A histopathological evaluation of gall bladder cancer with special reference to HER2/neu and E-cadherin in Southern part of Assam

Background/Objective: Gall bladder carcinoma (GBC) is an aggressive malignancy with high mortality and aggressive course, with palliation as the only available option. The signs and symptoms of gall bladder arcinoma are not specific and often present late. Diagnosis is, therefore, often made at advanced stage with poorer outcomes. Identifying biomarkers and cancer specific cellular targets, that will pave the way for novel therapeutic approaches and early diagnosis for gall bladder carcinoma, is urgently needed. Proto-oncogenes (HER-2) and E-Cadherin are commonly deregulated in gallbladder cancer (GBC). This study evaluates the prognostic significance of HER-2 and E-Cadherin in GBC patients in Silchar Medical College.Our main objective was to evaluate frequency of HER-2/neu overexpression in GBC and to seek its correlation, if any with conventional clinicopathological parameters and survival.Methods: A total of 168 cases were received and evaluated for Gall Bladder cancer and control specimens were prospectively collected from 2018-2020. Immunohistochemical staining was done using monoclonal antibodies to semiquantitatively evaluate HER-2 and E-Cadherin protein expression. The criterion for HER-2 and E-Cadherin positivity was set at 10% and >5% tumor cells showing complete, membranous staining. Clinicopathological correlations were drawn with major clinical outcomes. Results: It was observed that out of 168 cases the male to female ratio is 1:5 with highest number of cases in the age group of 50-59 , i.e., 70 cases with 41.7%. The most common location in this study was fundus with 69% of cases (116 out 0f 168), most commonly presented as biliary colic with 56 number of cases. Grading was also done in 168 cases where most number of cases were moderately differentiated with 86 number of cases with a percentage of 51%. Expression of Her2Neu and E-Cadherin was evaluated where highest number of cases were seen with 1+ score in the IHC expressions of both the markers with 81 and 61 number of cases respectively. Conclusion: The increasing global incidence, late presentation leading to poor prognosis and lack of effective therapy make the management of gall bladderv carcinoma really challenging. Our study shows the abnormal expression of HER-2 and E-Cadherin expression in gall bladder carcinoma patients in Southern Assam and suggests that these two markers can be used for potential tool for early detection of gall bladder carcinoma and also can be used for targeted therapy in gall bladder carcinoma.

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Improvement of survival in VA patients with gall bladder cancer given chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.4132 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 4132-4132 ◽

Cited By ~ 1

Author(s):

M. Atiq ◽

M. M. Safa ◽

R. S. Komrokji ◽

A. R. Jazieh ◽

A. F. Muhleman ◽

...

Keyword(s):

Bladder Cancer ◽

Adjuvant Chemotherapy ◽

Gall Bladder ◽

Median Survival ◽

Bladder Carcinoma ◽

Cox Regression ◽

Gall Bladder Cancer ◽

P Value ◽

Gall Bladder Carcinoma ◽

Metastatic Setting

4132 Background: Gallbladder carcinoma, though rare, has very poor prognosis. Most of patients with gall bladder carcinoma present with either unresectable disease or metastasis. Median survival in gall bladder carcinoma has been documented to be 6 months in SEER data. There is no data available on the outcome of Veterans’ Affair (VA) patients with gall bladder carcinoma. Impact of chemotherapy in adjuvant and metastatic setting is not well-studied. Methods: We used the VA Central Cancer Registry (VACCR) to analyze VA patients with Gall Bladder cancer diagnosed between 1995 and 2005. The reference date for data collection and reporting is January 1, 1995. This site aggregates the data collected by the medical centers’ cancer registries. Data was entered and analyzed using bio-statistical software SPSS. Results: There were a total of 232 patients. Of these, 185 (79.7%) were whites and 37 (15.9%) were blacks. The mean age was 71 years. Pathology was adenocarcinoma in 198 (85.3%), non-specified carcinoma in 29 (12.5%) and small cell carcinoma in 5 (2.2%) cases. Overall median survival was 5.27 months. Surgery was performed in 119 patients (51%). Only 19 (16%) patients received adjuvant chemotherapy. The baseline characteristics were similar between patients who received adjuvant chemotherapy and no adjuvant chemotherapy. Also, the median survival was similar (8.3 months vs. 8.7 months) (P-value 0.37). In patients who did not undergo surgery, the median survival for patients who received chemotherapy was 8.0 months vs 1.7 months for patients who did not receive chemotherapy (p-value 0.013). Eighty-nine (38.5%) patients were diagnosed with stage IV disease. Amongst these patients chemotherapy improved the median survival (2 months vs. 6.97 months; p-value 0.04). In a Cox regression model stage, surgical margins, surgery, chemotherapy were independent predictors of patient survival. Conclusions: Gall bladder carcinoma in VA patients has similar survival compared to other reports. Our data is one of the largest retrospective cohorts in gall bladder cancer and suggests that chemotherapy improves survival in advanced gall bladder cancer patients. No significant financial relationships to disclose.

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Anticancer and apoptosis-inducing effects of curcumin against gall bladder carcinoma

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v9i1.1176 ◽

2018 ◽

Vol 9 (1) ◽

pp. 68 ◽

Cited By ~ 1

Author(s):

Pratibha Pandey ◽

Uzma Sayyed ◽

Rohit Tiwari ◽

Neelam Pathak ◽

Mohammad Haris Siddiqui ◽

...

Keyword(s):

Cell Cycle ◽

Bladder Cancer ◽

Gall Bladder ◽

Cancer Cells ◽

Bladder Carcinoma ◽

Caspase 3 ◽

Gall Bladder Cancer ◽

Dependent Manner ◽

Gall Bladder Carcinoma ◽

Bladder Cancer Cells

Curcumin, the primary bioactive component isolated from turmeric, has been shown to possess variety of biologic functions including anti-cancer activity. However, meticulous mechanism of the curcumin in gall bladder cancer has not been explored yet. Therefore, in our study, we elucidated the mechanism of the anticancer action of curcumin against human gall bladder cancer cells. It was found that the curcumin treated GBC cells decreased cell viability in a dose and time-dependent manner. Nuclear condensation, Annexin V-FITC/PI positive cells, and caspase-3 activation confirmed the apoptotic induction due to anti-proliferative action of curcumin. Furthermore, curcumin induced disruption in the mitochondrial membrane potential and increased reactive oxygen species generation which has not yet been reported in earlier studies of curcumin with gall bladder cancer. Moreover, curcumin-induced apoptosis of gall bladder cancer cells was also accompanied by significant amount of growth arrest at the G0/G1 phase of the cell cycle which has also not been documented previously. To the best part of my knowledge, this study has established curcumin as one of the promising chemotherapeutic agent against gall bladder carcinoma. Thus the present study explored a novel mechanism explaining the anti cancerous effects of curcumin, and may provide an alternative therapeutic approach which can overcome the side effects of chemotherapy. Keywords: Gall bladder carcinoma Curcumin; Cell cycle analysis; Caspase-3; Apoptosis

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Gall bladder cancer presenting as upper gastrointestinal bleed: a rare initial presentation of gall bladder carcinoma

The American Journal of Gastroenterology ◽

10.1016/s0002-9270(01)03531-6 ◽

2001 ◽

Vol 96 (9) ◽

pp. S235-S236

Author(s):

T QUTOB

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Bladder Carcinoma ◽

Gall Bladder Cancer ◽

Initial Presentation ◽

Gall Bladder Carcinoma ◽

Gastrointestinal Bleed ◽

Upper Gastrointestinal Bleed ◽

Upper Gastrointestinal

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Type VI choledochal cyst with gall bladder carcinoma

BMJ Case Reports ◽

10.1136/bcr-2019-232715 ◽

2019 ◽

Vol 12 (12) ◽

pp. e232715

Author(s):

Venkata Vishwanath Reddych ◽

Ashok Kumar ◽

Manas Aggarwal ◽

Kailash Chand Kurdia

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Choledochal Cyst ◽

Cystic Duct ◽

Bladder Carcinoma ◽

World Literature ◽

Gall Bladder Cancer ◽

Gall Bladder Carcinoma ◽

The World

An isolated dilatation of the cystic duct (type VI choledochal cyst (CDC)) is extremely rare with only 21 cases reported in the world literature until now. There is only one case of in situ gall bladder cancer (GBC) reported in association with type VI CDC in the literature. Here we are reporting a case of type VI CDC with papillary GBC.

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Study of cholecystectomy specimens over a period of one year in tertiary care centre

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170636 ◽

2017 ◽

Vol 5 (3) ◽

pp. 916

Author(s):

I. Vijaya Bharathi ◽

P. Urmila Devi ◽

A. Bhagya Lakshmi

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Bladder Carcinoma ◽

Histopathological Examination ◽

Tertiary Care ◽

Gall Bladder Cancer ◽

Tertiary Care Centre ◽

Gall Bladder Carcinoma ◽

Hematoxylin And Eosin ◽

One Year

Background: Gall bladder is among the most common surgically resected organs with various neoplastic and non-neoplastic lesions. Chronic chocystitis is the most commonly encountered lesion in India and worldwide and 78-90% are associated with calculi. Gall bladder cancer constitutes 0.5% to 1.09% including both suspected and incidental diagnosis. The objective of present study was to evaluate the various lesions of Gall bladder and the importance of grossing and histopathological examination of every cholecystectomy specimen in order to diagnose the incidental gall bladder cancer (IGBC).Methods: A Retrospective study of cholecystectomy specimens for a period of one year, May 2015 to June 2016 was carried out. 252 Cholecystectomy specimens were received and all of them subjected for histopathological examination and the sections stained with routine Hematoxylin and Eosin stain.Results: Commonest age group being 21-40years (41%) followed by 41-60years (40%). Gall bladder (GB) lesions are more common in females 175 (70%) and M:F ratio 1:2.2.Most commonest lesions were Chronic calculous cholecystitis constituting 155 cases (61%) followed by chronic cholecystitis 52 cases (21%). Cholelithiasis was associated with both Acute and Chronic Cholecytitis constituting 67%. Acute calculous cholecystits constitute 13 cases (5%) and Acute cholecystitis constitutes 10 cases (4%). In Congenital anomalies, 3 cases (1.2%) of Biliary atresia and 4 cases (1.2%) of choledochal cyst were diagnosed. 4 cases (1.6%) of Gall bladder carcinoma was diagnosed. Among these 3 cases were incidental gall bladder carcinoma (IGBC).Conclusions: cholecystectomy specimens should be subjected for histopathological examination to study various lesions of GB and to detect unsuspected incidental gall bladder cancer as cholecystectomy itself is the treatment for gall bladder cancer and also other lesions of GB associated with cholelithiasis.

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Clinicopathological study of gall bladder cancer and its relationship with gall stones

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15308 ◽

2016 ◽

Vol 18 (3) ◽

pp. 46 ◽

Cited By ~ 1

Author(s):

R Poudel ◽

SK Singh ◽

S Basnet ◽

H Devkota ◽

SK Adhikari

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Medical Science ◽

Laboratory Data ◽

Gall Bladder Cancer ◽

Common Finding ◽

Female Ratio ◽

Pain Abdomen ◽

Gall Stones ◽

Constant Pain

Introduction: Gall bladder cancer is the most common cancer of the biliary tree and one of the highly malignant tumors with poor prognosis. Although its incidence is low in west, it is common in our part of the world. There are very few studies regarding gall bladder cancer in Nepal. The incidence of gallstones in patients with gall bladder cancer is high. The aim of the study was to evaluate the clinicopathological aspect of the disease in patients with gallbladder cancer and to Asses the incidence of gallstones in patients with gall bladder cancer.Material and Methods: This was a retrospective study carried out in GI Surgery unit of National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal. All patients diagnosed as gallbladder carcinomas during 12 years period from 2002 to 2014 were included in this study. Their clinical characteristics, laboratory data, tumor histopathology reports were obtained and analyzed using SPSS17.Results: Total of 47 patients who met inclusion criteria were included in the study. Male to Female ratio was 1:1.8. Age ranged from 32 to 72 years with mean age of 54. Most common presenting symptom was Pain abdomen (93.6%) followed by weight loss (51.1%) and Jaundice (46.8%). Most common finding on examination was Icterus (42.6%) followed by palpable gall bladder (34%) and Hepatomegaly (29.8%). Gall Stones were seen in 37 (72.3%) patients. Most common histopathology was Adenocarcinoma (93.6%).Conclusion: Most of the patient with gall bladder cancer remained asymptomatic until late. Pain abdomen was most common presenting symptom and icterus was most common findings. There was strong association between gall bladder cancer and gallstones. There should be high index of suspicion if patient with gallstones has constant pain in right hypochondrium and has jaundice.

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Role of EGFR and HER-2/NEU Expression in Gall Bladder Carcinoma

Journal of Laboratory Physicians ◽

10.1055/s-0041-1726561 ◽

2021 ◽

Author(s):

Chhanda Das ◽

Madhumita Mukhopadhyay ◽

Srijana Subba ◽

Ashis Kumar Saha ◽

Biswanath Mukhopadhyay

Keyword(s):

Gall Bladder ◽

Bladder Carcinoma ◽

Tertiary Care ◽

Molecular Therapy ◽

Tumor Type ◽

Care Hospital ◽

Gall Bladder Carcinoma ◽

Poorly Differentiated ◽

Her 2 ◽

Well Differentiated

Abstract Background Gall bladder carcinoma (GBC) is the most common malignancy of the biliary tract. Being known for its geographical and racial variations, and compared with the global statistics, its incidence is higher in the Indian subcontinent, mainly in the northern and eastern regions, accounting for 80 to 95% of cases. Aims and Objectives This study was conducted to evaluate the clinic-pathological spectrum and expression of EGFR and HER-2/NEU in GBCs and to understand their relation to prognosis, paving the way for targeted therapies for better treatment outcomes and patient survival. Materials and Methods This is a prospective study performed in a tertiary care hospital in 30 resected specimens of GBC cases recorded in our Department of Pathology from November 2017 to November 2019. Clinical history including the radiological reports and demographic parameters were included in the study pro forma. Immunohistochemical (IHC) staining for EGFR and HER-2/NEU was performed on all the selected cases. Clinicopathologic parameters like age, sex, histologic type, perineural, and lymphovascular invasion were compared and correlated with EGFR and HER-2/NEU status. Results Expression of EGFR was found in 93.33% of cases, which showed a highly significant correlation with histological tumor type (p = 0.000). HER-2/NEU expression was found in 56.66% of cases, which also showed a significant correlation with histological tumour type (p = 0.021). We found most of the cases with strong EGFR immunoreactivity (3+) were poorly differentiated tumors and most of the cases showing weak immunoreactivity for EGFR (1+) were well-differentiated. Conversely, in case of HER-2/NEU immunoreactivity, strong staining (3+) was seen in well-differentiated tumors and weak staining (1+) in poorly differentiated tumors. A significant correlation was also found between EGFR and HER-2/NEU expression (p = 0.000) and between cholelithiasis and EGFR expression (p = 0.033). Conclusion EGFR is expressed in most cases of GBC. Its expression is more in poorly differentiated carcinomas as compared to the well-differentiated carcinomas, whereas HER-2/NEU expression is more in well-differentiated carcinomas. Therefore, they may serve as independent prognostic factors and also as targets for molecular therapy in GBCs.

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EGFR and HER2neu Expression in Gall Bladder Carcinoma and Its Association with Clinicopathological Parameters - An Institutional Experience from North India

Asian Pacific Journal of Cancer Biology ◽

10.31557/apjcb.2021.6.1.57-65 ◽

2021 ◽

Vol 6 (1) ◽

pp. 57-65

Author(s):

Inara Abeer ◽

Sabina Khan ◽

Mohd. Jaseem Hasan ◽

Musharraf Hussain

Keyword(s):

Gall Bladder ◽

Bladder Carcinoma ◽

North India ◽

Clinicopathological Parameters ◽

Advanced Stage ◽

Gall Bladder Carcinoma ◽

Egfr Expression ◽

Poorly Differentiated ◽

Well Differentiated ◽

Biliary Tract Malignancy

Objective: Gallbladder cancer (GBC) is the most common biliary tract malignancy found worldwide with very high incidence in North India especially Delhi region. It is characterized by poor prognosis and ineffective treatment especially in advanced stage. The aim of this study was to evaluate EGFR and HER2/neu immunoexpression in cancer patients and to correlate it with the clinicopathological parameters so as to identify GBC patients who can benefit from targeted therapy.Methods: Present study was conducted in the Department of Pathology, Hamdard Institute of Medical Sciences & Research, New Delhi. A total of 40 cases of Gallbladder carcinoma (GBC) were evaluated for Immunohistochemical expression of EGFR and HER2/neu. Clinicopathological parameters of GBC were studied and correlated with immunoexpression of EGFR and HER2 /neu. Result: The mean age of the GBC patients was 55.9 years with 90% being females. On histopathology, 34(85%) cases were conventional adenocarcinoma. The EGFR expression was positive in 29/40 cases (72.5%). It was significantly more positive in poorly differentiated grade and advanced stages of gall bladder carcinoma (P<0.05). The expression of HER2/neu was positive in 13/40 cases (32.5%). It was significantly more positive in well differentiated gall bladder carcinoma (P<0.05). Immunoexpression of EGFR was inversely related with HER2/neu expression and this association was statistically significant.Conclusion: Among GBC patients, EGFR expression and HER2/neu expression was 72.5% and 32.5%, respectively. Significant EGFR expression was seen in poorly differentiated and advanced stage cancers while significant HER2/neu expression was seen in well differentiated gall bladder carcinomas. To conclude, these two markers HER2/neu and EGFR can be used as predictive and prognostic markers respectively, with rationale to further explore the use of anti-HER2 and anti- EGFR therapy in gall bladder cancer.

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Gallbladder Cancer: A Hospital Based Study

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v15i2.22815 ◽

2017 ◽

Vol 15 (2) ◽

pp. 2-5

Author(s):

Anup Sharma ◽

P Thapa ◽

A Dhakal

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Metastatic Disease ◽

Advanced Disease ◽

Staging Laparoscopy ◽

Gall Bladder Cancer ◽

Common Symptom ◽

Gastrointestinal Malignancies ◽

Female Ratio ◽

Number Of Patients

Introduction: Gallbladder carcinoma (GBC) is the commonest cancer of the biliary tree and the most frequent cause of death from biliary malignancies. The overall resection rates at presentation range from 10%-30% only. Therefore, a large number of patients are inoperable with overall survival of only 6-8 months. Palliation of the pain, jaundice, pruritus is a big challenge in patients with advanced disease. Methods: A prospective cross sectional study of patients with GBC during the period of October 2014 to September 2017 at Nepalgunj Medical College and Teaching Hospital, Kohalpur, department of surgery. Results: There were 216 cases of gastrointestinal malignancies with 54(25%) GBC. There was female (75.92%) preponderance with a male to female ratio of 1:3.15. The mean age was 61.41±12.18. The most common symptom at presentation was pain in a right upper abdomen (87.03%) followed by abdominal lump (41.23%) and surgical jaundice (18.51%). Fundus (70.37%) was the most common site of involvement followed by body (5.55%) and neck (24.05%). Gall stone was associated in 44 (81.48%) patients. Only 7 (12.96%) patients had localized GBC, 25 (46.29%) patients had locally advanced disease and 22 (40.74%) had metastatic disease. Liver was the commonest site of metastatis followed by peritoneum and two patients had left supraclavicular lymph node metastatis. There were two (3.72%) incidental gall bladder cancer after laparoscopic cholecystectomy. 13 (24.07%) patients were operated with intention of radical cholecystectomy but only six (46.15%) patient could undergo radical resection. Staging laparoscopy was done in all patients except for incidental gall bladder cancer. Metastatic disease was identified in 3 (23.07%) on staging laparoscopy. In eight (61.33%) among 13 patients the disease was unresectable. The most common histology was adenocarcinoma and most common stage was stage III and stage IV when both operated and non-operated groups were combined. Conclusions: GBC was the commonest gastrointestinal tract cancer with a female preponderance. A majority of patients were inoperable at presentation with pain in abdomen being the most common symptom. Surgery although is the main stay of treatment is not possible in many.

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