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Carcinoma of the gallbladder and anomalous arrangement of the pancreaticobiliary ductal system: Cell kinetic studies of gallbladder epithelial cells

  • Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Anomalous arrangement of the pancreatic-obiliary ductal system (AAPB), a congenital anomaly defined as a union of the pancreatic and biliary ducts located outside the duodenal wall, is a newly designated disease entity, and is frequently found in adult patients with gallbladder carcinoma (GBX). In the present study, the relationship of AAPB and GBX was investigated. We studied 27 patients with GBX and AAPB, 34 patients with AAPB and without GBX, and as a control group, 56 patients without AAPB (10 with GBX, 24 with cholecystolithiasis, and 22 with normal gallbladder). Tissue sections from cancerous and non-cancerous mucosa of the gallbladder of all of these patients were stained for proliferating cell nuclear antigen (PCNA), Ki-67 nuclear antigen, and bromodeoxyuridine (BrdU). The Ki-67 labeling index (Ki-67-LI), PCNA labeling index (PCNA-LI), and BrdU labeling index (BrdU-LI) of the noncancerous mucosa in the patients with AAPB and/or GBX were significantly higher than those in the patients without GBX and AAPB (P<0.01). These indices of the noncancerous mucosa in the patients with AAPB and GBX were significantly higher than those in the patients with either AAPB or GBX (P<0.05). Cell proliferation in the gallbladder epithelia was accelerated in patients with AAPB. Consequently, AAPB appears to be an important risk factor for the occurrence of GBX.

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References

  1. Babbitt DP. Congenital choledochal cyst: New etiological concept based on anomalous relationships of common bile duct and pancreatic bulb. Ann Radiol 1969;12:231–241.

    PubMed  CAS  Google Scholar 

  2. The Japanese Study Group on Pancreaticobiliary Maljunction. Diagnostic criteria of pancreaticobiliary maljunction. J Hep Bil Pancr Surg 1994;1:219–221.

    Article  Google Scholar 

  3. Alonso-Lej F, Rever WB, Pessagno DJ. Congenital choledochal cyst with a report of two and an analysis of 94 cases. Int Abstr Surg 1959;108:1–23.

    PubMed  CAS  Google Scholar 

  4. Kimura K, Ohto M, Ino T, et al. Congenital cystic dilatation of the common bile duct. Relationship to anomalous pancreatic biliary ductal union. AJR Am J Roentgenol 1977;128:571–577.

    PubMed  CAS  Google Scholar 

  5. Komi N, Takehara J, Kunitomo K. Choledochal cyst: Anomalous arrangement of the pancreaticobiliary ductal system and biliary malignancy. J Gastroenterol Hepatol 1989;4:63–74.

    Article  PubMed  CAS  Google Scholar 

  6. Kinoshita H, Nagata E, Kobayashi Y, et al. Carcinoma of the gallbladder with an anomalous connection between the choledochus and the pancreatic duct; report of ten cases and review of the literature in Japan. Cancer 1984;54:762–769.

    Article  PubMed  CAS  Google Scholar 

  7. Matsumoto Y, Uchida K, Honjo I, et al. Congenital cystic dilatation of the common bile duct as a cause of primary bile duct stone. Am J Surg 1977;134:346–352.

    Article  PubMed  CAS  Google Scholar 

  8. Kimura K, Ohto M, Saisho H, et al. Association of gallbladder carcinoma and anomalous pancreatico-biliary ductal union. Gastroenterology 1985;89:1258–1265.

    PubMed  CAS  Google Scholar 

  9. Hasumi A, Sugaya H, Aoki H, et al. Pancreaticobiliary maljunction and biliary duct cancer (in Japanese). J Biliary Tract Pancreas 1995;16:753–757.

    Google Scholar 

  10. Suda K, Miyano T, Konuma I, et al. An anomalous pancreaticocholedochal-ductal junction in cases of biliary tract carcinoma. Cancer 1983;52:2083–2088.

    Article  Google Scholar 

  11. Matsumoto Y, Fujii H, Aoyama H, et al. Surgical treatment of primary carcinoma of the gallbladder based on the histologic analysis of 48 surgical specimens. Am J Surg 1992;163:239–245.

    Article  PubMed  CAS  Google Scholar 

  12. Hanada K, Itoh M, Fujii K, et al. Pathology and cellular kinetics of gallbladder with an anomalous junction of the pancreaticobiliary duct. Am J Gastroenterol 1996;91:1007–1011.

    PubMed  CAS  Google Scholar 

  13. Miyachi K, Fritzler MJ, Tan EM. Autoantibodies to a nuclear antigen in proliferating cells. J Immunol 1978;121:2228–2234.

    PubMed  CAS  Google Scholar 

  14. Hall PA, Levision DA, Woods AL, et al. Proliferating cell nuclear antigen (PCNA) immunolocalization in paraffin sections: An index of cell proliferation with evidence of deregulated expression in some neoplasms. J Pathol 1990;162:285–294.

    Article  PubMed  CAS  Google Scholar 

  15. Gerdes J, Lemke H, Baisch H, et al. Cell cycle analysis of a cell proliferation-associated human nuclear antigen defined by the monoclonal antibody Ki-67. J Immunol 1984;133:1710–1715.

    PubMed  CAS  Google Scholar 

  16. Cattoretti G, Becker MHG, Key G, et al. Monoclonal antibodies produced against recombinant parts of the Ki-67 molecule (MIB-1 to 3) stain proliferating cells in formalin-fixed, paraffin-embedded microwave-processed tissues (abstract). Histochem J 1992;24:611.

    Google Scholar 

  17. Darmon E, Pincu-Hornstein A, Rosen P. A rapid and simple invitro method for evaluating human colorectal epithelial cell proliferation. Arch Pathol Lab Med 1990;114:855–857.

    PubMed  CAS  Google Scholar 

  18. Kozumi I, Kodama T. A case report and the etiology of choledochal cystic dilation (in Japanese). J Tokyo Med Assoc 1916;30:1413–1423.

    Google Scholar 

  19. Yotsuyanagi S. Contributions to aetiology and pathogeny of idiopathic cystic dilatation of common bile duct with report of three cases: New aetiologic theory. Gann 1936;30:601–650.

    Google Scholar 

  20. Fujita T, Shimada H, Nakagawara G. Cell kinetic study of the gallbladder epithelium with special reference to the pancreaticobiliary maljunction. J Hep Bil Pancr Surg 1944;1:229–235.

    Article  Google Scholar 

  21. Yamaguchi K, Enjoji M. Carcinoma of the gallbladder: A clinicopathology of 103 patients and a newly proposed staging Cancer 1988;62:1425–1432.

    Article  PubMed  CAS  Google Scholar 

  22. Duarte I, Llamos O, Domke H, et al. Metaplasia and precursor lesions of gallbladder carcinoma: Frequency, distribution and probability of detection in routine histologic samples. Cancer 1933;72:1878–1884.

    Article  Google Scholar 

  23. Irwin ST, Morisson JE. Congenital cyst of common bile duct containing stones and undergoing cancerous change. Br J Surg 1944;32:319–621.

    Article  Google Scholar 

  24. Matsumoto Y, Uchida K, Honjo I, et al. Clinicopathological classification of congenital cystic dilatation of the common bile duct. Am J Surg 1977;134:569–574.

    Article  PubMed  CAS  Google Scholar 

  25. Funabiki T, Sugie K, Matsubara T, et al. Bile acids and biliary carcinoma in pancreaticobiliary maljunction. Keio J Med 1991;40:118–122.

    PubMed  CAS  Google Scholar 

  26. Gratzner HG. Monoclonal antibody to 5-bromo- an 5-introdeoxyuridine: A new reagent for detection of DNA replication. Science 1982;218:475.

    Article  Google Scholar 

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Yang, Y., Fujii, H., Matsumoto, Y. et al. Carcinoma of the gallbladder and anomalous arrangement of the pancreaticobiliary ductal system: Cell kinetic studies of gallbladder epithelial cells. J Gastroenterol 32, 801–807 (1997). https://doi.org/10.1007/BF02936958

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  • DOI: https://doi.org/10.1007/BF02936958

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