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

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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Gall stones size, number, biochemical analysis and lipidogram- an association with gall bladder cancer: a study of 200 cases

International Journal of Cancer Therapy and Oncology ◽

10.14319/ijcto.0203.10 ◽

2014 ◽

Vol 2 (3) ◽

pp. 020310 ◽

Cited By ~ 1

Author(s):

Shveta Narang ◽

Parul Goyal ◽

Mohinder Bal ◽

Usha Bandlish ◽

Sunder Goyal

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Biochemical Analysis ◽

Gall Bladder Cancer ◽

Gall Stones ◽

Size Number

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20211871 ◽

2021 ◽

Vol 9 (5) ◽

pp. 1368

Author(s):

Madhusmita Choudhury ◽

Gargi Roy Choudhury ◽

Monoj K. Deka ◽

Shah A. Sheikh

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Bladder Carcinoma ◽

Prognostic Significance ◽

Gall Bladder Cancer ◽

Clinicopathological Parameters ◽

Gall Bladder Carcinoma ◽

Female Ratio ◽

Her 2 ◽

E Cadherin

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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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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Incidental Gall Bladder Adenocarcinoma in Cholecystectomy Specimens; A Single Center Experience and Review of the Literature

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2018.118 ◽

2018 ◽

Vol 10 (4) ◽

pp. 249-253

Author(s):

Bita Geramizadeh ◽

Ali Kashkooe

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Laboratory Data ◽

Clinicopathological Characteristics ◽

Gall Bladder Cancer ◽

Pathological Examination ◽

Time Of Surgery ◽

Single Center Experience ◽

Age Range ◽

Bladder Adenocarcinoma

BACKGROUND Gallbladder adenocarcinoma is the most common malignant tumor of the biliary tract. Most of gall bladder cancers are detected incidentally only after pathological examination of the surgical specimens. In this study we investigated the characteristics of incidental gallbladder cancers in our center and also reviewed the current literature regarding the diagnosis and treatment of such incidentally detected tumors in the gall bladder. METHODS We retrospectively reviewed all of the cholecystectomy specimens in the archives of Pathology Department in the hospitals affiliated to Shiraz University of Medical Sciences in the study period (2010-2016). Clinicopathological characteristics were extracted from the patients’ clinical charts, which included symptoms, radiological findings, laboratory data, and surgical procedures as well as outcome. RESULTS During these 7 years we identified 18 cases of incidental gall bladder cancer, consisted of 13 women and 5 men with the age range of 32 to 85 (62.5 ± 14.2) years detected after pathological study of the resected gall bladders among more than 4800 resected gall bladders. During the period, only two patients were operated on with the impression of gall bladder adenocarcinoma, which was not included in the study. Ten cases were T1 and eight were T2 at the time of surgery. They have been followed up for 1-7 years, during which, six cases of T2 died. All of the T1 cases are alive and symptom free. CONCLUSION By increasing laparoscopic cholecystectomies in our center we observed 0.37% incidental cases of gall bladder adenocarcinoma. Preoperative diagnosis of this cancer in early stages is very difficult and needs high degree of suspicion. The most important predictor of prognosis is the stage of the cancer at the time of surgery. To the best of our knowledge, this is the first report of incidental gall bladder cancer from Iran.

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Jab1-siRNA Induces Cell Growth Inhibition and Cell Cycle Arrest in Gall Bladder Cancer Cells via Targeting Jab1 Signalosome

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520619666190725122400 ◽

2020 ◽

Vol 19 (16) ◽

pp. 2019-2033 ◽

Cited By ~ 2

Author(s):

Pratibha Pandey ◽

Mohammad H. Siddiqui ◽

Anu Behari ◽

Vinay K. Kapoor ◽

Kumudesh Mishra ◽

...

Keyword(s):

Cell Cycle ◽

Bladder Cancer ◽

Cell Growth ◽

Gall Bladder ◽

Growth Inhibition ◽

Cell Cycle Arrest ◽

Gall Bladder Cancer ◽

Cell Growth Inhibition ◽

Cycle Arrest ◽

Apoptotic Induction

Background: The aberrant alteration in Jab1 signalosome (COP9 Signalosome Complex Subunit 5) has been proven to be associated with the progression of several carcinomas. However the specific role and mechanism of action of Jab1 signalosome in carcinogenesis of gall bladder cancer (GBC) are poorly understood. Objective: The main objective of our study was to elucidate the role and mechanism of Jab1 signalosome in gall bladder cancer by employing siRNA. Methods: Jab1 overexpression was identified in gall bladder cancer tissue sample. The role of Jab1-siRNA approach in cell growth inhibition and apoptotic induction was then examined by RT-PCR, Western Blotting, MTT, ROS, Hoechst and FITC/Annexin-V staining. Results: In the current study, we have shown that overexpression of Jab1 stimulated the proliferation of GBC cells; whereas downregulation of Jab1 by using Jab1-siRNA approach resulted incell growth inhibition and apoptotic induction. Furthermore, we found that downregulation of Jab1 induces cell cycle arrest at G1 phase and upregulated the expression of p27, p53 and Bax gene. Moreover, Jab1-siRNA induces apoptosis by enhancing ROS generation and caspase-3 activation. In addition, combined treatment with Jab1-siRNA and gemicitabine demonstrated an enhanced decline in cell proliferation which further suggested increased efficacy of gemcitabine at a very lower dose (5μM) in combination with Jab1-siRNA. Conclusion: In conclusion, our study strongly suggests that targeting Jab1 signalosome could be a promising therapeutic target for the treatment of gall bladder cancer.

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Elucidation of the Chemopreventive Role of Stigmasterol Against Jab1 in Gall Bladder Carcinoma

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190206124120 ◽

2019 ◽

Vol 19 (6) ◽

pp. 826-837 ◽

Cited By ~ 3

Author(s):

Pratibha Pandey ◽

Preeti Bajpai ◽

Mohammad H. Siddiqui ◽

Uzma Sayyed ◽

Rohit Tiwari ◽

...

Keyword(s):

Cell Cycle ◽

Bladder Cancer ◽

Gall Bladder ◽

Cancer Cells ◽

Caspase 3 ◽

Annexin V ◽

Gall Bladder Cancer ◽

Apoptosis Induction ◽

Bladder Cancer Cells ◽

Hoechst Staining

Background:Plant sterols have proven a potent anti-proliferative and apoptosis inducing agent against several carcinomas including breast and prostate cancers. Jab1 has been reported to be involved in the progression of numerous carcinomas. However, antiproliferative effects of sterols against Jab1 in gall bladder cancer have not been explored yet.Objective:In the current study, we elucidated the mechanism of action of stigmasterol regarding apoptosis induction mediated via downregulation of Jab1 protein in human gall bladder cancer cells.Methods:In our study, we performed MTT and Trypan blue assay to assess the effect of stigmasterol on cell proliferation. In addition, RT-PCR and western blotting were performed to identify the effect of stigmasterol on Jab1 and p27 expression in human gall bladder cancer cells. We further performed cell cycle, Caspase-3, Hoechst and FITC-Annexin V analysis, to confirm the apoptosis induction in stigmasterol treated human gall bladder cancer cells.Results:Our results clearly indicated that stigmasterol has up-regulated the p27 expression and down-regulated Jab1 gene. These modulations of genes might occur via mitochondrial apoptosis signaling pathway. Caspase-3 gets activated with the apoptotic induction. Increase in apoptotic cells and DNA were confirmed through annexin V staining, Hoechst staining, and cell cycle analysis.Conclusion:Thus, these results strongly suggest that stigmasterol has the potential to be considered as an anticancerous therapeutic agent against Jab1 in gall bladder cancer.

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