MRNA Profiling Involved in Triggering of STAT1 with Regulatory Involvement of IRF7, PTPRF, and miR-145p in Patients Suffering from Gall Bladder Carcinoma

Background. Gall Bladder Cancer (GBC) is a type of extremely malignant tumor, which has high incidences of mortality. There is rare information about its mechanisms of invasion and gene expression regulations. microRNA-155 (miR-155) has mostly been reported to be over expressed in cases of solid tumors and hematopoietic malignancies. In this study, we have investigated the role and clinical significance of miR-155 in a Chinese population suffering from GBC and compared the results with nonneoplastic inflammation. Methods. Tissue specimens were collected on 50 patients of Gall Bladder Carcinoma and 10 patients suffering from nonneoplastic inflammation who have undergone surgeries at the Department of Pathology, Renji Hospital, Shanghai, from January 2019 to January 2020. We performed profiling of miR-155 expression in both nonneoplastic and gall bladder carcinoma tissues by QRT-PCR. Results. Expression levels of miR-155 were found to be extremely high in GBC patients in comparison to the nonneoplastic tissues ( ∗ P < 0.05 ), as high miRNA is correlated with TNM stages. Further results noted were that miR-145-5p expressed genes mimic the gene expression of STAT1, a downregulation of IRF7 was noted in the GBC, and an activation of STAT1 was significantly noted in carcinoma cells of the gallbladder. Downregulation of PTPRF was also noted during the expression of miR-145. Conclusions. As downregulation of IRF7 is linked with low rates of survival, it was found that gall bladder carcinoma patients may face high mortality. The STAT-1 expression of unregulated in GBC patients was also noted.

INCIDENTAL GALL BLADDER CARCINOMA (IGBC) IN CHOLECYSTECTOMY SPECIMENS REMOVED FOR CHOLELITHIASIS

Background: The present study highlights the occurrence of Incidental gallbladder carcinoma (IGBC) detected during histopathological examination in cholecystectomy specimens removed for cholelithiasis. Methods- This is a tertiary hospital based cross-sectional study of 500 cholecystectomy specimens removed during cholelithiasis. Relevant hospital records, histopathology slides and reports were reviewed, re-evaluated and studied. Results: 4(0.80%) cases of incidental gall bladder carcinoma (IGBC) were diagnosed from the histopathological evaluation (HPE) of 500 cholecystectomy specimens, constituting 0.80% of gall bladder specimens received during the study period. The age of the patients with IGBC ranged from 51-80 years. More females were affected than males with a M:F ratio of 1:3. Conclusion: Early detection of IGBC by histopathological examination would have a favourable impact on prognosis and management thereby increasing the survival outcome. Keywords: Cholelithiasis, Incidental Gall Bladder Carcinoma

Association of gallbladder carcinoma with gallstone and its prevalence in a tertiary care teaching hospital

Objective: To see the association of gallstones with gallbladder carcinoma and its prevalence in patients undergoing surgery for cholelithiasis. Methods: This cross-sectional observational study was conducted from July 2012 to June 2013 at the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh with 150 cases of cholelithiasis. Results: Of 150 cases those were operated for gall bladder stone disease, 8 (eight) were found to have carcinoma of gall bladder i.e. prevalence was 5.3%. On ultrasound, only three (37.5%) patients were suspected as gall bladder carcinoma pre-operatively. Females are more affected than males by this disease. Also gall bladder carcinoma was found to be associated with single large-sized stone. Conclusion: The ultrasonography can miss a significant number of malignant lesions of the gall bladder in early stages and every cholecystectomy specimen should be examined histologically. Mediscope 2021;8(2): 87-93

A RARE PRESENTATION OF CHOLEDOCHAL CYST IN ADULT.

Choledochal cyst (CC) is a relative rare condition in adult population. Only 20% of CC presents in adult population, of these 80% presents with additional hepatobiliary pathology (1,2). With widespread usage of cross sectional imaging, more cysts are likely being identified incidentally in asymptomatic individuals. The development of cancer arising from cysts increases from <0.7% in first decade of life to >11.4% after 2nd decade of life. Anatomic abnormality pancreaticbiliary maljunction (PBM) is a noted etiologic factor for cyst development and even for development of cancer in cysts. We report a rare adult presentation of choledochal cyst with underlying abnormal pancreaticobiliary maljunction with gall bladder carcinoma.

INCIDENCE OF GALL BLADDER CARCINOMA: A RETROSPECTIVE CASE STUDY AT RIMS RANCHI

BACKGROUND: Gall bladder carcinoma is most common malignancy of the biliary tract and seventh most common gastrointestinal malignancy. Histologically most gall bladder carcinoma are pancreaticobiliary type adenocarcinoma, showing variable degrees of differentiation.The determination of the histology type of tumour and differential diagnosis from gall bladder adenocarcinoma are often difficult. It has unique significant and striking gender, geographic and ethnic variation in the incidence worldwide. MATERIAL AND METHOD: It is retrospective record based study, performed in department of Pathology RIMS, Ranchi. Study population included all cases who were operated for different pathology of gall bladder,with some common clinical presentations of upper right quadrant abdominal pain, jaundice, nausea and vomiting, from January 2018-December 2019. RESULT: Among the spectrum of gall bladder diseases most common finding was chronic cholecystitis, incidence of gall bladder carcinoma is a rare entity. In our present study female preponderance has been noted and mostly incidence is among the age group above 30 years.

Bilateral benign cystic teratoma of ovary concomitant with an occult gall bladder carcinoma in a post-menopausal woman

Mature cystic teratomas are the most common benign germ cell tumours, and commonly seen in the reproductive age group. It rarely occurs in postmenopausal women. We report a case of bilateral dermoid cyst with cholelithiasis and occult gall bladder carcinoma in a postmenopausal woman.

Mucinous Carcinoma of Gall Bladder – A Rare Case Report

Background: Mucinous carcinoma of the gall bladder is a very rare type of gall bladder carcinoma. It is characterized by production of extracellular mucin >50% of tumour volume. Case Report: We report a case of primary mucinous carcinoma of gall bladder in a 60-year-old female patient who was diagnosed clinically as acute cholecystitis. Histopathological examination gave the definitive diagnosis in this case. Conclusion: Mucinous carcinoma of gall bladder exhibit significant clinicopathological difference from conventional adenocarcinoma of gall bladder and display aggressive clinical behaviour. Key words: Mucinous Carcinoma, Gall Bladder, Primary.

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

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.

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.