Effect Observation of Clinical Treatment with Oxaliplatin and Tiggio for Biliary Tract Tumors on Advanced Stage

Objective: To investigate the effect of oxaliplatin combined with tiggio in the treatment of advanced biliary tract tumors. Methods: The research period was from November 2019 to November 2020. 80 patients with advanced biliary tumor disease were enrolled. They were divided into groups according to the order of admission, with 40 cases in each group. The control group received oxaliplatin combined with gemcitabine, and the experimental group received oxaliplatin combined with tiggio. Incidence of adverse reactions, time to disease progression, survival time and clinical efficacy were checked and assessed. Results: Compared with the incidence of adverse reaction of the experimental group, which was 5.00% (2/40), the incidence of adverse reaction of the control group was 25.00% (10/40). The chi-square value = 6.2745, p-value = 0.0122. The time to progression and survival time of patients in the experimental group were shorter than those of the control group, with significant differences between the groups (p<0.05); the clinical efficacy of the experimental group and the control group were 97.50% (39/40) and 77.50% (31/ 40) respectively, the comparative chi-square value = 7.3143, p-value = 0.0068. Conclusion: The combined treatment of oxaliplatin and Tiggio in the treatment of advanced biliary tract tumors has higher safety and reduces the incidence of adverse reactions.

Circular RNA Circ0021205 Promotes Cholangiocarcinoma Progression Through MiR-204-5p/RAB22A Axis

Cholangiocarcinomas (CCA) are biliary tract tumors that are often challenging to diagnosis and treatment. Accumulated evidence reveals that circular RNAs (circRNAs) are involved in multiple cancer progression. However, the function of circRNAs in cholangiocarcinoma remains largely unclear. In this study, we found that circ_0021205 expression was up-regulated in CCA and positively correlated with tumor size and TNM stage. To further explore the role of circ_0021205 in CCA, cell functional assays were performed. The results showed that circ_0021205 promoted the proliferation, migration, and invasion of CCA cells. In vivo experiments showed that circ_0021205 inhibition reduced tumorigenesis in mice. In addition, mechanisms investigation demonstrated that circ_0021205 exerts its oncogenic function by sponging miR-204-5p to regulate the expression of RAB22A. Overall, this study revealed that circ_0021205 might serve as a potential diagnostic biomarker or therapeutic target for CCA.

Tenascin-W Is a Novel Stromal Marker in Biliary Tract Cancers

Extrahepatic cancers of the biliary system are typically asymptomatic until after metastasis, which contributes to their poor prognosis. Here we examined intrahepatic cholangiocarcinomas (n = 8), carcinomas of perihilar bile ducts (n = 7), carcinomas of the gallbladder (n = 11) and hepatic metastasis from carcinomas of the gallbladder (n = 4) for the expression of the extracellular matrix glycoproteins tenascin-C and tenascin-W. Anti-tenascin-C and anti-tenascin-W immunoreactivity was found in all biliary tract tumors examined. Unlike tenascin-C, tenascin-W was not detected in normal hepatobiliary tissue. Tenascin-W was also expressed by the cholangiocarcinoma-derived cell line Huh-28. However, co-culture of Huh-28 cells with immortalized bone marrow-derived stromal cells was necessary for the formation and organization of tenascin-W fibrils in vitro. Our results indicate that tenascin-W may be a novel marker of hepatobiliary tumor stroma, and its absence from many normal tissues suggests that it may be a potential target for biotherapies.

Ultrasonography (USG) diagnostic test compared to magnetic resonance cholangio pancreatografy (MRCP) in patients with obstructive jaundice in Dr. Moewardi Public Hospital

Background: Ultrasonography (USG) is still the first imaging modality for initial examination in patients with obstructive jaundice. Abdominal ultrasonography is quite good in seeing the morphology of the biliary tract, although the diagnostic etiological sensitivity of various causes of obstruction is very low. Magnetic resonance cholangio pancreatography (MRCP) is a new technique and can show the same picture as ERCP examination and no contrast media is needed. Aim: Aim for this study is knowing the results of ultrasound diagnostic tests in detecting Obstruction jaundice which was confirmed by the results of MRCP examination at Dr. Moewardi public hospital. Method: This study uses a diagnostic test that assesses sensitivity, big specifications, negative predictive value and positive predictive value of ultrasound in detecting jaundice obstruction confirmed by the results of the MRCP examination. Sampling was done by purposive sampling, on 68 research subjects. Results: This study show the characteristics of jaundice in the form of stones with sensitivity and specificity values ​​of 84% and 83%, positive predictive value 75% and negative predictive value 90% and in biliary tract tumors 83% and 84%, positive predictive value 75% and predictive value negative 90%. Conclusions: Ultrasound has a high sensitivity and specificity value in diagnosing obstructive jaundice in the case of biliary tract stones and biliary tract tumors

The alteration of TERT in 10,000 Chinese patients with solid tumors.

e13655 Background: The reactivation of telomerase reverse transcriptase ( TERT) is one of the characters that make cancer cells immortal. TERT expression has been shown in various human cancers.However, the landscape of TERT alterations in Chinese patients with solid tumors still remains unclear. Here, we illustrated the profile of TERT variations of Chinese solid tumor patients by using next generation sequencing (NGS)-based targeted sequencing. Methods: Formalin fixed, paraffin embedded (FFPE) tumor tissues and matching blood samples were collected from 9874 Chinese patients and subjected to a NGS-based panel at a College of American Pathologists (CAP) accredited and Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. All classes of alterations were assessed. Results: FFPE samples from 9874 Chinese solid tumor patients included lung cancers (39.7%), liver cancers (12.5%), colorectal cancers (10.8%), gastric cancers (5.7%), pancreatic cancers (4.9%), biliary tract tumors (4.6%), and other 18 cancer types (21.7%) were assessed. And 1187 (12.0%) out of 9874 cancer samples had TERT variations. TERT variations occurred in all types of cancer with various frequencies: urothelial neoplasms (52.0%), central nervous system tumors (40.0%), melanomas (38.9%), liver cancers (30.7%), thyroid tumors (24.3%), cervical cancers (20.6%), biliary tract tumors (16.3%), head and neck tumors (14.6%), soft tissue tumors (12.2%) and lung cancers (10.3%). Substitution was the most common variation of TERT and accounted for 58.7% of all the alterations, followed by gene amplification (38.8%) and fusions (2.4%). There were 86.8% of substitution variations presented in TERT promoter region comprising of c.-124C > T (70.7%) and c.-146C > T (13.1%). Patients with TERT alterations included 414 females and 773 males with a median age of 59 years old (range: 8-88). Tumors included stage IV (34.0%), stage III (22.2%), stage II (12.7%), stage I (18.7%) and stage 0 (12.3%). TERT variations were correlated with patients’ age (p = 0.00083) and gender (p = 5.59×10−7). There was no significant correlation of TERT alterations with the highly mutated TP53. The frequencies of TERT alterations were similar in patients with mutated and wild type TP53 (12.7% vs 11.1%). Conclusions: Our study revealed that 12.0% Chinese solid tumor patients harbored TERT alterations, especially two hotspots mutations (c.-124C > T and c.-146C > T) in the promoter region. TERT variations had a correlation with patients’ age and gender, but no correlation with hotspot TP53 mutations.

Follicular Cholecystitis: Reappraisal of Incidence, Definition, and Clinicopathologic Associations in an Analysis of 2550 Cholecystectomies

Context. Follicular cholecystitis (FC) is a poorly characterized entity. Objective. To determine its frequency/clinicopathologic associations. Design. A total of 2550 cholecystectomy specimens were examined. Two hundred three of these were consecutive routine cholecystectomies submitted entirely for microscopic examination to determine the relative frequency of incidental pathologies in gallbladders (GBs). The remainder had representative sampling. Underlying conditions were nonobstructive pathologies (1270 nonspecific cholecystitis), obstructive (62 distal biliary tract tumors, 35 primary sclerosing cholangitis, and 31 autoimmune pancreatitis), and neoplastic (n = 949). FC was defined as 3 distinct lymphoid follicles (LFs)/centimeter. Results. In the GBs totally submitted for microscopic examination, the true frequency of FC was found to be 2.5% (5/203), and in the representatively sampled group, it was 1.9%, with similar frequencies in nonobstructive, obstructive, and neoplastic cases (2.3%, 3.1%, and 1.3%, respectively, P = .77). When the 39 FC in nonneoplastic GBs contrasted with ordinary chronic cholecystitis, they were associated with older age (68 vs 49 years, P < .0001), similar gallstone frequency (68 vs 81%), female/male ratio (2.7 vs 2.6), and wall thickness (4 mm for both). None had lymphoma/parasites/ Salmonella infection. Of 17 cases who had undergone gastric biopsy, 5 had chronic gastritis (2 with Helicobacter pylori). Microscopically, the LFs were the main inflammatory process often with minimal intervening inflammation. IgG4-positive plasma cell density was low (<10/high-power field) in 21/24(87.5%) cases. Conclusions. Follicular cholecystitis is seen in 2% of cholecystectomies, typically in significantly older patients, suggesting a deranged immune response. A third of the patients reveal biopsy-proven gastritis. FC does not seem to be associated with autoimmunity, lymphoma, or obstructive pathologies.