Gene expression profiling reveals upregulated FUT1 and MYBPC1 in children with pancreaticobiliary maljunction

Pancreaticobiliary maljunction (PBM) is associated with high risk of epithelial atypical growth and malignant transformation of the bile duct or gallbladder. However, overall changes in genetic expression have not been examined in children with PBM. Genome-wide expression was analyzed using peripheral blood samples from 10 children with PBM and 15 pediatric controls. Differentially expressed genes (DEGs) were identified using microarray. Bioinformatics analysis was conducted using Gene Ontology and KEGG analyses. The top 5 in the up-regulated genes in PBM were verified with qRT-PCR. Receiver operator characteristic curve analysis was conducted to evaluate the predictive accuracy of selected genes for PBM. The microarray experiments identified a total of 876 DEGs in PBM, among which 530 were up-regulated and the remaining 346 were down-regulated. Verification of the top 5 up-regulated genes (TYMS, MYBPC1, FUT1, XAGE2, and GREB1L) by qRT-PCR confirmed the up-regulation of MYBPC1 and FUT1. Receiver operating characteristic curve analysis suggested that FUT1 and MYBPC1 up-regulation could be used to predict PBM, with the area under the curve of 0.873 (95%CI=0.735−1.000) and 0.960 (95%CI=0.891−1.000), respectively. FUT1 and MYBPC1 were up-regulated in children with PBM, and could be used as potential biomarkers for PBM.

Cholangiocarcinoma arising in von Meyenburg complexes / 대한간학회지

No abstract available.

Expressions and Clinical Significances of c-met, c-erbB-2, COX-2, and IL-6 in the Biliary Tract Cancers / 대한소화기학회지

BACKGROUND/AIMS: c-met, c-erbB-2, interleukin (IL)-6, and cyclooxygenase (COX)-2 expressions are considered to be implicated in the carcinogenesis and progression of cholangiocarcinoma, but the molecular pathogenesis of cholangiocarcinoma is still poorly understood. We aimed to analyze the expressions of each marker and their relationships with clinicopathologic factors. METHODS: One hundred and fourteen tissue samples were obtained from surgically resected specimens from patients with billiary tract cancer. The expressions of c-met, c-erbB-2, COX-2, and IL-6 were examined by immunohistochemically. The expression of each marker and correlations between these markers and clinicopathologic factors were analyzed. RESULTS: The expression rates of each maker were as follows: c-met 34/112 (30.4%), c-erbB-2 5/112 (4.5%), COX-2 53/113 (46.9%), and IL-6 68/113 (60.2%), respectively. c-met expression was more frequently observed in cases with invasion through the adjacent connective tissues (p=0.0263). IL-6 overexpression was more frequently observed in cases with absent lymph node metastasis (p=0.0325). Either c-erbB-2 expression or COX-2 expression was significantly associated with lymph node metastasis (p=0.0442). CONCLUSIONS: The expression of c-met was closely related to the invasiveness of cholangiocarcinoma. Co-expression of c-met, COX-2 and, IL-6 showed a significant correlation with invasiveness and lymph node metastasis and these could be useful marker to guide clinical outcome in patients with cholangiocarcinoma.

Management of hilar malignant biliary strictures

To determine the etiology of Hilar malignant biliary strictures and the efficacy of hepaticojejunostomy in it's management with or without segmental liver resection. A retrospective study of 33 patients was carried out at Civil Hospital and Lyari General Hospital Karachi. They presented with signs and symptoms of mechanical cholestasis. Study was conducted to find the etiology, level of obstruction and the extent of the disease together with approaches to either cure the disease or to relieve the symptoms. Curative resection was attempted where possible in all 33 patients but decision of curative resection or palliative bypass with or without liver resection was made per operatively after accessing the level of obstruction and extent of local, parenchymal or vascular infiltration. Of the 33 patients studied, 72.73% [n=24] had cholangiocarcinoma and 27.27% [n=9] had gall bladder Ca with local bile duct extension. Four different sites of biliary tree [i] common hepatic duct [CHD], [ii] confluence of common hepatic duct [CCHD], [iii] right and left hepatic duct [R and LHD] separately, and [iv] left hepatic duct [LHD] were anastamosed with jejunum. Normal liver functions with complete relieve from symptoms was achieved where CHD or CCHD was anastamosed whereas only a significant decrease was observed when R and LHD and only LHD were anastamosed with jejunum. Surgical resection of the tumor together with biliary decompression using different approaches of hepaticojejunostomy is an effective way of managing malignant Hilar bile duct obstruction as well as significantly decreasing the severity of symptoms in irresectable tumours

Riesgo de neoplasia en adultos con quiste de colédoco / Risk of neoplasia in adults due to choledochal cyst

Objetivo: describir la presentación clínica del quiste de colédoco en un paciente adulto y revisar la literatura respecto al riesgo de malignidad que se asocia a esta patología. Caso clínico: mujer de 50 años de edad con quiste de colédoco y antecedente familiar de cáncer en vías biliares. Biometría hemática y pruebas de función hepática normales. Por ultrasonografía se observó vesícula biliar alitiásica, con un pólipo en su interior y colédoco de 27 mm de diámetro en su porción distal. Colangiográficamente se corroboró quiste de colédoco tipo I. Se realizó colecistectomía con excisión completa del quiste y anastomosis hepático-duodeno. El análisis histopatológico demostró vesícula alitiásica, sin pólipos ni datos de malignidad. A dos años de la cirugía la paciente sólo ha sufrido un cuadro de colangitis, que se resolvió médicamente. Discusión: el promedio de edad para presentación del quiste de colédoco es de 34 años y el riesgo de malignidad se incrementa con la edad: 0.7 por ciento en pacientes menores de 10 años; 6.8 por ciento, de 11 a 20 años, y 14.3 por ciento, en mayores de 20 años. La incidencia de neoplasia en enfermos con quiste de colédoco es de 23 a 39.4 por ciento, mientras que en la población general es de 0.003 a 0.004 por ciento. Conclusión: el paciente adulto con quiste de colédoco tiene elevado riesgo para presentar cáncer de vías biliares. En este caso el tratamiento de elección es la excisión total del quiste y debe mantenerse seguimiento estrecho a largo plazo porque existe la posibilidad de neoplasia metacrónica

Traumatic neuroma as a cause of obstructive jaundice.

A 70-year-old man with previous cholecystectomy developed progressive obstructive jaundice, 3 months before hospitalization. Intraoperatively, a 2 x 2 x 1.5-cm mass in the distal part of the right hepatic duct was excised to release complete obstruction. It was verified as traumatic (amputation) neuroma. Despite rarity, traumatic neuroma of the bile duct should be considered in patients who have antecedent surgical procedure of the biliary tract with subsequent occurrence of extrahepatic biliary obstruction.

alpha 1-antitrypsin phenotype PiMZ, a risk factor for liver cirrhosis but not for liver cancers in Thailand.

The risk of developing liver cirrhosis, hepatoma (HCC) and bile duct carcinoma (BDC) have been associated with homozygous alpha 1-antitrypsin (AT) deficiency especially linked to the Z allele. While the association between liver cancers and AT deficiency remains debatable, the risk of adult AT deficiency carriers to develop liver cirrhosis has not been assessed quantitatively. Liver cancers and liver diseases with subsequent liver cirrhosis are highly prevalent in tropical countries such as Thailand and heterozygous AT phenotypes are rather common in this country as well. The aim of this study was to assess the risk of developing liver cirrhosis, HCC and BDC by means of case-control studies with Thai patients and controls in connection with AT deficiency. For hepatitis, HCC and BDC to association with AT deficiency was detected. Carriers of PiMZ phenotype in Thailand have a high risk to develop liver cirrhosis (odds. ratio of 10.8, 95% confidence interval = 1.3-88.1). Patients with predisposing diseases should be screened for Pi phenotypes so that rigorous measures to combat the occurrence of liver cirrhosis can be implemented.

role of typhoid carrier state in the aetiopathology of hepatobiliary carcinoma in Egypt

The relationship between typhoid infection, typhoid carrier state and hepatobiliary cancer was pointed out worldwide, in New York, Norway, California and in Egypt. In Egypt, typhoid is an endemic problem. This work included 100 patients with hepatobiliary carcinoma [60 with hepatocellular carcinoma, 35 with cholangiocarcinoma, 5 with cancer gall-bladder]. 100 healthy individuals were also studied as a control group [selected to match the diseased group]. Screening for typhoid carrier state was done by bacteriological stool cultures for patients with hepatocellular carcinoma and bile cultures for patients with cholangiocarcinoma and gallbladder cancer. Serological Vi [Virulence] antibodies detection was done for all cases including the healthy matched control group [which was the only method of detection]. The overall percentage of typhoid carrier state among 100 patients with hepatobiliary cancer was 13%. In the first group of patients [60 patients with hepatocellular carcinoma], 5 cases were positive [only 1 of them was +ve for HBsAg] [8.4%], while in the second group [40 patients with cholangiocarcinoma and cancer gall- bladder] there were 8 +ves [20%]. In the control group, there was only one +ve case among 100 healthy individuals, detected by serological examination. The explanation of such association/complication was correlated to obstruction and stasis. It is attributed to prolonged and repeated use of chloramphenicol which got an immunosuppressive action. Eradicating typhoid carriers, probably by using a 3-day course of ceftriaxone [proved superior to a 14-day oral therapy with chloramphenicol] can be considered as a step in omitting a precancerous lesion in the hepatobiliary tree which is on the rise among Egyptians