas, gallbladder, bone, bilateral supraclavicular fossa, anterior mediastinum, bilateral axillary and retroperitoneal lymph nodes. Gastroduodenal endoscopy revealed primary BL with massive involvement of the gastric body and duodenum. The patient refused chemotherapeutic treatment and died one week later due to upper gastrointestinal hemorrhage. Afterward, we reviewed the characteristics of 11 patients with BL involving the stomach, pancreas or spinal cord.
CONCLUSION: Clinicians should be aware that BL can be the potential cause of acute pancreatitis or a rapidly progressive spinal tumor with accompanying paraplegia. For gastric BL, gastroscopy biopsies and pathology are necessary for a definite diagnosis.
PMID:34963746 | PMC:PMC8661376 | DOI:10.3748/wjg.v27.i45.7844
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Multimodality management of gallbladder cancer can lead to a better outcome: Experience from a tertiary care oncology centre in North India
Fetched: December 31st, 2021, 5:01am GMT by Shaifali Goel
World J Gastroenterol. 2021 Dec 7;27(45):7813-7830. doi: 10.3748/wjg.v27.i45.7813.
ABSTRACT
BACKGROUND: Surgical resection is a treatment of choice for gallbladder cancer (GBC) patients but only 10% of patients have a resectable disease at presentation. Even after surgical resection, overall survival (OS) has been poor due to high rates of recurrence. Combination of surgery and systemic therapy can improve outcomes in this aggressive disease.
AIM: To summarize our single-center experience with multimodality management of resectable GBC patients.
METHODS: Data of all patients undergoing surgery for suspected GBC from January 2012 to December 2018 was retrieved from a prospectively maintained electronic database. Information extracted included demographics, operative and perioperative details, histopathology, neoadjuvant/adjuvant therapy, follow-up, and recurrence. To know the factors associated with recurrence and OS, univariate and multivariate analysis was done using log rank test and cox proportional hazard analysis for categorical and continuous variables, respectively. Multivariate analysis was done using multiple regression analysis.
RESULTS: Of 274 patients with GBC taken up for surgical resection, 172 (62.7%) were female and the median age was 56 years. On exploration, 102 patients were found to have a metastatic or unresectable disease (distant metastasis in 66 and locally unresectable in 34). Of 172 patients who finally underwent surgery, 93 (54%) underwent wedge resection followed by anatomical segment IVb/V resection in 66 (38.4%) and modified extended right hepatectomy in 12 (7%) patients. The postoperative mortality at 90 d was 4.6%. During a median follow-up period of 20 mo, 71 (41.2%) patients developed recurrence. Estimated 1-, 3-, and 5-years OS rates were 86.5%, 56%, and 43.5%, respectively. Estimated 1- and 3-year disease free survival (DFS) rates were 75% and 49.2%, respectively. On multivariate analysis, inferior OS was seen with pT3/T4 tumor (P = 0.0001), perineural invasion (P = 0.0096), and R+ resection (P = 0.0125). However, only pT3/T4 tumors were associated with a poor DFS (P < 0.0001).
CONCLUSION: Multimodality treatment significantly improves the 5-year survival rate of patients with GBC up to 43%. R+ resection, higher T stage, and perineural invasion adversely affect the outcome and should be considered for systemic therapy in addition to surgery to optimize the outcomes. Multimodality treatment of GBC has potential to improve the survival of GBC patients.
PMID:34963744 | PMC:PMC8661382 | DOI:10.3748/wjg.v27.i45.7813
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Neoadjuvant therapy trials in biliary tract malignancies
Fetched: December 30th, 2021, 5:01am GMT by Caroline R Medin
J Surg Oncol. 2022 Jan;125(1):84-88. doi: 10.1002/jso.26714.
NO ABSTRACT
PMID:34897705 | DOI:10.1002/jso.26714
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First-In-Human Results on the Biodistribution, Pharmacokinetics, and Dosimetry of [177Lu]Lu-DOTA.SA.FAPi and [177Lu]Lu-DOTAGA.(SA.FAPi)2
Fetched: December 29th, 2021, 5:01am GMT by Sanjana Ballal
Pharmaceuticals (Basel). 2021 Nov 24;14(12):1212. doi: 10.3390/ph14121212.
ABSTRACT
Recently, great interest has been gained regarding fibroblast activation protein (FAP) as an excellent target for theranostics. Several FAP inhibitor molecules such as [68Ga]Ga-labelled FAPI-02, 04, 46, and DOTA.SA.FAPi have been introduced and are highly promising molecular targets from the imaging point of view. FAP inhibitors introduced via bifunctional DOTA and DOTAGA chelators offer the possibility to complex Lutetium-177 due to an additional coordination site, and are suitable for theranostic applications owing to the increased tumor accumulation and prolonged tumor retention time. However, for therapeutic applications, very little has been accomplished, mainly due to residence times of the compounds. In an attempt to develop a promising therapeutic radiopharmaceutical, the present study aimed to evaluate and compare the biodistribution, pharmacokinetics, and dosimetry of [177Lu]Lu-DOTA.SA.FAPi, and [177Lu]Lu-DOTAGA.(SA.FAPi)2 in patients with various cancers. The FAPi agents, [177Lu]Lu-DOTA.SA.FAPi and [177Lu]Lu-DOTAGA.(SA.FAPi)2, were administered in two different groups of patients. Three patients (mean age-50 years) were treated with a median cumulative activity of 2.96 GBq (IQR: 2.2-3 GBq) [177Lu]Lu-DOTA.SA.FAPi and seven (mean age-51 years) were treated with 1.48 GBq (IQR: 0.6-1.5) of [177Lu]Lu-DOTAGA.(SA.FAPi)2. Patients in both the groups underwent serial imaging whole-body planar and SPECT/CT scans that were acquired between 1 h and 168 h post-injection (p.i.). The residence time and absorbed dose estimate in the source organs and tumor were calculated using OLINDA/EXM 2.2 software. Time versus activity graphs were plotted to determine the effective half-life (Te) in the whole body and lesions for both the radiotracers. Physiological uptake of [177Lu]Lu-DOTA.SA.FAPi was observed in the kidneys, colon, pancreas, liver, gall bladder, oral mucosa, lacrimal glands, and urinary bladder contents. Physiological biodistribution of [177Lu]Lu-DOTAGA.(SA.FAPi)2 involved liver, gall bladder, colon, pancreas, kidneys, and urinary bladder contents, lacrimal glands, oral mucosa, and salivary glands. In the [177Lu]Lu-DOTA.SA.FAPi group, the highest absorbed doses were noted in the kidneys (0.618 ± 0.015 Gy/GBq), followed by the colon (right colon: 0.472 Gy/GBq and left colon: 0.430 Gy/GBq). In the [177Lu]Lu-DOTAGA.(SA.FAPi)2 group, the colon received the highest absorbed dose (right colon: 1.160 Gy/GBq and left colon: 2.870 Gy/GBq), and demonstrated a significantly higher mean absorbed dose than [177Lu]Lu-DOTA.SA.FAPi (p < 0.011). [177Lu]Lu-DOTAGA.(SA.FAPi)2 had significantly longer median whole-body Te compared to that of [177Lu]Lu-DOTA.SA.FAPi [46.2 h (IQR: 38.5-70.1) vs. 23.1 h (IQR: 17.8-31.5); p-0.0167]. The Te of tumor lesions was significantly higher for [177Lu]Lu-DOTAGA.(SA.FAPi)2 compared to [177Lu]Lu-DOTA.SA.FAPi [86.6 h (IQR: 34.3-94.6) vs. 14 h (IQR: 12.8-15.5); p-0.0004]. The median absorbed doses to the lesions were 0.603 (IQR: 0.230-1.810) Gy/GBq and 6.70 (IQR: 3.40-49) Gy/GBq dose per cycle in the [177Lu]Lu-DOTA.SA.FAPi, and [177Lu]Lu-DOTAGA.(SA.FAPi)2 groups, respectively. The first clinical dosimetry study demonstrated significantly higher tumor absorbed doses with [177Lu]Lu-DOTAGA.(SA.FAPi)2 compared to [177Lu]Lu-DOTA.SA.FAPi. [177Lu]Lu-DOTAGA.(SA.FAPi)2 is safe and unveiled new frontiers to treat various end-stage cancer patients with a theranostic approach.
PMID:34959613 | PMC:PMC8707268 | DOI:10.3390/ph14121212
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Dual HER2 Blockade: An Emerging Option in Metastatic Biliary Tract Cancer?
Fetched: December 29th, 2021, 5:01am GMT by Angela Dalia Ricci
Medicina (Kaunas). 2021 Nov 27;57(12):1301. doi: 10.3390/medicina57121301.
ABSTRACT
Biliary tract cancer (BTC) includes a heterogeneous group of aggressive and rare hepatobiliary malignancies, including gallbladder cancer, ampullary carcinomas, intrahepatic cholangiocarcinoma (iCCA), and extrahepatic cholangiocarcinoma, further subclassified into distal (dCCA) and perihilar cholangiocarcinoma (pCCA) [...].
PMID:34946246 | PMC:PMC8706370 | DOI:10.3390/medicina57121301
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Reiterating the Emergence of Noncoding RNAs as Regulators of the Critical Hallmarks of Gall Bladder Cancer
Fetched: December 25th, 2021, 5:01am GMT by Varsha Rana
Biomolecules. 2021 Dec 8;11(12):1847. doi: 10.3390/biom11121847.
ABSTRACT
Gall bladder cancer (GBC) is a rare and one of the most aggressive types of malignancies, often associated with a poor prognosis and survival. It is a highly metastatic cancer and is often not diagnosed at the initial stages, which contributes to a poor survival rate of patients. The poor diagnosis and chemoresistance associated with the disease limit the scope of the currently available surgical and nonsurgical treatment modalities. Thus, there is a need to explore novel therapeutic targets and biomarkers that will help relieve the severity of the disease and lead to advanced therapeutic strategies. Accumulating evidence has correlated the atypical expression of various noncoding RNAs (ncRNAs), including circular RNAs (circRNAs), long noncoding RNAs (lncRNAs), microRNAs (miRNAs), and small nucleolar RNAs (snoRNA) with the increased cell proliferation, epithelial-mesenchymal transition (EMT), invasion, migration, metastasis, chemoresistance, and decreased apoptosis in GBC. Numerous reports have indicated that the dysregulated expression of ncRNAs is associated with poor prognosis and lower disease-free and overall survival in GBC patients. These reports suggest that ncRNAs might be considered novel diagnostic and prognostic markers for the management of GBC. The present review recapitulates the association of various ncRNAs in the initiation and progression of GBC and the development of novel therapeutic strategies by exploring their functional and regulatory role.
PMID:34944491 | PMC:PMC8699045 | DOI:10.3390/biom11121847
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Association of Diabetes Mellitus and Alcohol Abuse with Cancer: Molecular Mechanisms and Clinical Significance
Fetched: December 24th, 2021, 5:01am GMT by Bao Q Lam
Cells. 2021 Nov 8;10(11):3077. doi: 10.3390/cells10113077.
ABSTRACT
Diabetes mellitus (DM), one of the metabolic diseases which is characterized by sustained hyperglycemia, is a life-threatening disease. The global prevalence of DM is on the rise, mainly in low- and middle-income countries. Diabetes is a major cause of blindness, heart attacks, kidney failure, stroke, and lower limb amputation. Type 2 diabetes mellitus (T2DM) is a form of diabetes that is characterized by high blood sugar and insulin resistance. T2DM can be prevented or delayed by a healthy diet, regular physical activity, maintaining normal body weight, and avoiding alcohol and tobacco use. Ethanol and its metabolites can cause differentiation defects in stem cells and promote inflammatory injury and carcinogenesis in several tissues. Recent studies have suggested that diabetes can be treated, and its consequences can be avoided or delayed with proper management. DM has a greater risk for several cancers, such as breast, colorectal, endometrial, pancreatic, gallbladder, renal, and liver cancer. The incidence of cancer is significantly higher in patients with DM than in those without DM. In addition to DM, alcohol abuse is also a risk factor for many cancers. We present a review of the recent studies investigating the association of both DM and alcohol abuse with cancer incidence.
PMID:34831299 | PMC:PMC8620339 | DOI:10.3390/cells10113077
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Serum carcinoembryonic antigen and carbohydrate antigen 19-9 as preoperative diagnostic biomarkers of extrahepatic bile duct cancer
Fetched: December 23rd, 2021, 5:01am GMT by Hyeong Seok Kim
BJS Open. 2021 Nov 9;5(6):zrab127. doi: 10.1093/bjsopen/zrab127.
ABSTRACT
BACKGROUND: Serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 have been proposed as useful preoperative biomarkers of extrahepatic bile duct cancer (EBDC). This study investigated the accuracy of CEA and CA19-9 for preoperative diagnosis of EBDC.
METHODS: Patients who underwent surgery for EBDC at a tertiary centre between 1995 and 2018 were studied, and those with concurrent hepatobiliary diseases (including gallbladder cancer, intraductal papillary mucinous neoplasms of pancreas), which could affect CEA or CA19-9 levels, were excluded. The control group included patients who underwent cholecystectomy for benign gallbladder diseases during the same period. Diagnostic accuracy was determined using sensitivity, specificity and area under the receiver operating characteristic curve (AUC).
RESULTS: After excluding 23 patients, 687 patients (488 men and 199 women, mean age 65.8 years) were compared with the control group of 2310 patients. Median CEA and CA19-9 levels were 1.8 μg/l and 47.0 kU/l in patients with EBDC. CEA (cut-off 5.0 μg/l) showed AUC of 0.541, sensitivity 9.0 per cent and specificity 99.2 per cent, whereas CA19-9 (cut-off 37.0 kU/l) showed AUC of 0.753, sensitivity 56.2 per cent and specificity 94.5 per cent. Sensitivity of CA19-9 was lower in early (T stages 0-II) than advanced (T stages III and IV) cancer (47.0 versus 64.9 per cent), and also lower in N0 stage cancer than lymph node metastasis (50.1 versus 68.8 per cent).
CONCLUSION: Serum CEA and CA19-9 showed low sensitivity limiting their usefulness as diagnostic biomarkers of EBDC.
PMID:34935900 | PMC:PMC8693162 | DOI:10.1093/bjsopen/zrab127
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Pathological features of pyloric gland adenoma of the gallbladder in comparison with gastric subtype of intracholecystic papillary neoplasm
Fetched: December 23rd, 2021, 5:01am GMT by Yasuni Nakanuma
Ann Diagn Pathol. 2022 Feb;56:151879. doi: 10.1016/j.anndiagpath.2021.151879. Epub 2021 Dec 16.
ABSTRACT
BACKGROUND AND AIMS: Pyloric gland adenoma (PGA) of the gallbladder is a polypoid, preinvasive epithelial neoplasm composed of uniform back-to-back, pyloric glands in a tubular configuration. Intracholecystic papillary neoplasm (ICPN), another preinvasive grossly visible neoplasm of the gallbladder, is subdividable into four subtypes, including gastric subtype. In this study, PGA was reappraised referring to gastric subtype of ICPN (gICPN).
MATERIALS AND METHODS: PGA and gICPN pathologically defined by WHO 2019 classification were surveyed in a total of 104 cases of gallbladder epithelial neoplasms of our Hospital (2002 January to 2021 May) and were pathologically and immunohistochemically compared.
RESULTS: PGA (7 cases) was characterized by i) a well-demarcated, polypoid lesion and ii) packed tubular components resembling pyloric glands. gICPNs (14 cases) were subdivided into i) pyloric gland predominant (2 cases), ii) foveola predominant (6 cases) and iii) mixed foveola and pyloric gland type (6 cases). gICPNs were also divided into a solitary, polypoid lesion with well demarcation from the surrounding mucosa (5 cases) and a conglomerated polypoid and granular lesions with poor demarcation (9 cases). PGA shared gross and histologic features with solitary, polypoid gICPNs, and PGA could be regarded as solitary gICPN predominantly composed of pyloric glands. Nuclear expression of β-catenin was found in 6 of 7 PGA, but absent in gICPN, including solitary, polypoid gICPN.
CONCLUSION: PGA could correspond to a solitary gICPN mainly composed of pyloric glands, but may undergo a different molecular pathway from gICPN.
PMID:34933153 | DOI:10.1016/j.anndiagpath.2021.151879
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Management and follow-up of gallbladder polyps: updated joint guidelines between the ESGAR, EAES, EFISDS and ESGE
Fetched: December 18th, 2021, 5:01am GMT by Kieran G Foley
Eur Radiol. 2021 Dec 17. doi: 10.1007/s00330-021-08384-w. Online ahead of print.
ABSTRACT
MAIN RECOMMENDATIONS: 1. Primary investigation of polypoid lesions of the gallbladder should be with abdominal ultrasound. Routine use of other imaging modalities is not recommended presently, but further research is needed. In centres with appropriate expertise and resources, alternative imaging modalities (such as contrast-enhanced and endoscopic ultrasound) may be useful to aid decision-making in difficult cases. Strong recommendation, low-moderate quality evidence. 2. Cholecystectomy is recommended in patients with polypoid lesions of the gallbladder measuring 10 mm or more, providing the patient is fit for, and accepts, surgery. Multidisciplinary discussion may be employed to assess perceived individual risk of malignancy. Strong recommendation, low-quality evidence. 3. Cholecystectomy is suggested for patients with a polypoid lesion and symptoms potentially attributable to the gallbladder if no alternative cause for the patient's symptoms is demonstrated and the patient is fit for, and accepts, surgery. The patient should be counselled regarding the benefit of cholecystectomy versus the risk of persistent symptoms. Strong recommendation, low-quality evidence. 4. If the patient has a 6-9 mm polypoid lesion of the gallbladder and one or more risk factors for malignancy, cholecystectomy is recommended if the patient is fit for, and accepts, surgery. These risk factors are as follows: age more than 60 years, history of primary sclerosing cholangitis (PSC), Asian ethnicity, sessile polypoid lesion (including focal gallbladder wall thickening > 4 mm). Strong recommendation, low-moderate quality evidence. 5. If the patient has either no risk factors for malignancy and a gallbladder polypoid lesion of 6-9 mm, or risk factors for malignancy and a gallbladder polypoid lesion 5 mm or less, follow-up ultrasound of the gallbladder is recommended at 6 months, 1 year and 2 years. Follow-up should be discontinued after 2 years in the absence of growth. Moderate strength recommendation, moderate-quality evidence. 6. If the patient has no risk factors for malignancy, and a gallbladder polypoid lesion of 5 mm or less, follow-up is not required. Strong recommendation, moderate-quality evidence. 7. If during follow-up the gallbladder polypoid lesion grows to 10 mm, then cholecystectomy is advised. If the polypoid lesion grows by 2 mm or more within the 2-year follow-up period, then the current size of the polypoid lesion should be considered along with patient risk factors. Multidisciplinary discussion may be employed to decide whether continuation of monitoring, or cholecystectomy, is necessary. Moderate strength recommendation, moderate-quality evidence. 8. If during follow-up the gallbladder polypoid lesion disappears, then monitoring can be discontinued. Strong recommendation, moderate-quality evidence.
SOURCE AND SCOPE: These guidelines are an update of the 2017 recommendations developed between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery-European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE). A targeted literature search was performed to discover recent evidence concerning the management and follow-up of gallbladder polyps. The changes within these updated guidelines were formulated after consideration of the latest evidence by a group of international experts. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence.
KEY POINT: • These recommendations update the 2017 European guidelines regarding the management and follow-up of gallbladder polyps.
PMID:34918177 | DOI:10.1007/s00330-021-08384-w
Trials - Gall Bladder Cancer
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Identification of New Biomarkers for Patients With Cholangiocarcinoma and Gallbladder Cancer
Posted: January 11th, 2022, 3:00pm GMT
Conditions: Biliary Tract Cancer; Cholangiocarcinoma; Gallbladder Cancer
Intervention:
Sponsor: Herlev and Gentofte Hospital
Recruiting -
Comparison of Chemotherapy Before and After Surgery Versus After Surgery Alone for the Treatment of Gallbladder Cancer
Posted: September 22nd, 2020, 2:00pm GMT
Conditions: Stage II Gallbladder Cancer AJCC v8; Stage IIA Gallbladder Cancer AJCC v8; Stage IIB Gallbladder Cancer AJCC v8; Stage III Gallbladder Cancer AJCC v8; Stage IIIA Gallbladder Cancer AJCC v8; Stage IIIB Gallbladder Cancer AJCC v8
Interventions: Drug: Cisplatin; Drug: Gemcitabine Hydrochloride; Procedure: Lymphadenectomy; Procedure: Partial Hepatectomy
Sponsors: ECOG-ACRIN Cancer Research Group; National Cancer Institute (NCI)
Recruiting