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Metaplasia, dysplasia and carcinoma sequence in gallbladder

Year 2007, Volume: 6 Issue: 1, 25 - 29, 01.04.2007

Abstract

Metaplastic changes in the gallbladder commonly associated with cholelithiasis and chronic inflammation may represent premalignant lesions in the course of malignant transformation. Moreover, existence of a probable metaplasia-dysplasia-carcinoma sequence may bear importance in developing gallbladder carcinomas. Materials and methods: In this study, 351 cholecystectomy specimens of 121 male and 230 female patients with chronic cholecystitis seen from May 2001 to November 2006 in Karaelmas University Faculty of Medicine were re-evaluated in terms of metaplasia, dysplasia, carcinoma in situ and carcinoma. Results: While pure antral-type metaplasia was the most common metaplasia (81 cases), intestinal metaplasia was detected in 18 cases. Eight cases displayed coexistence of antral and intestinal metaplasia. Varying degrees of dysplasia were revealed in 3 cases with antral metaplasia, in 11 cases with intestinal metaplasia and in 3 cases with both antral and intestinal metaplasia. Incidental carcinoma was determined in 4 of the 11 cases with intestinal metaplasia and dysplasia. Conclusions: The occurrence of metaplasia, perceived as 30% in the current study, points out that chronic tissue injury secondary to cholelithiasis and chronic inflammation is the major factor contributing to developing metaplasia. In addition to the possibility of intestinal metaplasia developing from antral metaplasia, progressing to carcinoma by causing dysplasia, the high incidence of metaplasia in both carcinomatous components and surrounding mucosa supports the idea that this spectrum of changes may play a role in the development of gallbladder cancer.

References

  • Shimizu M, Kitoh K, Fujimitsu Y, et al. Cellular differentation and development of pyloric mucosal metaplasia in the human gallblad- der. Pathol Int 1996; 46: 261-6.
  • Tsutsumi Y, Nagura H, Osamura RY, et al. Histochemical studies of metaplastic lesions in human gallbladder. Arch Pathol Lab Med 1984; 108: 917-21.
  • Rosai J. Gallbladder and Extrahepatic Bile Ducts. In: Rosai J edi- tor, Rosai and Ackerman’s Surgical Pathology, 9th ed. Philadelphia: Mosby, 2004: 1035-60.
  • Dowling GP, Kelly JK. The histogenesis of adenocarcinoma of the gallbladder. Cancer 1986; 58: 1702-8.
  • Albores-Saavedra J, de Jesus Manrique J, Angele-Angeles A, et al. Carcinoma in situ of the gallbladder. A clinicopathologic study of 18 cases. Am J Surg Pathol 1984; 8: 323-33.
  • Duarte I, Llanos O, Domke H, et al. Metaplasia and precursor lesi- ons of gallbladder carcinoma. Frequency, distribution, and proba- bility of detection in routine histologic samples Cancer 1993; 72: 1878-84.
  • Kozuka S, Kurashina M, Tsubone M, et al. Significance of intestinal metaplasia for the evaluation of cancer in the biliary tract. Cancer 1984, 54: 2277-85.
  • Albores-Saavedra J, Alcantara-Vazquez A, Cruz Ortis H, et al. The precursor lesions of invasive gallbladder carcinoma. Hyperplasia, atypical hyperplasia and carcinoma in situ. Cancer 1980; 45: 919- 27.
  • Mukhopadhyay S, Landas SK. Putative precursors of gallbladder dysplasia. Arch Pathol Lab Med 2005; 129: 386-90.
  • Yamagiwa H, Tomiyama H. Intestinal metaplasia-dysplasia-carci- noma sequence of the gallbladder. Acta Pathol Jpn 1986; 36: 989- 97.
  • Yamomoto M, Nakajo S, Tahara E. Dysplasia of the gallbladder. Its histogenesis and correlation to gallbladder adenocarcinoma. Pat- hol Res Pract 1989; 454-60.
  • Tatematsu M, Furihata C, Miki K, et al. Complete and incomplete pyloric gland metaplasia of human gallbladder. Acta Pathol Jpn 1987; 37: 39-46.
  • Roa I, De Aretxabala X, Araya JC, Roa J. Preneoplastic lesions in gallbladder cancer. J Surg Oncol 2006; 93: 615-23.
  • Tazuma S, Kajiyama G. Carcinogenesis of malingnant lesions of the gallbladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg 2001; 386: 224-9.

Safra kesesinde metaplazi, displazi ve karsinom dizgesi

Year 2007, Volume: 6 Issue: 1, 25 - 29, 01.04.2007

Abstract

Safra kesesinde çoğunlukla safra taşı varlığı ve kronik inflamasyonla ilişkili olarak görülen metaplastik değişiklikler karsinomatöz dönüşüm sürecindeki premalign lezyonların temsilcisi olabilirler. Bunun ötesinde olası bir metaplazi, displazi, karsinom zincirinin varlığı safra kesesi karsinomlarının gelişiminde önem taşıyabilir. Gereç ve yöntem: Çalışmamızda Mayıs 2001 ile Kasım 2006 tarihleri arasında Karaelmas Üniversitesi Tıp Fakültesi Hastanesi'nde kronik kolesistit tanı sı ile izlenen ve kolesistektomi uygulanan 121 erkek ve 230 kadın hastanı n toplam 351 safra kesesi materyaline ait preparatlar metaplazi, displazi, karsinoma in situ ve karsinom açısından tekrar değerlendirilmiştir. Bulgular: Saf antral tip metaplazi 81 olgu ile en sık görülen metaplazi tipi iken, 18 olguda intestinal metaplazi izlenmiştir. Sekiz olguda ise aynı anda antral ve intestinal metaplazi varlığı mevcuttur. Antral metaplazi bulunan 3, intestinal metaplazi izlenen 11, hem antral hem de intestinal metaplazi görülen olguların üçünde değişen derecelerde displazi belirlenmiştir. İntestinal metaplazi ve displazi izlenen 11 olgunun dördünde insidental karsinom saptanmıştır. Sonuç: Çalışmamızda safra keselerinde %30 oranında saptanan metaplazi varlığı metaplazinin oluşumunda rol oynayan en önemli etkenin safra taşı ve inflamasyon varlığına ikincil olarak gerçekleşen kronik doku zedelenmesi olduğunu göstermektedir. İntestinal metaplazilerin antral metaplazilerden gelişebilmesi, displaziye yol açarak karsinoma dönüşebilme olasılığı yanı sıra gerek kanserli dokularda gerekse kanser alanını çevreleyen mukozada metaplazi sıklığındaki yükseklik, bu değişiklik spektrumunun safra kesesi kanseri gelişiminde rol oynayabileceği görüşünü desteklemektedir.

References

  • Shimizu M, Kitoh K, Fujimitsu Y, et al. Cellular differentation and development of pyloric mucosal metaplasia in the human gallblad- der. Pathol Int 1996; 46: 261-6.
  • Tsutsumi Y, Nagura H, Osamura RY, et al. Histochemical studies of metaplastic lesions in human gallbladder. Arch Pathol Lab Med 1984; 108: 917-21.
  • Rosai J. Gallbladder and Extrahepatic Bile Ducts. In: Rosai J edi- tor, Rosai and Ackerman’s Surgical Pathology, 9th ed. Philadelphia: Mosby, 2004: 1035-60.
  • Dowling GP, Kelly JK. The histogenesis of adenocarcinoma of the gallbladder. Cancer 1986; 58: 1702-8.
  • Albores-Saavedra J, de Jesus Manrique J, Angele-Angeles A, et al. Carcinoma in situ of the gallbladder. A clinicopathologic study of 18 cases. Am J Surg Pathol 1984; 8: 323-33.
  • Duarte I, Llanos O, Domke H, et al. Metaplasia and precursor lesi- ons of gallbladder carcinoma. Frequency, distribution, and proba- bility of detection in routine histologic samples Cancer 1993; 72: 1878-84.
  • Kozuka S, Kurashina M, Tsubone M, et al. Significance of intestinal metaplasia for the evaluation of cancer in the biliary tract. Cancer 1984, 54: 2277-85.
  • Albores-Saavedra J, Alcantara-Vazquez A, Cruz Ortis H, et al. The precursor lesions of invasive gallbladder carcinoma. Hyperplasia, atypical hyperplasia and carcinoma in situ. Cancer 1980; 45: 919- 27.
  • Mukhopadhyay S, Landas SK. Putative precursors of gallbladder dysplasia. Arch Pathol Lab Med 2005; 129: 386-90.
  • Yamagiwa H, Tomiyama H. Intestinal metaplasia-dysplasia-carci- noma sequence of the gallbladder. Acta Pathol Jpn 1986; 36: 989- 97.
  • Yamomoto M, Nakajo S, Tahara E. Dysplasia of the gallbladder. Its histogenesis and correlation to gallbladder adenocarcinoma. Pat- hol Res Pract 1989; 454-60.
  • Tatematsu M, Furihata C, Miki K, et al. Complete and incomplete pyloric gland metaplasia of human gallbladder. Acta Pathol Jpn 1987; 37: 39-46.
  • Roa I, De Aretxabala X, Araya JC, Roa J. Preneoplastic lesions in gallbladder cancer. J Surg Oncol 2006; 93: 615-23.
  • Tazuma S, Kajiyama G. Carcinogenesis of malingnant lesions of the gallbladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg 2001; 386: 224-9.
There are 14 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Burak Bahadır This is me

Banu Doğan Gün This is me

Sacide Çolak This is me

Gürkan Kertiş This is me

Mustafa Cömert This is me

Şükrü Oğuz Özdamar This is me

Publication Date April 1, 2007
Published in Issue Year 2007 Volume: 6 Issue: 1

Cite

APA Bahadır, B., Gün, B. D., Çolak, S., Kertiş, G., et al. (2007). Safra kesesinde metaplazi, displazi ve karsinom dizgesi. Akademik Gastroenteroloji Dergisi, 6(1), 25-29.

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