Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.893
Filtrar
1.
Medicine (Baltimore) ; 99(5): e18920, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000402

RESUMO

The aim of this study was to compare the diagnostic yield of conventional cytology (CC) with ethanol-based fixation, a cytological analysis using an ethanol based fixative system including a cell block procedure (EBF) to evaluate indeterminate biliary strictures (IBStr). We also compared additionally taken fluorescence-guided forceps biopsies (FB) with EBF concerning a potential additive diagnostic benefit.Early detection and accurate diagnosis are crucial for patients with suspected carcinoma within the biliary tree to preserve curative treatment options but diagnostics and patient care in the evaluation of IBStr are still challenging. ERC-guided brush cytology is the gold standard of nonsurgical evaluation of IBStr. However, accuracy is generally low. New specimen processing's are needed to higher the diagnostic yield in the evaluation of IBStr.We performed a retrospective evaluation in 404 patients referred for further diagnosis of IBStr. Gold standard was defined as surgically obtained histology or patient follow-up of at least 1 year to diagnose or exclude malignancy.Three hundred thirty-four patients were included into the final analysis. One hundred seventy-two strictures were malignant, 162 strictures benign. One hundred seventeen specimens were evaluated by CC, 217 processed by EBF. EBF performed significantly better in terms of sensitivity (24.6% vs 60%, P < .001) and accuracy (59.0% vs 75.1%, P = .006). Fifty-eight FB were additionally taken and showed a numerically improved sensitivity compared to EBF alone (80% vs 62.9%, P = .19).EBF is a simple and inexpensive technique that substantially improved sensitivity and accuracy in the evaluation of IBStr. FB specimen did not significantly improve diagnostic yield.


Assuntos
Ductos Biliares/diagnóstico por imagem , Ductos Biliares/patologia , Colangiografia , Endoscopia do Sistema Digestório , Etanol , Fixadores , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Neoplasias dos Ductos Biliares/patologia , Biópsia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Óptica , Estudos Retrospectivos , Sensibilidade e Especificidade , Fixação de Tecidos
3.
Z Gastroenterol ; 58(2): 152-159, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31863426

RESUMO

Patients with indeterminate biliary stricture frequently pose a challenge in the clinical management. Patients with malignant and potentially resectable diseases should be treated surgically as soon as possible. On the other hand, in patients with benign diseases which might be cured with medial treatment, surgery should be avoided. This review shall provide a concise overview on the diagnostic yield of currently available endoscopic methods as well as describe methods of potential relevance in the future.


Assuntos
Ductos Biliares/patologia , Colangiopancreatografia Retrógrada Endoscópica , Colestase/terapia , Constrição Patológica , Colestase/etiologia , Drenagem , Humanos
4.
Indian J Pathol Microbiol ; 62(4): 602-604, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31611450

RESUMO

Myeloid sarcoma is an extra medullary manifestation of acute myeloid leukemia (AML). Primary involvement of the biliary tract with myeloid sarcoma presenting as obstructive jaundice without evidence of leukemia is very rare. Here we present a case of 72 year old lady, who initially presented with features of biliary obstruction and was clinically considered as cholangiocarcinoma. She was diagnosed as myeloid sarcoma involving right and left hepatic duct, common bile duct (CBD) on histopathological and immunohistochemistry (IHC) examination after surgical resection. Since she did not show evidence of leukemia on peripheral blood and bone marrow examination treatment was deferred. However, she developed full blown picture of AML within two months and succumbed to her disease. We conclude that obstructive jaundice can be the presenting symptom in myeloid sarcoma without evidence of AML in peripheral blood and bone marrow. However, these cases have to be treated aggressively to obtain remission.


Assuntos
Ductos Biliares/patologia , Icterícia Obstrutiva/diagnóstico , Sarcoma Mieloide/diagnóstico , Idoso , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Icterícia Obstrutiva/etiologia , Leucemia Mieloide Aguda/diagnóstico , Sarcoma Mieloide/complicações
5.
Zhonghua Bing Li Xue Za Zhi ; 48(10): 755-761, 2019 Oct 08.
Artigo em Chinês | MEDLINE | ID: mdl-31594038

RESUMO

Objective: To evaluate the diagnostic value of a histologic scoring system in congenital biliary atresia and its prognostic relevance. Methods: From January 2017 to June 2018 at Children's Hospital of Fudan University, 172 wedge liver biopsy specimens were obtained from infants with neonatal cholestasis [119 patients with congenital biliary atresia (CBA) and 53 patients with non-obstructive cholestasis as control]. A pathologist, single-blinded to the final diagnosis, made the histological diagnosis individually based on an 8-feature (portal ductal proliferation, bile duct reaction, bile plugs in portal ductules, liver fibrosis, edema in portal region, cholestasis, inflammatory cells infiltration in portal region, and ductal plate malformation), 21-point scoring system. Results: The main pathologic changes of biliary atresia were hepatocyte cholestasis, hyperplasia of bile ducts, fibrosis and infiltration of inflammatory cells in the portal area. There were significant difference in the degree of portal edema, bile duct hyperplasia and fibrosis between two groups (P<0.01). In addition, there were characteristic bile duct thrombosis in 97.5%(116/119) of the cases and abnormal development of bile duct plate in 9.2%(11/119) of the cases. Compared with non-CBA infant cholestasis group, the difference was statistically significant (P<0.05). The scoring system has high sensitivity, specificity (both 94.1%) and accuracy (94.3%) in the diagnosis of CBA. A score equal to or more than 11 points supported a diagnosis of CBA; whereas a score less than 11 points might suggest cholestasis. The degree of hepatic fibrosis and ductal plate malformation were related to prognosis. Conclusions: The liver pathology scoring system (8-feature, 21-point) is more accurate in diagnosing CBA than previous methods, which may guide the clinicopathological diagnosis. This histological scoring system also helps to assess the prognosis of CBA.


Assuntos
Atresia Biliar/diagnóstico , Fígado/patologia , Ductos Biliares/patologia , Colestase/diagnóstico , Humanos , Recém-Nascido , Prognóstico
6.
Arkh Patol ; 81(5): 22-29, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31626201

RESUMO

OBJECTIVE: To determine the morphological features of IgG4-related lesions and to improve pathomorphological criteria for diagnosing various clinical variants of IgG4-related disease. MATERIAL AND METHODS: Biopsy and surgical materials from 100 patients with tumor-like lesions at various sites (63 cases of IgG4-related lesion and 37 cases of non-IgG4-related inflammatory processes) were studied. Histological and immunohistochemical studies were conducted to determine the absolute counts of CD138+ cells, IgG+ and IgG4+ in the inflammatory infiltrates, as well as IgG4/IgG and IgG4/CD138 cell ratios. RESULTS: When IgG4-related disease manifested, pancreatic, lacrimal, and salivary gland lesions prevailed. Brisk lymphoplasmacytic infiltration is characteristic for tissue damage in the eye, salivary glands, thyroid, pancreas, and skin. The formation of moiré fibrosis was specific to damages to the pancreas, liver and bile ducts, and eye tissues. Obliterative phlebitis is most often observed in pancreatic and salivary gland lesions. According to international criteria, the frequency of achieving the required level of IgG4+ plasma cells in each organ was high in lesions of the pancreas, bile ducts, and lymph nodes and that was low in lesions of the salivary and lacrimal glands and skin. The IgG4+/CD138+ and IgG4+/IgG+ cell ratios exceeded 40% in all cases. CONCLUSION: The morphologic diagnosis of IgG4-related disease is based on the detection of lymphoplasmacytic infiltration, moiré fibrosis, and obliterative phlebitis, as well as on the calculation of the absolute number of IgG4+ plasma cells in the inflammatory infiltrate and on the determination of IgG4+/IgG+ and IgG4+/CD138+ cell ratios. The number of IgG4+ plasma cells depends on the location of the lesion and on the phase of the process.


Assuntos
Fibrose , Doença Relacionada a Imunoglobulina G4/patologia , Ductos Biliares/patologia , Biópsia , Humanos , Imunoglobulina G , Aparelho Lacrimal/patologia , Fígado/patologia , Pâncreas/patologia , Plasmócitos , Glândulas Salivares/patologia
7.
Int J Hyperthermia ; 36(1): 980-985, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31544547

RESUMO

Objective: This study aimed to evaluate the risk factors of biloma formation and secondary infection after thermal ablation for malignant hepatic tumors. Patients and methods: A total of 58 patients with 68 bilomas after thermal ablation were recruited as the complication group, and 61 patients with 72 lesions without major complications were selected randomly as the control group. The potential risk factors for biloma formation were analyzed with the chi-square test and multivariate logistic regression analysis. To determine the optimum management method for biloma, patients with secondary infection were included for the subgroup analysis of risk factors. Results: A history of transcatheter arterial chemoembolization (TACE) treatment (odds ratio [OR]: 3.606, 95% confidence interval [CI]: 1.165-11.156, p = .026) and tumor location (OR: 37.734, 95% CI: 13.058-109.034, p = .000) were independent predictors of biloma formation. Among the 58 patients with biloma, 49 (84.5%) showed no symptoms (i.e., the asymptomatic group), while the remaining 9 (15.5%) developed symptoms related to secondary infections (i.e., the symptomatic group). There were significant differences in the history of biliary manipulation (p = .031) between the symptomatic and asymptomatic groups. Conclusion: A history of TACE treatment and the distance from the biliary tract were independent predictors of biloma formation after thermal ablation. Therefore, protecting the bile duct (i.e., cooling of the bile duct and combing thermal ablation with chemical ablation) should be considered for high-risk patients. Moreover, active monitoring and management should be performed for patients with bilomas who underwent biliary surgery before.


Assuntos
Técnicas de Ablação/efeitos adversos , Ductos Biliares/patologia , Carcinoma Hepatocelular/complicações , Hipertermia Induzida/efeitos adversos , Neoplasias Hepáticas/complicações , Técnicas de Ablação/métodos , Carcinoma Hepatocelular/radioterapia , Feminino , Humanos , Hipertermia Induzida/métodos , Neoplasias Hepáticas/radioterapia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
8.
Cardiovasc Intervent Radiol ; 42(12): 1745-1750, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31493058

RESUMO

INTRODUCTION: Biliary duct injuries pose a significant management challenge due to the propensity for recurrent biliary strictures. Development of a modified Roux-en-Y hepaticojejunostomy known as a Hutson-Russell Pouch (HRP) provides a point of entry for repetitive access to the biliary tree. We aim to highlight the effectiveness of using the HRP as an access point for the long-term management of anastomotic and distal biliary strictures, thereby showcasing the value in potential widespread adoption of this modification to a standard surgical procedure. MATERIALS AND METHODS: IRB-approved retrospective study of 36 patients (10 M, 26 F; mean age 55.19 ± 13.94; 15-83) underwent a total of 110 transjejunal cholangiograms. Indications for cholangiogram included cholangitis (n = 38), surveillance (n = 36), and elevated liver enzymes (n = 36). Technical success was defined by the ability to access and intervene in the biliary tree via HRP access. In case of stenosis, the ability to successfully dilate (< 30%) residual stenosis was considered a technically successful procedure. Clinical success was defined by normalization of the liver function tests or resolution of cholangitis. RESULTS: Technical success was achieved in 83/110 (75.45%) of the cases, and clinical success was achieved in 102/110 (98.2%). Transhepatic access was needed in 27/110 (24.5%) of the cases. Interventions performed included balloon cholangioplasty in 104/110 (94.5%), biliary stone removal in 2/110 (1.8%), biliary stent placement in 2/110 (1.8%), and biliary drain placement in 4/110 (3.6%). There were a total of 9/110 complications (8.2%). CONCLUSION: The HRP was an effective access point in the management of recurrent benign biliary strictures in this cohort.


Assuntos
Anastomose em-Y de Roux/métodos , Doenças dos Ductos Biliares/patologia , Doenças dos Ductos Biliares/cirurgia , Colangiografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças dos Ductos Biliares/diagnóstico por imagem , Ductos Biliares/diagnóstico por imagem , Ductos Biliares/patologia , Ductos Biliares/cirurgia , Estudos de Coortes , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Adulto Jovem
9.
Int J Mol Sci ; 20(16)2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31416247

RESUMO

In modern hepatology, diseases of the biliary epithelium, currently termed cholangiopathies, represent one of the main gaps in knowledge, both on experimental and clinical grounds, though they started to draw attention since the late 80s [...].


Assuntos
Doenças Biliares/etiologia , Doenças Biliares/metabolismo , Comunicação Celular , Suscetibilidade a Doenças , Animais , Ductos Biliares/metabolismo , Ductos Biliares/patologia , Doenças Biliares/diagnóstico , Humanos , Fígado/metabolismo , Fígado/patologia , Regeneração Hepática , Cicatrização
11.
Zhonghua Gan Zang Bing Za Zhi ; 27(5): 321-324, 2019 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-31177654

RESUMO

Intrahepatic cholestasis is a pathological condition in which the synthesis, secretion, and excretion of bile are blocked, and thus the bile does not flow normally into the duodenum and bloodstream. According to cytological damage site, it can be divided into hepatocellular cholestasis, biliary duct cell cholestasis and mixed cell cholestasis. The two kinds of pathophysiological models [ascending or upstream (damage begins with cholangiocytes and then extends to the hepatocytes) and descending or downstream (the damage starts from the liver cells and then extends to the bile duct cells)] has distinct features in the process of disease occurrence and development. This article mainly elaborates the "descending" pathophysiological model of cholestatic liver disease (hepatocytic damage progresses to biliary duct cell), and further explores its etiology, pathogenesis and treatment methods.


Assuntos
Colestase Extra-Hepática/fisiopatologia , Colestase Intra-Hepática/fisiopatologia , Colestase/etiologia , Colestase/patologia , Bile , Ácidos e Sais Biliares , Ductos Biliares/patologia , Humanos
12.
Acta Cir Bras ; 34(5): e201900504, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31166460

RESUMO

PURPOSE: To establish a new rat model, the pathogenesis of which is closer to the clinical occurrence of chronic obstructive jaundice with liver fibrosis. METHODS: 90 SD rats were randomly divided into 3 groups. Group A common bile duct ligation, group B common bile duct injection compont and group C injection saline. The serum of three groups was extracted, and the liver function was detected by ELISA. HE staining, Masson staining and immunohistochemistry were used to detect liver pathology. RESULTS: Group B showed a fluctuant development of jaundice, obstructive degree reached a peak at 2 weeks, and decreased from 3 weeks. HA, LA and PCIII were significantly higher than control group. 3 weeks after surgery, liver tissue fibrosis occurred in group B, and a wide range of fiber spacing was formed at 5 weeks. Immunohistochemistry showed that hepatic stellate cells were more active than the control group. CONCLUSION: Intra-biliary injection of Compont gel is different from the classic obstructive jaundice animal model caused by classic bile duct ligation, which can provide an ideal rat model of chronic obstructive jaundice with liver fibrosis.


Assuntos
Ductos Biliares/efeitos dos fármacos , Modelos Animais de Doenças , Géis/administração & dosagem , Icterícia Obstrutiva/induzido quimicamente , Cirrose Hepática/induzido quimicamente , Fosfatase Alcalina/sangue , Animais , Aspartato Aminotransferases/sangue , Compostos Azo , Ductos Biliares/patologia , Bilirrubina/análise , Ensaio de Imunoadsorção Enzimática , Amarelo de Eosina-(YS) , Feminino , Imuno-Histoquímica , Injeções , Icterícia Obstrutiva/patologia , Cirrose Hepática/patologia , Verde de Metila , Distribuição Aleatória , Ratos Sprague-Dawley , Valores de Referência , Reprodutibilidade dos Testes , Albumina Sérica/análise , Fatores de Tempo , gama-Glutamiltransferase/sangue
13.
Transplant Proc ; 51(5): 1545-1548, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31155189

RESUMO

The deep peribiliary glands (DPBG) are a niche of progenitor cells in the wall of the biliary duct (BD) and are the second line of multiplication when severe lesion of the epithelium occurs. Previous studies have identified DPBG injury as a cause of post-liver transplant (LT) biliary stenosis; this complication is a major cause of post-LT morbidity. The incidence of biliary stenosis in our center is high (38.1%). This study evaluates the lesion of DPBG in response to ischemia. Graft BD was collected in adult LT between August 2016-July 2017, from donation after brain death. Samples of 45 grafts were collected at 2 moments: BD1-during graft preparation and BD2-before biliary anastomosis. Histological analysis of the samples was performed and then classified according to degree of lesion (0, ≤50%, and >50%). A comparison was made between the degree of lesion and graft ischemia, graft histology, donor, and procurement variables. The DPBG lesion was more frequent in BD2 (20.9% vs 7%, P = .079). BD2 lesions with DPBG lesions had higher medians and means at all times of ischemia. The difference was greater in the warm ischemia time (0: 43.3 ± 12.53 minutes vs ≤50%: 52.4 ± 14.38 minutes, P = .068). The group of BD1 with DPBG lesion presented superior median cold ischemia time (CIT). In the analysis of the remaining variables there were also no statistically significant differences. We concluded that during the period of CIT there is already lesion of the DPBG, which increases after reperfusion of the graft, in greater association with longer warm ischemia time.


Assuntos
Ductos Biliares/patologia , Isquemia Fria/efeitos adversos , Transplante de Fígado , Isquemia Quente/efeitos adversos , Adulto , Feminino , Humanos , Isquemia/patologia , Transplante de Fígado/efeitos adversos , Transplante de Fígado/métodos , Masculino , Estudos Prospectivos , Reperfusão/efeitos adversos
14.
Biomed Pharmacother ; 116: 109034, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31152924

RESUMO

BACKGROUND: Our previous study found that insulin-like growth factor binding protein-associated protein (IGFBPrP1) drives hepatic stellate cells (HSCs) activation, and IGFBPrP1 and transforming growth factor ß1 (TGFß1) likely interact with each other to promote HSCs activation. TGFß1 reportedly promotes autophagy and contributes to HSCs activation; however, the mechanism between IGFBPrP1 and autophagy in liver fibrogenesis is yet unknown. Moreover, long noncoding RNA (lncRNA) H19 participates in autophagy regulation and plays a crucial function in liver fibrosis. AIMS: To define the relationship between IGFBPrP1 and autophagy and the role of H19 in IGFBPrP1-induced hepatic fibrosis. METHODS: IGFBPrP1 and autophagy were detected in bile duct ligation (BDL)-induced hepatic fibrosis. Adenovirus-mediated IGFBPrP1 was transfected into mouse liver and JS-1 cells with or without LY294002 or rapamycin to examine the effects of IGFBPrP1 on HSCs activation and autophagy as well as the PI3K/AKT/mTOR pathway. lncRNA H19 in liver fibrosis tissues and JS-1 cells induced by IGFBPrP1 were detected, then autophagy and HSCs activation level were detected in JS-1 cells by IGFBPrP1 with H19 overexpression or knowdown. RESULTS: IGFBPrP1 expression and autophagy level were concomitantly increased in liver tissue with BDL-induced hepatic fibrosis. Furthermore, we found that IGFBPrP1 stimulated autophagy and HSCs activation in vivo and in vitro, and PI3K/AKT/mTOR signaling pathway was involved in the regulation of autophagy by IGFBPrP1. In addition, H19 promoted autophagy by interacting with the PI3K/AKT/mTOR pathway in IGFBPrP1-induced HSCs activation. CONCLUSIONS: IGFBPrP1 promoted autophagy and contributed to HSCs activation via mutual regulation between H19 and the PI3K/AKT/mTOR pathway.


Assuntos
Autofagia , Células Estreladas do Fígado/metabolismo , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , RNA Longo não Codificante/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Animais , Ductos Biliares/patologia , Linhagem Celular , Fígado Gorduroso/patologia , Células Estreladas do Fígado/patologia , Células Estreladas do Fígado/ultraestrutura , Ligadura , Fígado/patologia , Masculino , Camundongos Endogâmicos C57BL
15.
Intern Med ; 58(17): 2523-2527, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31178502

RESUMO

The characteristic finding of sausage-shaped pancreas or capsule-like rim facilitates the diagnosis of autoimmune pancreatitis. We herein report a case of a 67-year-old man showing a sausage-shaped, enlarged pancreas with a capsule-like rim on computed tomography. Furthermore, endoscopic retrograde cholangiopancreatography demonstrated diffuse narrowing of the main pancreatic duct, in addition to stenosis of the lower bile duct. Finally, we were able to diagnose pancreatic cancer in this patient by an endoscopic ultrasound-guided fine-needle aspiration biopsy following peroral cholangioscopy and bile cytology. This report emphasizes the significance of pathological confirmation before starting treatment, even in cases with diffuse pancreatic enlargement.


Assuntos
Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Doenças Autoimunes/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Pancreatite/diagnóstico , Idoso , Doenças Autoimunes/imunologia , Ductos Biliares/patologia , Colangiopancreatografia Retrógrada Endoscópica , Constrição Patológica , Diagnóstico Diferencial , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Humanos , Masculino , Pâncreas/patologia , Ductos Pancreáticos/patologia , Tomografia Computadorizada por Raios X
16.
PLoS Pathog ; 15(5): e1007818, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31121000

RESUMO

Clonorchis sinensis is a carcinogenic human liver fluke, prolonged infection which provokes chronic inflammation, epithelial hyperplasia, periductal fibrosis, and even cholangiocarcinoma (CCA). These effects are driven by direct physical damage caused by the worms, as well as chemical irritation from their excretory-secretory products (ESPs) in the bile duct and surrounding liver tissues. We investigated the C. sinensis ESP-mediated malignant features of CCA cells (HuCCT1) in a three-dimensional microfluidic culture model that mimics an in vitro tumor microenvironment. This system consisted of a type I collagen extracellular matrix, applied ESPs, GFP-labeled HuCCT1 cells and quiescent biliary ductal plates formed by normal cholangiocytes (H69 cells). HuCCT1 cells were attracted by a gradient of ESPs in a concentration-dependent manner and migrated in the direction of the ESPs. Meanwhile, single cell invasion by HuCCT1 cells increased independently of the direction of the ESP gradient. ESP treatment resulted in elevated secretion of interleukin-6 (IL-6) and transforming growth factor-beta1 (TGF-ß1) by H69 cells and a cadherin switch (decrease in E-cadherin/increase in N-cadherin expression) in HuCCT1 cells, indicating an increase in epithelial-mesenchymal transition-like changes by HuCCT1 cells. Our findings suggest that C. sinensis ESPs promote the progression of CCA in a tumor microenvironment via the interaction between normal cholangiocytes and CCA cells. These observations broaden our understanding of the progression of CCA caused by liver fluke infection and suggest a new approach for the development of chemotherapeutic for this infectious cancer.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Ductos Biliares/patologia , Colangiocarcinoma/patologia , Clonorquíase/metabolismo , Clonorchis sinensis/patogenicidade , Proteínas de Helminto/toxicidade , Animais , Neoplasias dos Ductos Biliares/metabolismo , Neoplasias dos Ductos Biliares/parasitologia , Ductos Biliares/metabolismo , Ductos Biliares/parasitologia , Técnicas de Cultura de Células , Células Cultivadas , Colangiocarcinoma/metabolismo , Colangiocarcinoma/parasitologia , Clonorquíase/parasitologia , Técnicas de Cocultura , Proteínas de Helminto/metabolismo , Humanos , Masculino , Coelhos , Células Tumorais Cultivadas
17.
Int J Mol Med ; 44(1): 79-88, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31115490

RESUMO

In hepatolithiasis, chronic proliferative cholangitis (CPC), an active and longstanding inflammation of stone­containing bile ducts with enhanced mucin­producing activity, not only affects the progression of the disease, it can also induce biliary carcinogenesis. The present study aimed to examine the effect of the epidermal growth factor receptor (EGFR) monoclonal antibody panitumumab (Pani) on CPC. Following the establishment of CPC rat models, periodic acid Schiff staining was used to observe the positive rate of EGFR expression. The expression levels of EGFR, mucin 5AC (MUC5AC), Ki­67, type I collagen and mammalian target of rapamycin (mTOR), and the activity of ß­glucuronidase (ß­G), were measured. The rats treated with Pani demonstrated a significantly lower degree of hyperproliferation of the epithelium and submucosal glands of the bile duct and collagen fibers of the bile duct wall, a significantly decreased positive rate of EGFR, reduced phosphorylation of mTOR, decreased expression of EGFR, MUC5AC, Ki­67 and type I collagen, and reduced ß­G activity. The therapeutic effects in rats treated with 4 and 6 mg/kg of Pani were more marked than those in rats treated with 2 mg/kg of Pani. Collectively, the data obtained in the present study suggest that the EGFR monoclonal antibody Pani can effectively inhibit the excessive proliferation and stone­forming potential of bile duct mucosa in CPC with a receptor saturation effect. Therefore, Pani offers promise as a treatment for the prevention and control of intrahepatic choledocholithiasis caused by CPC.


Assuntos
Ductos Biliares/metabolismo , Proliferação de Células/efeitos dos fármacos , Colangite/tratamento farmacológico , Regulação para Baixo/efeitos dos fármacos , Receptores ErbB/biossíntese , Panitumumabe/farmacologia , Animais , Ductos Biliares/patologia , Colangite/metabolismo , Colangite/patologia , Doença Crônica , Masculino , Ratos , Ratos Sprague-Dawley
19.
Am J Forensic Med Pathol ; 40(3): 285-288, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31033491

RESUMO

Methamphetamine is a central nervous system stimulant that induces arousal, a positive mood, cardiac stimulation, and an acute improvement in cognitive domains. Its illicit exploitation is rapidly growing in North America. Typically, extended use of the drug induces organ damage via vasoconstriction and subsequent ischemia. This case specifically discusses hepatic and pancreatic pathology resulting from methamphetamine overdose alongside an unusual discovery of globally necrotic von Meyenburg complexes.


Assuntos
Estimulantes do Sistema Nervoso Central/efeitos adversos , Isquemia/induzido quimicamente , Fígado/irrigação sanguínea , Metanfetamina/efeitos adversos , Pâncreas/irrigação sanguínea , Adulto , Transtornos Relacionados ao Uso de Anfetaminas/complicações , Ductos Biliares/patologia , Overdose de Drogas , Hamartoma/induzido quimicamente , Hamartoma/patologia , Hepatócitos/patologia , Humanos , Isquemia/patologia , Fígado/patologia , Masculino , Necrose , Pâncreas/patologia , Pancreatite/induzido quimicamente , Pancreatite/patologia
20.
Medicine (Baltimore) ; 98(17): e15364, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027122

RESUMO

There is no specific method for the preoperative diagnosis of atypical bile duct hyperplasia, which is a precursor of cholangiocarcinoma. This study aimed to create a new model for diagnosing atypical bile duct hyperplasia based on routine laboratory tests in patients with intrahepatic lithiasis.The new diagnostic model was developed with a derivation cohort that included 375 patients with intrahepatic lithiasis. Clinical and pathological data were retrospectively collected. Prognostic factors were evaluated with univariate and logistic regression analyses. The validation cohort included 136 patients who were retrospectively screened to quantify the model's predictive value.Age and Carbohydrate Antigen 19-9 (CA-199) were revealed to be diagnostic indicators of atypical bile duct hyperplasia in patients with intrahepatic lithiasis. The new diagnostic model was created with the formula: -6.612 + (0.002 × CA-199) + (0.072 × Age). The area under the receiver operating curve of the model was 0.721. With 0.25 as the cutoff point, the sensitivity and specificity of this model in the derivation cohort were 13.9% and 95.9%, respectively. In the validation cohort, these values were 28.5% and 88.7%, respectively. The novel model has an acceptable and stable ability to predict atypical hyperplasia in the intrahepatic bile duct.This novel model provides a simple system for diagnosing atypical bile duct hyperplasia before surgery in patients with intrahepatic lithiasis.


Assuntos
Doenças dos Ductos Biliares/diagnóstico , Ductos Biliares/patologia , Cálculos Biliares/complicações , Lesões Pré-Cancerosas/diagnóstico , Doenças dos Ductos Biliares/complicações , Doenças dos Ductos Biliares/patologia , Doenças dos Ductos Biliares/cirurgia , Feminino , Cálculos Biliares/diagnóstico , Cálculos Biliares/patologia , Cálculos Biliares/cirurgia , Humanos , Hiperplasia/diagnóstico , Litíase/complicações , Litíase/diagnóstico , Litíase/patologia , Litíase/cirurgia , Fígado , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Lesões Pré-Cancerosas/complicações , Lesões Pré-Cancerosas/patologia , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA