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1. Wojtuń S, Gil J, Zyśko B: [The use of endoscopic method in treatment of strictures of biliary tree]. Pol Merkur Lekarski; 2007 May;22(131):477-81
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  • The strictures of bilitary tree may occur as a result of benign and malignant pathologies of liver and pancreas.
  • The benign stricture of biliary tree are usually results of the surgery and if it is possible the endoscopic methods should be implemented in this group of patients.
  • In course of cholangitis sclerosans endoscopic treatment is to ensure bile flow.
  • The treatment of malignant stricture of biliary tree depends on the early diagnosis, placement and the extension of malignant lesion.
  • Palliative surgical treatment is usually used in laparotomy, when the non-removable tumor was diagnosed.
  • The palliative endoscopic treatment usually is based on widening the stricture and putting into bilitary tree the plastic stent or more effective selfplacing metal ones, which are usually more effective, The achievement of long lasting medical effects after application of endoscopic methods relies on the cause leading to extrahepatic cholestasis and the extension of common bile structure.
  • The study shows some of the treatment methods and the combination of different techniques, which may be used in case of bile flow obstruction because of the stricture of biliary tree.
  • [MeSH-major] Biliary Tract Surgical Procedures. Catheterization. Cholangiopancreatography, Endoscopic Retrograde. Cholestasis, Extrahepatic / therapy. Cholestasis, Intrahepatic / therapy
  • [MeSH-minor] Bile Duct Diseases / diagnosis. Bile Duct Diseases / therapy. Bile Duct Neoplasms / diagnosis. Bile Duct Neoplasms / therapy. Cholangitis, Sclerosing / diagnosis. Cholangitis, Sclerosing / therapy. Constriction, Pathologic / etiology. Constriction, Pathologic / therapy. Humans. Palliative Care. Postoperative Complications. Sphincterotomy, Endoscopic. Stents

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  • (PMID = 17679400.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Number-of-references] 24
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2. Wang X, Dai S, Zhang Z, Liu L, Wang J, Xiao X, He D, Liu B: Characterization of apolipoprotein A-I as a potential biomarker for cholangiocarcinoma. Eur J Cancer Care (Engl); 2009 Nov;18(6):625-35
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  • Serum samples from 60 cholangiocarcinoma (CC), 60 benign diseases of hepatobiliary and 53 normal individuals were analysed by SELDI-TOF-MS (Surface Enhanced Laser Desorption/Ionization Time of Flight Mass Spectrometry).
  • It was found that a 28 k m/z peak was significantly decreased in CC and retained discriminatory value between CC and normal group, also between CC and benign groups.
  • [MeSH-major] Apolipoprotein A-I / blood. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Biomarkers, Tumor / blood. Cholangiocarcinoma / diagnosis

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  • (PMID = 19486127.001).
  • [ISSN] 1365-2354
  • [Journal-full-title] European journal of cancer care
  • [ISO-abbreviation] Eur J Cancer Care (Engl)
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Apolipoprotein A-I; 0 / Biomarkers, Tumor
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3. Alvaro D: Serum and bile biomarkers for cholangiocarcinoma. Curr Opin Gastroenterol; 2009 May;25(3):279-84
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  • [Title] Serum and bile biomarkers for cholangiocarcinoma.
  • PURPOSE OF REVIEW: To discuss recent studies proposing new markers in serum or bile for the diagnosis and prognosis of cholangiocarcinoma (CCA), which could help in the differential diagnosis between malignant and benign biliary disorders or for the surveillance of disorders at risk, including primitive sclerosing cholangitis.
  • Studies have been focused on cytokines, growth factors or enzymes produced and secreted by CCA cells as well as on the proteomic analysis of serum and bile.
  • SUMMARY: The serum levels of interleukin 6, trypsinogen, mucin-5AC, soluble fragment of cytokeratin 19 and the platelet-lymphocyte ratio have been recently shown to help in the diagnosis of CCA with, in some cases, a prognostic value.
  • As far as bile is concerned, the ratio of pancreatic elastase/amylase, mucin-4, minichromosome maintenance replication protein and insulin-like growth factor 1 have been explored, with the insulin-like growth factor 1 biliary concentration capable of completely discriminating CCA from benign biliary disorders and pancreatic cancer.
  • We have also discussed advances in the proteomic of serum and bile, which seem promising in identifying new markers for CCA.
  • [MeSH-major] Bile / chemistry. Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic. Biomarkers, Tumor / metabolism. Cholangiocarcinoma / metabolism. Cytokines / metabolism
  • [MeSH-minor] Diagnosis, Differential. Humans

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  • (PMID = 19396965.001).
  • [ISSN] 1531-7056
  • [Journal-full-title] Current opinion in gastroenterology
  • [ISO-abbreviation] Curr. Opin. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cytokines
  • [Number-of-references] 33
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4. Thelen A, Neuhaus P: Liver transplantation for hilar cholangiocarcinoma. J Hepatobiliary Pancreat Surg; 2007;14(5):469-75
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  • Owing to disappointing long-term results for this indication, and in parallel, encouraging results in patients with benign disease, hilar cholangiocarcinoma has generally not been accepted as an indication for liver transplantation in recent years.
  • To improve results, more aggressive approaches have been used: "abdominal organ cluster transplantation" and "extended bile duct resection", which lead to increased long-term survival rates.
  • However, with improving results after conventional extrahepatic bile duct resection in combination with partial hepatectomy, extended procedures in combination with liver transplantation never became a real option in the treatment of hilar cholangiocarcinoma.
  • Current results show increased survival figures, in particular in well-selected patients with early tumor stages.
  • [MeSH-major] Bile Duct Neoplasms / surgery. Bile Ducts, Intrahepatic / surgery. Cholangiocarcinoma / surgery. Liver Transplantation


5. Leelawat K, Leelawat S, Ratanachu-Ek T, Trubwongchareon S, Wannaprasert J, Tripongkaruna S, Chantawibul S, Tepaksorn P: Circulating hTERT mRNA as a tumor marker in cholangiocarcinoma patients. World J Gastroenterol; 2006 Jul 14;12(26):4195-8
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  • [Title] Circulating hTERT mRNA as a tumor marker in cholangiocarcinoma patients.
  • METHODS: The serum of thirty three cholangiocarcinoma patients, forty one benign biliary tract disease patients and ten healthy volunteers were collected and analyzed for the expression of hTERT mRNA by real-time reverse transcriptase-polymerase chain reaction (RT-PCR).
  • RESULTS: hTERT mRNA was detected in 28 of 33 (84.85%) of serum obtained from cholangiocarcinoma patients and 9 of 41 (21.9%) of serum obtained from benign biliary tract disease patients. hTERT mRNA was not detected in any serum obtained from healthy volunteers. on the other hand the common tumor marker, CA19-9 was detected in 20 of 33 (60.6%) of serum obtained from cholangiocarcinoma patients and 8 of 41 (19.5%) of serum obtained from benign biliary tract disease patients.
  • However, no correlation was found between the present of serum hTERT mRNA and tumor staging.
  • It offers a novel tumor marker, which can be used as a complementary study for diagnosis of cholangiocarcinoma.
  • [MeSH-major] Bile Duct Neoplasms / blood. Biomarkers, Tumor / blood. Cholangiocarcinoma / blood. DNA-Binding Proteins / genetics. RNA, Messenger / blood. Telomerase / genetics
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Bile Ducts, Intrahepatic. Cell Line, Tumor. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Middle Aged. Neoplasm Staging. Reverse Transcriptase Polymerase Chain Reaction

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  • (PMID = 16830373.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / RNA, Messenger; EC 2.7.7.49 / Telomerase
  • [Other-IDs] NLM/ PMC4087372
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6. Jarnagin WR, Klimstra DS, Hezel M, Gonen M, Fong Y, Roggin K, Cymes K, DeMatteo RP, D'Angelica M, Blumgart LH, Singh B: Differential cell cycle-regulatory protein expression in biliary tract adenocarcinoma: correlation with anatomic site, pathologic variables, and clinical outcome. J Clin Oncol; 2006 Mar 1;24(7):1152-60
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  • METHODS: Tissue microarrays were prepared from paraffin-embedded surgical specimens with triplicate cores of BTA and benign tissue.
  • Tumor sites of origin were intrahepatic cholangiocarcinoma (IH; n = 23), hilar cholangiocarcinoma (Hilar; n = 54), gallbladder (GB; n = 32), and distal bile duct (Distal; n = 19).
  • CONCLUSION: BTAs differentially express cell cycle-regulatory proteins based on tumor location and morphology.
  • [MeSH-major] Bile Duct Neoplasms / pathology. Bile Ducts, Intrahepatic. Biomarkers, Tumor / analysis. Cell Cycle Proteins / analysis. Cholangiocarcinoma / pathology. Gallbladder Neoplasms / pathology
  • [MeSH-minor] Aged. Cyclin D1 / analysis. Cyclin-Dependent Kinase Inhibitor p21 / analysis. Female. Gene Expression Regulation, Neoplastic. Humans. Immunohistochemistry. Ki-67 Antigen / analysis. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Proliferating Cell Nuclear Antigen / analysis. Proto-Oncogene Proteins c-bcl-2 / analysis. Proto-Oncogene Proteins c-mdm2 / analysis. Survival Analysis. Tumor Suppressor Protein p53 / analysis. Up-Regulation

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  • (PMID = 16505435.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CDKN1A protein, human; 0 / Cell Cycle Proteins; 0 / Cyclin-Dependent Kinase Inhibitor p21; 0 / Ki-67 Antigen; 0 / Proliferating Cell Nuclear Antigen; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Tumor Suppressor Protein p53; 0 / p27 antigen; 136601-57-5 / Cyclin D1; EC 6.3.2.19 / Proto-Oncogene Proteins c-mdm2
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7. Scarlett CJ, Saxby AJ, Nielsen A, Bell C, Samra JS, Hugh T, Baxter RC, Smith RC: Proteomic profiling of cholangiocarcinoma: diagnostic potential of SELDI-TOF MS in malignant bile duct stricture. Hepatology; 2006 Sep;44(3):658-66
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  • [Title] Proteomic profiling of cholangiocarcinoma: diagnostic potential of SELDI-TOF MS in malignant bile duct stricture.
  • Proteomic techniques promise to improve the diagnosis of cholangiocarcinoma (CC) in both tissue and serum as histological diagnosis and existing serum markers exhibit poor sensitivities.
  • Twenty-two resected CC samples were compared with adjacent noninvolved bile duct tissue.
  • Serum from patients with CC (n=20) was compared with patients with benign disease (n=20), and healthy volunteers (n=25).
  • Univariate analysis revealed 14 individual peaks differentially expressed between CC and bile duct tissue, 4 peaks between CC and benign disease, and 12 peaks between CC and sera of healthy volunteers.
  • The training models developed panels of peaks that distinguished CC from bile duct tissue (92.5% sensitivity, 92.3% specificity; ROC AUC=0.96), CC from benign serum (65.0% sensitivity, 70.0% specificity; ROC AUC=0.83), and CC from sera of healthy volunteers (75.0% sensitivity, 100% specificity; ROC AUC=0.92).
  • Serum results were further improved with the inclusion of CA19.9 and CEA (ROC AUC=0.86 and 0.99 for CC vs benign and healthy volunteer serum, respectively).
  • In conclusion, biomarker panels are capable of distinguishing CC from nonmalignant tissue; serum markers have important diagnostic implications for unknown bile duct stricture.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. CA-19-9 Antigen / analysis. Carcinoembryonic Antigen / analysis. Cholangiocarcinoma / diagnosis. Cholestasis, Intrahepatic / diagnosis. Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Diagnosis, Differential. Female. Humans. In Vitro Techniques. Male. Middle Aged. Prognosis. ROC Curve

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  • (PMID = 16941699.001).
  • [ISSN] 0270-9139
  • [Journal-full-title] Hepatology (Baltimore, Md.)
  • [ISO-abbreviation] Hepatology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen
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8. Xu AM, Xian ZH, Zhang SH, Chen XF: Intrahepatic cholangiocarcinoma arising in multiple bile duct hamartomas: report of two cases and review of the literature. Eur J Gastroenterol Hepatol; 2009 May;21(5):580-4
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  • [Title] Intrahepatic cholangiocarcinoma arising in multiple bile duct hamartomas: report of two cases and review of the literature.
  • Multiple bile duct hamartomas (BDHs)/von Meyenburg complexes, are tumor-like lesions of the liver.
  • Malignant transformation in BDHs has been previously reported in very rare instances, and the most common tumor arising in this clinical setting is cholangiocarcinoma.
  • Histopathologically, multiple BDHs showed morphologic transition from clearly benign to dysplasia or carcinoma in situ, then to invasive carcinoma sequence of the biliary epithelium.
  • Staining for Hep Par 1, alpha-fetoprotein, cytokeratin 20, and alpha1-antitrypsin was negative.
  • Any other clinically detectable primary tumor was not found.
  • [MeSH-major] Bile Duct Neoplasms / pathology. Bile Ducts, Intrahepatic / pathology. Cholangiocarcinoma / pathology. Hamartoma / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Bile Duct Diseases / complications. Bile Duct Diseases / pathology. Cell Transformation, Neoplastic / pathology. Female. Humans. Male

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  • (PMID = 19282767.001).
  • [ISSN] 1473-5687
  • [Journal-full-title] European journal of gastroenterology & hepatology
  • [ISO-abbreviation] Eur J Gastroenterol Hepatol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 42
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9. Tangkijvanich P, Chanmee T, Komtong S, Mahachai V, Wisedopas N, Pothacharoen P, Kongtawelert P: Diagnostic role of serum glypican-3 in differentiating hepatocellular carcinoma from non-malignant chronic liver disease and other liver cancers. J Gastroenterol Hepatol; 2010 Jan;25(1):129-37
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  • METHODS: Six groups were studied which included 40 healthy subjects, 50 patients with chronic hepatitis (CH), 50 patients with liver cirrhosis (LC), 100 patients with HCC, 50 patients with intrahepatic cholangiocarcinoma (ICC) and 50 patients with metastatic carcinoma (MCA).
  • Detectable GPC3 was significantly correlated with the presence of viral hepatitis markers but was not correlated with tumor size and stage of HCC.
  • The combined use of serum GPC3 and AFP provides a potentially promising tool to better differentiate HCC from benign liver disorders, as well as from other liver cancers.
  • [MeSH-major] Biomarkers, Tumor / blood. Carcinoma, Hepatocellular / blood. Glypicans / blood. Liver Neoplasms / blood
  • [MeSH-minor] Adult. Aged. Bile Duct Neoplasms / blood. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic / pathology. Cholangiocarcinoma / blood. Cholangiocarcinoma / diagnosis. Diagnosis, Differential. Enzyme-Linked Immunosorbent Assay. Female. Hepatitis, Chronic / blood. Hepatitis, Chronic / diagnosis. Humans. Liver Cirrhosis / blood. Liver Cirrhosis / diagnosis. Male. Middle Aged. Neoplasm Staging. Predictive Value of Tests. ROC Curve. Sensitivity and Specificity. Up-Regulation. alpha-Fetoproteins / analysis

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  • (PMID = 19793164.001).
  • [ISSN] 1440-1746
  • [Journal-full-title] Journal of gastroenterology and hepatology
  • [ISO-abbreviation] J. Gastroenterol. Hepatol.
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / AFP protein, human; 0 / Biomarkers, Tumor; 0 / GPC3 protein, human; 0 / Glypicans; 0 / alpha-Fetoproteins
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10. Zhou JP, Dong M, Zhang Y, Kong FM, Guo KJ, Tian YL: Giant mucinous biliary cystadenoma: a case report. Hepatobiliary Pancreat Dis Int; 2007 Feb;6(1):101-3
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  • BACKGROUND: Biliary cystadenoma is a very rare cystic neoplasm of the liver.
  • Its clinical features, diagnosis, pathologic characteristics, and optimal surgical management have not been defined clearly.
  • Gross examination showed that the tumor almost occupied.
  • Pathologically, additional lobulated spaces were seen in the tumor with a lot of mucusa.
  • The interior wall was lined with bile duct tissue, indicating a benign mucinous biliary cystadenoma.
  • CONCLUSIONS: Ultrasonography and CT are the major methods for the diagnosis of mucinous biliary cystadenoma liver.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Duct Neoplasms / surgery. Bile Ducts, Intrahepatic. Cystadenoma, Mucinous / diagnosis. Cystadenoma, Mucinous / surgery

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  • (PMID = 17287176.001).
  • [ISSN] 1499-3872
  • [Journal-full-title] Hepatobiliary & pancreatic diseases international : HBPD INT
  • [ISO-abbreviation] HBPD INT
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
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11. Hughes NR, Goodman ZD, Bhathal PS: An immunohistochemical profile of the so-called bile duct adenoma: clues to pathogenesis. Am J Surg Pathol; 2010 Sep;34(9):1312-8
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  • [Title] An immunohistochemical profile of the so-called bile duct adenoma: clues to pathogenesis.
  • The so-called bile duct adenoma and peribiliary glands are characterized by the expression of two foregut antigens (designated D10 and 1F6) and secretion of acid mucin.
  • On account of this similarity in phenotype and their frequent close association with a large caliber bile duct, it was earlier suggested that bile duct adenoma represent a peribiliary gland hamartoma.
  • Here, we compare the expression of 13 tissue antigens in bile duct adenomas, other benign bile duct lesions, and various foregut-derived tissues, to further investigate the bile duct adenoma phenotype and pathogenesis.
  • Five foregut antigens (D10, 1F6, MUC6, MUC5AC, and TFF2) and secretion of acid mucin were of use in distinguishing bile duct adenoma from other hepatic lesions.
  • 1F6 and MUC6 were normally present in bile ductules and canals of Hering, whereas the epithelium lining the larger bile ducts stained focally for D10, MUC5AC, MUC6, or TFF2 in, respectively, 21%, 36%, 43%, and 100% of the livers examined.
  • Thirty-six bile duct adenomas examined were distinguished by expression of MUC6 (94% of bile duct adenoma), MUC5AC (90%), TFF2 (80%), D10 (67%), and 1F6 (61%), and varying degrees of acid mucin secretion (100%).
  • Of 30 bile duct adenoma tested for all 5 antigens, 40% expressed all 5, 27% expressed 4, 17% expressed 3, 13% expressed 2, and 1 expressed only MUC6.
  • The distinguishing feature of so-called bile duct adenoma is their display of the same phenotype as pyloric gland metaplasia.
  • [MeSH-major] Adenoma, Bile Duct / pathology. Bile Duct Neoplasms / pathology. Bile Ducts, Intrahepatic / pathology
  • [MeSH-minor] Adult. Aged. Biomarkers, Tumor / metabolism. Female. Gastric Mucosa / metabolism. Gastric Mucosa / pathology. Humans. Hyperplasia / metabolism. Hyperplasia / pathology. Immunoenzyme Techniques. Intestines / metabolism. Intestines / pathology. Liver / metabolism. Liver / pathology. Male. Middle Aged. Mucins / metabolism. Phenotype. Young Adult

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  • (PMID = 20679879.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Mucins
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12. Yaman B, Nart D, Yilmaz F, Coker A, Zeytunlu M, Kilic M: Biliary intraductal papillary mucinous neoplasia: three case reports. Virchows Arch; 2009 May;454(5):589-94
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  • [Title] Biliary intraductal papillary mucinous neoplasia: three case reports.
  • Intrahepatic cholangiocarcinoma is subdivided as mass-forming, periductal-infiltrating, and intraductal-growing types.
  • Intraductal-growing type is an entity described in recent years as mucin-producing intrahepatic cholangiocarcinoma or intrahepatic (biliary) intraductal papillary mucinous neoplasia (b-IPMN).
  • b-IPMN is classified as adenoma, borderline tumor, carcinoma in situ, and carcinoma, from benign to malignant.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Bile Duct Neoplasms / pathology. Bile Ducts, Intrahepatic / pathology. Carcinoma, Papillary / pathology. Cholangiocarcinoma / pathology
  • [MeSH-minor] Aged. Biomarkers, Tumor / metabolism. Carcinoma in Situ / metabolism. Carcinoma in Situ / pathology. Carcinoma in Situ / surgery. Disease-Free Survival. Hepatitis B / complications. Hepatitis B / surgery. Humans. Immunoenzyme Techniques. Liver Cirrhosis / surgery. Liver Cirrhosis / virology. Liver Transplantation. Male. Middle Aged. Mucin 5AC / metabolism. Mucin-1 / metabolism. Pancreatic Neoplasms / metabolism. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / surgery. Treatment Outcome

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  • [Cites] Pathology. 2007 Aug;39(4):413-8 [17676483.001]
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  • (PMID = 19347361.001).
  • [ISSN] 0945-6317
  • [Journal-full-title] Virchows Archiv : an international journal of pathology
  • [ISO-abbreviation] Virchows Arch.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / MUC1 protein, human; 0 / MUC5AC protein, human; 0 / Mucin 5AC; 0 / Mucin-1
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13. Albiin N, Smith IC, Arnelo U, Lindberg B, Bergquist A, Dolenko B, Bryksina N, Bezabeh T: Detection of cholangiocarcinoma with magnetic resonance spectroscopy of bile in patients with and without primary sclerosing cholangitis. Acta Radiol; 2008 Oct;49(8):855-62
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  • [Title] Detection of cholangiocarcinoma with magnetic resonance spectroscopy of bile in patients with and without primary sclerosing cholangitis.
  • PURPOSE: To evaluate 1H magnetic resonance spectroscopy ((1)H-MRS) of bile as a diagnostic marker for CC in patients with and without PSC.
  • Bile from 49 patients was sampled and investigated using 1H-MRS.
  • MR spectra of bile samples from 45 patients (18 female; age range 22-87 years, mean age 57 years) were analyzed both conventionally and using computerized multivariate analysis.
  • Sixteen of the patients had CC, 18 had PSC, and 11 had other benign findings.
  • RESULTS: The spectra of bile from CC patients differed from the benign group in the levels of phosphatidylcholine, bile acids, lipid, and cholesterol.
  • It was possible to distinguish CC from benign conditions in all patients with malignancy.
  • Two benign non-PSC patients were misclassified as malignant.
  • CONCLUSION: With 1H-MRS of bile, cholangiocarcinoma could be discriminated from benign biliary conditions with or without PSC.
  • [MeSH-major] Bile / chemistry. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Cholangiocarcinoma / diagnosis. Cholangitis, Sclerosing / complications. Magnetic Resonance Spectroscopy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Bile Acids and Salts / analysis. Biomarkers, Tumor / analysis. Cholesterol / analysis. Diagnosis, Differential. Female. Humans. Lipids / analysis. Male. Middle Aged. Multivariate Analysis. Phosphatidylcholines / analysis. Reproducibility of Results. Sensitivity and Specificity

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  • (PMID = 18608012.001).
  • [ISSN] 1600-0455
  • [Journal-full-title] Acta radiologica (Stockholm, Sweden : 1987)
  • [ISO-abbreviation] Acta Radiol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Bile Acids and Salts; 0 / Biomarkers, Tumor; 0 / Lipids; 0 / Phosphatidylcholines; 97C5T2UQ7J / Cholesterol
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14. Li Q, Wang JM, Liu C, Xiao BL, Lu JX, Zou SQ: Correlation of aPKC-iota and E-cadherin expression with invasion and prognosis of cholangiocarcinoma. Hepatobiliary Pancreat Dis Int; 2008 Feb;7(1):70-5
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  • BACKGROUND: The abnormal expression of atypical protein kinase C-iota (aPKC-iota) subtype and E-cadherin play important roles in tumor occurrence and progression.
  • This study was designed to investigate the correlation of expression of aPKC-iota and E-cadherin with the clinicopathological characteristics and prognosis of cholangiocarcinoma, and to analyze the molecular mechanisms of invasion and metastasis of the tumor.
  • METHODS: EnVision immunohistochemistry was used to detect the expression of aPKC-iota and E-cadherin in 9 specimens of benign bile duct tissues, 35 specimens of cholangiocarcinoma and 6 specimens of metastatic cholangiocarcinoma.
  • RESULTS: The positive expression level of aPKC-iota in cholangiocarcinoma was remarkably higher than that in benign bile duct tissues (68.6% vs. 11.1%, P=0.006), but the expression level of E-cadherin was lower in cholangiocarcinoma than in benign bile duct tissues (37.1% vs. 88.9%, P=0.016).
  • Correlation analysis revealed that the expression of aPKC-iota was positively related to tumor differentiation and invasion, whereas that of E-cadherin was entirely the contrary.
  • [MeSH-major] Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic / metabolism. Cadherins / metabolism. Cholangiocarcinoma / metabolism. Isoenzymes / metabolism. Protein Kinase C / metabolism
  • [MeSH-minor] Adult. Aged. Cell Polarity. Female. Humans. Immunohistochemistry. Kaplan-Meier Estimate. Male. Middle Aged. Neoplasm Invasiveness. Predictive Value of Tests. Prognosis

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  • (PMID = 18234642.001).
  • [ISSN] 1499-3872
  • [Journal-full-title] Hepatobiliary & pancreatic diseases international : HBPD INT
  • [ISO-abbreviation] HBPD INT
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Cadherins; 0 / Isoenzymes; EC 2.7.11.13 / Protein Kinase C; EC 2.7.11.13 / protein kinase C lambda
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15. Van den Bergh K, Op de Beeck K: Acute abdominal pain due to biliary cystadenoma. JBR-BTR; 2010 Nov-Dec;93(6):310-1
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  • We present a case of a biliary cystadenoma, a rare benign cystic tumor arising in most cases of the intrahepatic bile ducts.
  • The diagnosis of a biliary cystadenoma was proposed and complete surgical resection of the mass was performed.
  • [MeSH-major] Abdomen, Acute / etiology. Bile Duct Neoplasms / complications. Cystadenoma / complications
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans. Tomography, X-Ray Computed

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  • (PMID = 21381530.001).
  • [ISSN] 0302-7430
  • [Journal-full-title] JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)
  • [ISO-abbreviation] JBR-BTR
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
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16. Goodman ZD: Neoplasms of the liver. Mod Pathol; 2007 Feb;20 Suppl 1:S49-60
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  • Hepatocellular carcinoma, in which the tumor cells resemble hepatocytes, is the most frequent primary liver tumor, and is highly associated with chronic viral hepatitis and cirrhosis of any cause.
  • Benign tumors, such as hepatocellular adenoma in a noncirrhotic liver or a large, dysplastic nodule in a cirrhotic liver, must be distinguished from well-differentiated hepatocellular carcinoma.
  • Cholangiocarcinoma, a primary adenocarcinoma that arises from a bile duct, is second in frequency.
  • It is associated with inflammatory disorders and malformations of the ducts, but most cases are of unknown etiology.
  • Cholangiocarcinoma resembles adenocarcinomas arising in other tissues, so a definitive diagnosis relies on the exclusion of an extrahepatic primary and distinction from benign biliary lesions.
  • [MeSH-minor] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic / pathology. Cholangiocarcinoma / diagnosis. Diagnosis, Differential. Female. Humans. Male

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  • (PMID = 17486052.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Yu FC, Chen JH, Yang KC, Wu CC, Chou YY: Hepatobiliary cystadenoma: a report of two cases. J Gastrointestin Liver Dis; 2008 Jun;17(2):203-6
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  • Abdominal echo revealed biliary tracts dilatation; ERCP revealed amorphous filling defect inside the dilated CBD, a cystic tumor in the left lobe communicated with bile duct was disclosed by MRI/MRCP.
  • Abdominal ultrasound detected a huge cystic tumor over the left hepatic lobe in a 69-year-old male.
  • An abdominal ultrasound 6 months later revealed intrahepatic spread of cystadenocarcinoma over both lobes.
  • Hepatobiliary cystadenoma is a rare benign cystic tumor of the liver.
  • Elevated serum and cystic fluid tumor markers CA19-9 are only seen in some patients; cystic fluid cytology does not provide adequate diagnostic aid.
  • Its morphologic features maybe confused with biliary papillomatosis or IPMN of bile duct.
  • [MeSH-major] Bile Ducts, Intrahepatic. Biliary Tract Neoplasms / diagnosis. Cystadenoma / diagnosis. Liver Neoplasms / diagnosis
  • [MeSH-minor] Aged. Biopsy. Cholangiopancreatography, Endoscopic Retrograde. Cholecystectomy. Diagnosis, Differential. Follow-Up Studies. Hepatectomy. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 18568143.001).
  • [ISSN] 1841-8724
  • [Journal-full-title] Journal of gastrointestinal and liver diseases : JGLD
  • [ISO-abbreviation] J Gastrointestin Liver Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Romania
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18. Ishizaki Y, Yoshimoto J, Miwa K, Sugo H, Kawasaki S: Safety of prolonged intermittent pringle maneuver during hepatic resection. Arch Surg; 2006 Jul;141(7):649-53; discussion 654
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  • PATIENTS: Resections were performed for metastatic carcinoma in 19 patients, hepatocellular carcinoma in 7 patients, hilar bile duct carcinoma in 3 patients, intrahepatic cholangiocarcinoma in 1 patient, combined hepatocellular carcinoma and cholangiocarcinoma in 1 patient, undifferentiated embryonal sarcoma in 1 patient, carcinoid tumor in 1 patient, and benign mucinous cystic tumor in 1 patient.

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  • (PMID = 16847234.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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19. Dumitrascu T, Ionescu M, Ciurea S, Herlea V, Lupescu I, Popescu I: Klatskin-mimicking lesions--a case series and literature review. Hepatogastroenterology; 2010 Jul-Aug;57(101):961-7
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  • Obstruction of the hepatic hilum in patients without prior surgery is generally due to hilar adenocarcinoma (Klatskin tumor).
  • Although uncommon, benign strictures of the proximal bile duct should be taken into consideration in differential diagnosis of Klatskin tumors, since the incidence could reach up to 25% of patients with presumed Klatskin tumor diagnosis.
  • This group of benign proximal bile duct strictures (Klatskin-mimicking lesions) is usually represented by segmental fibrosis and non-specific chronic inflammation.
  • The clinical and imaging features can not differentiate between benign and malignant strictures.
  • Herein, we present a case series of three patients with benign proximal bile duct strictures (representing 4.1% of 73 patients resected with presumptive preoperative diagnosis of Klatskin tumor) and literature review.
  • For benign strictures of the hilum limited resections are curative.
  • However, despite new diagnosis tools developed in the last years, patients with hilar obstructions still require unnecessary extensive resections due to impossibility of excluding the malignancy.
  • In all cases of proximal bile duct obstruction presumed malignant, they should be managed accordingly, even with the risk of over-treatment for some benign lesions.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Hepatic Duct, Common. Klatskin Tumor / diagnosis
  • [MeSH-minor] Adult. Bile Ducts, Intrahepatic / pathology. Cholangiopancreatography, Endoscopic Retrograde. Cholangiopancreatography, Magnetic Resonance. Cholestasis. Diagnosis, Differential. Dilatation, Pathologic. Humans. Magnetic Resonance Imaging. Male. Middle Aged

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  • (PMID = 21033260.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA016672
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Greece
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20. Li Q, Wang JM, Liu C, Xiao BL, Su Y, Zou SQ: [Expression and significance of aPKC-iota and E-cadherin in cholangiocarcinoma]. Ai Zheng; 2007 Jul;26(7):715-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND & OBJECTIVE: Studies showed that the abnormal expression of atypical protein kinase C iota subtype (aPKC-iota) and E-cadherin plays an important role in tumor genesis and progression.
  • METHODS: The expression of aPKC-iota and E-cadherin in 9 specimens of benign bile duct tissues and 35 specimens of cholangiocarcinoma was detected by EnVision immunohistochemistry, and their correlations to the clinicopathologic characteristics and invasion of cholangiocarcinoma were analyzed.
  • RESULTS: The positive rate of aPKC-iota was significantly higher in cholangiocarcinoma than in benign bile duct tissues (68.6% vs. 11.1%, P = 0.006), while the positive rate of E-cadherin was significantly lower in cholangiocarcinoma than in benign bile duct tissues (37.1% vs. 88.9%, P = 0.016).
  • [MeSH-major] Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic. Cadherins / metabolism. Cholangiocarcinoma / metabolism. Isoenzymes / metabolism. Protein Kinase C / metabolism
  • [MeSH-minor] Adult. Aged. Bile Ducts / metabolism. Cell Differentiation. Cholangitis / metabolism. Choledochal Cyst / metabolism. Female. Humans. Immunohistochemistry. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Young Adult

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  • (PMID = 17626746.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Cadherins; 0 / Isoenzymes; EC 2.7.11.13 / Protein Kinase C; EC 2.7.11.13 / protein kinase C lambda
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21. Leelawat K, Sakchinabut S, Narong S, Wannaprasert J: Detection of serum MMP-7 and MMP-9 in cholangiocarcinoma patients: evaluation of diagnostic accuracy. BMC Gastroenterol; 2009;9:30
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  • BACKGROUND: Cholangiocarcinoma is an aggressive tumor with a tendency for local invasion and distant metastases.
  • Timely diagnosis is very important because surgical resection (R0) remains the only hope for a cure.
  • However, at present, there is no available tumor marker that can differentiate cholangiocarcinoma from benign bile duct disease.
  • METHODS: This study was designed to determine whether the serum levels of MMP-7 and MMP-9 can discriminate cholangiocarcinoma patients from benign biliary tract disease patients in comparison to carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9).
  • We measured the level of CEA, CA19-9, MMP-7 and MMP-9 in the serum of 44 cholangiocarcinoma and 36 benign biliary tract diseases patients.
  • RESULTS: Among the serum levels of CEA, CA19-9, MMP-7 and MMP-9, only the serum MMP-7 level was significantly higher in the patients with cholangiocarcinoma (8.9 +/- 3.43 ng/ml) compared to benign biliary tract disease patients (5.9 +/- 3.03 ng/ml) (p < 0.001).
  • An receiver operating characteristic (ROC) curve analysis revealed that the detection of the serum MMP-7 level is reasonably accurate in differentiating cholangiocarcinoma from benign biliary tract disease patients (area under curve = 0.73; 95% CI = 0.614-0.848).
  • CONCLUSION: Serum MMP-7 appears to be a valuable diagnostic marker in the discrimination of cholangiocarcinoma from benign biliary tract disease.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Biliary Tract Diseases / diagnosis. Biomarkers, Tumor / blood. Cholangiocarcinoma / diagnosis. Matrix Metalloproteinase 7 / blood. Matrix Metalloproteinase 9 / blood
  • [MeSH-minor] Adult. Aged. CA-19-9 Antigen / blood. Carcinoembryonic Antigen / blood. Diagnosis, Differential. Female. Humans. Jaundice, Obstructive / blood. Jaundice, Obstructive / diagnosis. Male. Middle Aged. ROC Curve. Sensitivity and Specificity

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  • (PMID = 19405942.001).
  • [ISSN] 1471-230X
  • [Journal-full-title] BMC gastroenterology
  • [ISO-abbreviation] BMC Gastroenterol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen; EC 3.4.24.23 / Matrix Metalloproteinase 7; EC 3.4.24.35 / Matrix Metalloproteinase 9
  • [Other-IDs] NLM/ PMC2680894
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22. Paik KY, Heo JS, Choi SH, Choi DW: Intraductal papillary neoplasm of the bile ducts: the clinical features and surgical outcome of 25 cases. J Surg Oncol; 2008 May 1;97(6):508-12
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  • [Title] Intraductal papillary neoplasm of the bile ducts: the clinical features and surgical outcome of 25 cases.
  • BACKGROUND AND OBJECTIVES: Intraductal papillary neoplasm of the bile ducts (IPN-B) is considered an uncommon tumor.
  • Radiologically, 23 of the 25 (92.0%) showed bile duct dilatation, bile duct dilatation with or without an intraductal mass, and cystic changes of bile ducts.
  • Twenty three of the 25 patients underwent hepatic resection with or without extrahepatic bile duct resection.
  • All six patients with benign IPN-B remained alive at a mean of 26.2 postoperative months without recurrence.
  • CONCLUSIONS: A diagnosis of IPN-B is usually made in patients with biliary dilatation by radiologic study.
  • The prognosis of IPN-B, especially of the benign category, is excellent.
  • [MeSH-major] Bile Duct Neoplasms / surgery. Bile Ducts, Intrahepatic / surgery. Carcinoma, Papillary / surgery
  • [MeSH-minor] Adenocarcinoma, Mucinous / secondary. Adenocarcinoma, Mucinous / surgery. Adult. Aged. Cholangiocarcinoma / secondary. Cholangiocarcinoma / surgery. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / diagnosis. Prognosis. Survival Rate. Treatment Outcome

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  • [Copyright] (c) 2007 Wiley-Liss, Inc.
  • (PMID = 18314868.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Uenishi T, Yamazaki O, Tanaka H, Takemura S, Yamamoto T, Tanaka S, Nishiguchi S, Kubo S: Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma. Ann Surg Oncol; 2008 Feb;15(2):583-9
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  • [Title] Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma.
  • This study aimed to establish the clinical significance of preoperative serum CYFRA21-1 in patients with intrahepatic cholangiocarcinoma.
  • METHODS: CYFRA21-1, carcinoembryonic antigen (CEA), and carbohydrate antigen (CA) 19-9 concentrations were measured in sera from 71 patients with intrahepatic cholangiocarcinoma.
  • RESULTS: Analysis of the areas under the receiver operator characteristic (ROC) curves clearly showed better discrimination between intrahepatic cholangiocarcinoma and benign liver diseases for CYFRA 21-1 than for CEA or CA 19-9.
  • The serum CYFRA21-1 concentration was related to tumor stage, since the CYFRA21-1 concentrations varied according to tumor size, vascular invasion, and number of tumors.
  • On multivariate analysis, a high concentration of CYFRA21-1, nodal metastases, and a microscopic resection margin involvement were independent prognostic factors associated with both tumor recurrence and postoperative death.
  • CONCLUSIONS: A high serum CYFRA21-1 concentration is associated with tumor progression and poor postoperative outcomes in patients with intrahepatic cholangiocarcinoma.
  • [MeSH-major] Antigens, Neoplasm / blood. Bile Duct Neoplasms / blood. Bile Ducts, Intrahepatic. Biomarkers, Tumor / blood. Cholangiocarcinoma / blood. Keratins / blood
  • [MeSH-minor] Aged. CA-19-9 Antigen / blood. Carcinoembryonic Antigen / blood. Disease-Free Survival. Female. Humans. Keratin-19. Lymphatic Metastasis. Male. Multivariate Analysis. Neoplasm Invasiveness. Prognosis. ROC Curve. Sensitivity and Specificity


24. Yamaguchi K, Nakano K, Nagai E, Chijiiwa K, Kinoshita M, Ohta M, Tanaka M: Ki-ras mutations in codon 12 and p53 mutations (biomarkers) and cytology in bile in patients with hepatobiliary-pancreatic carcinoma. Hepatogastroenterology; 2005 May-Jun;52(63):713-8
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  • [Title] Ki-ras mutations in codon 12 and p53 mutations (biomarkers) and cytology in bile in patients with hepatobiliary-pancreatic carcinoma.
  • BACKGROUND/AIMS: The differentiation between benign and malignant jaundice is sometimes difficult even with modern diagnostic modalities.
  • The purpose of this study was to compare exfoliative bile cytology and biomarkers of the bile in patients with hepatobiliary and pancreatic diseases.
  • METHODOLOGY: Cytologic examination and novel biomarkers, point mutations of codon 12 of Ki-ras and p53 mutations, were examined in the biliary tract bile aspirated through percutaneous transhepatic biliary drainage (PTBD) tube in 30 Japanese patients with benign and malignant hepatobiliary and pancreatic diseases.
  • RESULTS: Sensitivity of the exfoliative bile cytology for malignant conditions was 31% and specificity 100%, while sensitivity of molecular markers of the bile was 25% and specificity 93%.
  • CONCLUSIONS: These findings suggest that genetic examinations of the bile, when used in conjunction with cytology, may improve the diagnostic yield for suspected malignant tumors of the hepatobiliary and pancreatic system.
  • [MeSH-major] Bile / cytology. Bile Duct Neoplasms / genetics. Bile Ducts, Extrahepatic. Bile Ducts, Intrahepatic. Biomarkers, Tumor / genetics. Codon / genetics. DNA Mutational Analysis. Genes, ras / genetics. Pancreatic Neoplasms / genetics. Proto-Oncogene Proteins p21(ras) / genetics. Tumor Suppressor Protein p53 / genetics
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Bile Duct Diseases / diagnosis. Bile Duct Diseases / genetics. Female. Humans. Male. Middle Aged. Pancreatic Diseases / diagnosis. Pancreatic Diseases / genetics. Point Mutation. Reference Values. Sensitivity and Specificity

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  • (PMID = 15966189.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Codon; 0 / Tumor Suppressor Protein p53; EC 3.6.5.2 / Proto-Oncogene Proteins p21(ras)
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25. Levy M, Lin F, Xu H, Dhall D, Spaulding BO, Wang HL: S100P, von Hippel-Lindau gene product, and IMP3 serve as a useful immunohistochemical panel in the diagnosis of adenocarcinoma on endoscopic bile duct biopsy. Hum Pathol; 2010 Sep;41(9):1210-9
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  • [Title] S100P, von Hippel-Lindau gene product, and IMP3 serve as a useful immunohistochemical panel in the diagnosis of adenocarcinoma on endoscopic bile duct biopsy.
  • Histopathologic distinction between benign and malignant bile duct epithelial lesions on endoscopic biopsies can be extremely challenging because of limited material, crush artifact, and compounding inflammatory and/or reactive changes particularly after stent placement.
  • In this study, a total of 72 endoscopic bile duct biopsies, including 40 adenocarcinomas and 32 benign cases, were immunohistochemically examined for the expression of S100P, von Hippel-Lindau gene product (pVHL), and IMP3 to evaluate their diagnostic value.
  • All 32 benign biopsies were completely negative for IMP3 with the exception of 2 cases with focal dysplasia where focal immunoreactivity was observed.
  • Thirty benign biopsies (93.8%) were positive for pVHL with a diffuse staining pattern observed in 28 cases (93.3%).
  • Eight benign biopsies (25%) showed focal S100P positivity.
  • Twenty-two benign biopsies (68.8%) displayed a S100P-/IMP3-/pVHL+ staining pattern.
  • In conclusion, an immunohistochemical panel consisting of S100P, pVHL, and IMP3 can be helpful in distinguishing adenocarcinoma from reactive epithelial changes on challenging bile duct biopsies.
  • The findings of focal S100P and/or IMP3 expression with reciprocal loss of pVHL immunoreactivity in a few benign biopsies suggest a use of these markers in the detection of early epithelial dysplasia that may be beyond histologic recognition.
  • [MeSH-major] Adenocarcinoma / diagnosis. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic / pathology. Biomarkers, Tumor / analysis. Carrier Proteins / analysis. Nuclear Proteins / analysis. RNA-Binding Proteins / analysis. Von Hippel-Lindau Tumor Suppressor Protein / analysis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy. Carcinoma, Pancreatic Ductal / chemistry. Carcinoma, Pancreatic Ductal / diagnosis. Cholangiopancreatography, Endoscopic Retrograde. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Pancreatic Neoplasms / chemistry. Pancreatic Neoplasms / diagnosis. Precancerous Conditions / diagnosis

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • [CommentIn] Hum Pathol. 2011 Sep;42(9):1368; author reply 1368-9 [21704356.001]
  • (PMID = 20382408.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Carrier Proteins; 0 / IMP3 protein, human; 0 / Nuclear Proteins; 0 / RNA-Binding Proteins; 0 / S100PBP protein, human; EC 6.3.2.19 / VHL protein, human; EC 6.3.2.19 / Von Hippel-Lindau Tumor Suppressor Protein
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26. Feldmann G, Nattermann J, Nischalke HD, Gorschlüter M, Kuntzen T, Ahlenstiel G, Gerhardt T, Wolff M, Sauerbruch T, Spengler U, Dumoulin FL: Detection of human aspartyl (asparaginyl) beta-hydroxylase and homeobox B7 mRNA in brush cytology specimens from patients with bile duct cancer. Endoscopy; 2006 Jun;38(6):604-9
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  • [Title] Detection of human aspartyl (asparaginyl) beta-hydroxylase and homeobox B7 mRNA in brush cytology specimens from patients with bile duct cancer.
  • BACKGROUND AND STUDY AIMS: The diagnosis of bile duct cancer is hampered by the low sensitivity of intraductal brush cytology and forceps biopsy.
  • Both markers are overexpressed in biliary cancer cell lines and possibly involved in the pathogenesis of bile duct cancer.
  • Target gene expression was determined in brush cytology specimens from 16 patients with biliary strictures (11 with histologically proven cholangiocarcinomas and five with benign biliary strictures).
  • CONCLUSIONS: Detection of these markers using the RT-PCR assays from brush cytology specimens described here may prove to be a useful additional tool for the diagnosis of bile duct carcinoma.
  • [MeSH-major] Bile Duct Neoplasms / genetics. Bile Ducts, Intrahepatic. Cholangiocarcinoma / genetics. Gene Expression Regulation, Neoplastic. Homeodomain Proteins / genetics. Mixed Function Oxygenases / genetics. RNA, Messenger / genetics
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cell Line, Tumor. Female. Humans. Male. Middle Aged. Reproducibility of Results. Retrospective Studies. Reverse Transcriptase Polymerase Chain Reaction

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  • (PMID = 16673309.001).
  • [ISSN] 0013-726X
  • [Journal-full-title] Endoscopy
  • [ISO-abbreviation] Endoscopy
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Validation Studies
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / HOXB7 protein, human; 0 / Homeodomain Proteins; 0 / RNA, Messenger; EC 1.- / Mixed Function Oxygenases; EC 1.14.11.- / aspartic acid 2-oxoglutarate-dependent dioxygenase
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27. Kim YS, Rha SE, Oh SN, Jung SE, Shin YR, Choi BG, Byun JY, Jung ES, Kim DG: Imaging findings of intrahepatic bile duct adenoma (peribiliary gland hamartoma): a case report and literature review. Korean J Radiol; 2010 Sep-Oct;11(5):560-5
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  • [Title] Imaging findings of intrahepatic bile duct adenoma (peribiliary gland hamartoma): a case report and literature review.
  • Intrahepatic bile duct adenoma is a rare benign epithelial hepatic tumor derived from bile duct cells.
  • We report the imaging findings of a patient with bile duct adenoma, which appeared as a small heterogeneously enhancing mass with focal small cystic change on CT and MRI.
  • Follow-up images at seven months showed a slight increase in tumor size, which could be partly explained by intratumoral hemorrhage on pathologic examination.
  • Although rare, bile duct adenoma should be considered as a differential diagnosis of a small hypervascular tumor located in the periphery of liver.
  • [MeSH-major] Adenoma, Bile Duct / diagnosis. Bile Duct Neoplasms / diagnosis. Hamartoma / diagnosis

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  • (PMID = 20808701.001).
  • [ISSN] 2005-8330
  • [Journal-full-title] Korean journal of radiology
  • [ISO-abbreviation] Korean J Radiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Contrast Media
  • [Other-IDs] NLM/ PMC2930166
  • [Keywords] NOTNLM ; Adenoma / Bile duct / Computed tomography (CT) / Liver / Magnetic resonance (MR)
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28. Matsuda A, Kuno A, Kawamoto T, Matsuzaki H, Irimura T, Ikehara Y, Zen Y, Nakanuma Y, Yamamoto M, Ohkohchi N, Shoda J, Hirabayashi J, Narimatsu H: Wisteria floribunda agglutinin-positive mucin 1 is a sensitive biliary marker for human cholangiocarcinoma. Hepatology; 2010 Jul;52(1):174-82
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  • Cholangiocarcinoma (CC) is an aggressive malignant tumor for which useful markers are not presently available for early and precise diagnosis.
  • In the course of study, we found that Wisteria floribunda agglutinin (WFA) is the best probe to differentiate intrahepatic cholangiocarcinoma (ICC) lesions from normal bile duct epithelia (BDE) (P < 0.0001).
  • Moreover, glyco-alteration of MUC1 could be verified by western blotting of WFA-captured bile samples from patients with CC patients.
  • Thus, we attempted to construct an enzyme-linked immunosorbent assay system for more convenient CC diagnosis, where WFA-coated plates, the specific monoclonal antibody MY.1E12, and the bile specimens from CC including ICC (n = 30) and benign diseases (n = 38) were combined.
  • As a result, CC was clearly distinguished from benign diseases with statistical scores (sensitivity = 90.0%, specificity = 76.3%, and area under the curve = 0.85).
  • [MeSH-major] Bile / chemistry. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Biomarkers, Tumor / analysis. Cholangiocarcinoma / diagnosis. Enzyme-Linked Immunosorbent Assay. Mucin-1 / analysis. Plant Lectins / chemistry. Receptors, N-Acetylglucosamine / chemistry

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  • (PMID = 20578261.001).
  • [ISSN] 1527-3350
  • [Journal-full-title] Hepatology (Baltimore, Md.)
  • [ISO-abbreviation] Hepatology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Biomarkers, Tumor; 0 / Mucin-1; 0 / Plant Lectins; 0 / Receptors, N-Acetylglucosamine; 0 / wisteria lectin
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29. Vivekanandan P, Torbenson M: Low frequency of Helicobacter DNA in benign and malignant liver tissues from Baltimore, United States. Hum Pathol; 2008 Feb;39(2):213-6
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  • [Title] Low frequency of Helicobacter DNA in benign and malignant liver tissues from Baltimore, United States.
  • Thirty-five individuals had paired tumor/nontumor samples, including 21 cases of hepatocellular carcinoma, for a total of 92 samples studied.
  • Tissues from 22 hepatocellular carcinomas and 10 cholangiocarcinomas were all negative as were tissues from 8 benign primary hepatic tumors.
  • In conclusion, Helicobacter DNA was detectable in 9% of liver tissues in this cohort but was not found in primary benign or malignant liver tumors.

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  • (PMID = 17949788.001).
  • [ISSN] 0046-8177
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] ENG
  • [Grant] United States / NIDA NIH HHS / DA / DA016370-05; United States / NIDA NIH HHS / DA / K08 DA016370; United States / NIDA NIH HHS / DA / K08 DA016370-05
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Bacterial
  • [Other-IDs] NLM/ NIHMS39966; NLM/ PMC2946621
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30. Khunamornpong S, Siriaunkgul S, Suprasert P, Pojchamarnwiputh S, Na Chiangmai W, Young RH: Intrahepatic cholangiocarcinoma metastatic to the ovary: a report of 16 cases of an underemphasized form of secondary tumor in the ovary that may mimic primary neoplasia. Am J Surg Pathol; 2007 Dec;31(12):1788-99
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  • [Title] Intrahepatic cholangiocarcinoma metastatic to the ovary: a report of 16 cases of an underemphasized form of secondary tumor in the ovary that may mimic primary neoplasia.
  • Although an origin in the gallbladder or extrahepatic bile ducts is acknowledged for some cases little information exists on tumors originating within the intrahepatic bile ducts.
  • Foci often mimicked mucinous borderline tumors of typical type or with intraepithelial carcinoma and benign-appearing mucinous epithelium was seen in 62% of tumors.
  • Intrahepatic cholangiocarcinoma should be included in the list of origins of possible ovarian metastatic tumors that mimic primary ovarian mucinous neoplasia, particularly in parts of the world where cholangiocarcinoma of the liver is relatively common.
  • [MeSH-major] Bile Duct Neoplasms / pathology. Cholangiocarcinoma / secondary. Ovarian Neoplasms / secondary
  • [MeSH-minor] Adult. Aged. Bile Ducts, Intrahepatic / pathology. Diagnosis, Differential. Female. Humans. Middle Aged


31. Kitajima K, Shiba H, Nojiri T, Uwagawa T, Ishida Y, Ichiba N, Yanaga K: Intrahepatic cholangiocarcinoma mimicking hepatic inflammatory pseudotumor. J Gastrointest Surg; 2007 Mar;11(3):398-402
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  • [Title] Intrahepatic cholangiocarcinoma mimicking hepatic inflammatory pseudotumor.
  • A 50-year-old male with hepatitis B was referred for a small intrahepatic nodule.
  • Magnetic resonance images raised strong suspicion of a benign lesion, such as an inflammatory pseudotumor, while the other radiological studies were equivocal.
  • Furthermore, the high-intensity image on diffusion magnified-weighted imaging with a low B value strongly suggested a benign tumor.
  • In spite of the absence of typical clinical or radiological findings, needle biopsy revealed an intrahepatic cholangiocarcinoma (ICC).
  • The diagnosis of peripheral ICC rich in fibrous tissue seems to require needle biopsy for pathological examination with immunohistochemical staining because it frequently mimics other diseases, including benign tumors.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Cholangiocarcinoma / diagnosis. Granuloma, Plasma Cell / diagnosis. Liver Neoplasms / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Humans. Male. Middle Aged

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  • (PMID = 17458614.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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32. Deng FT, Li YX, Ye L, Tong L, Yang XP, Chai XQ: Hilar inflammatory pseudotumor mimicking hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int; 2010 Apr;9(2):219-21
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  • BACKGROUND: Inflammatory pseudotumor of the biliary tract is a benign disease, and is extremely rare.
  • Its diagnosis often depends on pathological examination after operation.
  • This study was undertaken to elucidate that an inflammatory pseudotumor in the right hepatic duct is especially difficult to distinguish from hilar cholangiocarcinoma.
  • METHOD: The clinical data of one patient with inflammatory pseudotumor of the right hepatic duct were analyzed.
  • RESULTS: An occupying lesion of the right hepatic duct was revealed by abdominal ultrasound and magnetic resonance cholangiopancreatography.
  • The right hepatic duct inflammatory pseudotumor was not identified during the operation but was confirmed by postoperative histopathological analysis.
  • CONCLUSIONS: The preoperative evaluation for optimizing surgical management is important to the diagnosis of hepatobiliary occupying lesions.
  • The evaluation involves clinical manifestations, imaging appearance and tumor markers.
  • Malignant tumors and possible benign lesions should be considered to avoid aggressive surgical treatment.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Cholangiocarcinoma / diagnosis. Granuloma, Plasma Cell / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Middle Aged. alpha-Fetoproteins / analysis

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  • (PMID = 20382598.001).
  • [ISSN] 1499-3872
  • [Journal-full-title] Hepatobiliary & pancreatic diseases international : HBPD INT
  • [ISO-abbreviation] HBPD INT
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / alpha-Fetoproteins
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33. Yang B, House MG, Guo M, Herman JG, Clark DP: Promoter methylation profiles of tumor suppressor genes in intrahepatic and extrahepatic cholangiocarcinoma. Mod Pathol; 2005 Mar;18(3):412-20
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  • [Title] Promoter methylation profiles of tumor suppressor genes in intrahepatic and extrahepatic cholangiocarcinoma.
  • Recent studies indicate that tumor suppressor genes can be epigenetically silenced through promoter hypermethylation.
  • To further understand epigenetic alterations in cholangiocarcinoma, we have studied the methylation profiles of 12 candidate tumor suppressor genes (APC, E-cadherin/CDH1, MGMT, RASSF1A, GSTP, RAR-beta, p14ARF, p15INK4b, p16INK4a, p73, hMLH1 and DAPK) in 72 cases of cholangiocarcinoma, including equal number cases of intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma.
  • A total of 10 cases of benign biliary epithelia were included as controls.
  • The methylation status of tumor suppressor genes was analyzed using methylation-specific PCR.
  • We found that 85% of all cholangiocarcinomas had methylation of at least one tumor suppressor gene.
  • The frequency of tumor suppressor gene methylation in cholangiocarcinoma was: RASSF1A (65%), p15INK4b (50%), p16INK4a (50%), APC (46%), E-cadherin/CDH1 (43%), p14(ARF) (38%), p73 (36%), MGMT (33%), hMHL1 (25%), GSTP (14%), RAR-beta (14%) and DAPK (3%).
  • Although single tumor suppressor gene methylation can be seen in benign biliary epithelium, methylation of multiple tumor suppressor genes is only seen in cholangiocarcinoma.
  • About 70% (50/72) of the cholangiocarcinomas had three or more tumor suppressor genes methylated and 52% (38/72) of cases had four or more tumor suppressor genes methylated.
  • Concerted methylation of multiple tumor suppressor genes was closely associated with methylation of RASSF1A, p16 and/or hMHL1.
  • Methylation of RASSF1A was more common in extrahepatic cholangiocarcinoma than intrahepatic cholangiocarcinoma (83 vs 47%, P=0.003) while GSTP was more frequently seen in intrahepatic compared to extrahepatic cholangiocarcinoma (31 vs 6%, P=0.012).
  • Our study indicates that methylation of promoter CpG islands of tumor suppressor genes is a common epigenetic event in cholangiocarcinoma.
  • Based on distinct methylation profiles, intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma are two closely related but biologically unique neoplastic processes.
  • Taking advantage of the unique concurrent methylation profile of multiple genes in cholangiocarcinoma may facilitate the distinction of cholangiocarcinoma from benign biliary epithelium in clinical settings.
  • [MeSH-major] Bile Duct Neoplasms / genetics. Cholangiocarcinoma / genetics. DNA Methylation. Promoter Regions, Genetic / genetics. Tumor Suppressor Proteins / genetics
  • [MeSH-minor] Bile Ducts, Extrahepatic / metabolism. Bile Ducts, Extrahepatic / pathology. Bile Ducts, Intrahepatic / metabolism. Bile Ducts, Intrahepatic / pathology. Humans


34. Evert M, Schildhaus HU, Schneider-Stock R, Dombrowski F: Cystic cholangiomas after transplantation of pancreatic islets into the livers of diabetic rats. Virchows Arch; 2006 Jun;448(6):776-87
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  • In our study, we investigated the effect of the transplantation of a low number (n = 350) of pancreatic islets into the right liver part on the neighboring portal bile ducts.
  • During the next 12-24 months, many peri-insular ductules progressed via tumor-like cystic lesions to large cystic cholangiomas, accompanied by a translocation of the insulin receptor into the cytoplasm and an increase in expression of insulin-related signaling proteins (Insulin-receptor-substrate-1, Raf-1, Mek-1).
  • After 24 months, 53% of rats with low-number transplantation exhibited at least one cholangioma >10 mm, significantly outnumbering tumor development in the transplant-free left liver part and in any control group.
  • Conclusively, low-number intrahepatic islet transplantation, most likely acting by permanent local hyperinsulinism, leads to prolonged cholangiocellular proliferation in streptozotocin- and in autoimmune-diabetic rats, resulting in the development of benign cystic cholangiomas.
  • [MeSH-major] Adenoma, Bile Duct / etiology. Bile Duct Neoplasms / etiology. Bile Ducts, Intrahepatic / pathology. Diabetes Mellitus, Experimental / complications. Diabetes Mellitus, Type 1 / complications. Islets of Langerhans Transplantation / adverse effects


35. Droy L, Sagan C, Paineau J, Gournay J, Mosnier JF: [Cholangiocarcinomas developing on multiple bile duct hamartomas syndrome]. Ann Pathol; 2009 Feb;29(1):24-7
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  • [Title] [Cholangiocarcinomas developing on multiple bile duct hamartomas syndrome].
  • Two cases of cholangiocarcinoma arising in a background of multiple bile duct hamartomas are reported.
  • In each case, the clinical and radiological investigations showed a liver tumor with no other concomitant disease.
  • It revealed also numerous bile duct hamartomas scattered throughout the liver.
  • In one case, some bile duct hamartomas showed a gradual morphologic transition from benign to dysplastic and neoplastic epithelium.
  • Patients with multiple bile duct hamartomas may have an increased risk of developing cholangiocarcinomas.
  • [MeSH-major] Bile Duct Neoplasms / pathology. Cholangiocarcinoma / pathology. Cholangiocarcinoma / surgery. Hamartoma / pathology
  • [MeSH-minor] Bile Ducts, Intrahepatic / pathology. Bile Ducts, Intrahepatic / surgery. Cell Division. Disease Progression. Female. Hepatectomy. Humans. Male. Middle Aged. Neoplasm Staging. Treatment Outcome

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  • (PMID = 19233090.001).
  • [ISSN] 0242-6498
  • [Journal-full-title] Annales de pathologie
  • [ISO-abbreviation] Ann Pathol
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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36. Püspök A, Lomoschitz F, Dejaco C, Hejna M, Sautner T, Gangl A: Endoscopic ultrasound guided therapy of benign and malignant biliary obstruction: a case series. Am J Gastroenterol; 2005 Aug;100(8):1743-7
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  • [Title] Endoscopic ultrasound guided therapy of benign and malignant biliary obstruction: a case series.
  • OBJECTIVES: Endoscopic retrograde cholangiography is an established method for treatment of common bile duct stones as well as for palliation of patients with malignant pancreaticobiliary strictures.
  • It may be unsuccessful in the presence of a complex peripapillary diverticulum, prior surgery, obstructing tumor, papillary stenosis, or impacted stones.
  • METHODS: The EUS guided transduodenal puncture of the common bile duct with stent placement was performed in 5 patients.
  • In 2 of these patients, the stents were removed after several weeks and common bile duct stones were extracted.
  • In another patient with gastrectomy, the left intrahepatic bile duct was punctured transjejunally and a metal stent was introduced transhepatically to bridge a distal common bile duct stenosis.
  • CONCLUSIONS: Interventional EUS guided biliary drainage is a new technique that allows drainage of the biliary system in benign and malignant diseases when the bile duct is inaccessible by conventional ERCP.
  • [MeSH-major] Bile Ducts. Cholestasis / therapy. Drainage. Endosonography. Stents
  • [MeSH-minor] Aged. Aged, 80 and over. Cholangiopancreatography, Endoscopic Retrograde. Common Bile Duct Diseases / etiology. Common Bile Duct Diseases / therapy. Female. Gallstones / therapy. Humans. Male. Middle Aged. Pancreatic Neoplasms / complications. Ultrasonography, Interventional

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  • (PMID = 16086710.001).
  • [ISSN] 0002-9270
  • [Journal-full-title] The American journal of gastroenterology
  • [ISO-abbreviation] Am. J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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37. Bilanović D, Boricić I, Zdravković D, Randjelović T, Stanisavljević N, Toković B: Granular cell tumor of the common hepatic duct presenting as cholangiocarcinoma and acute acalculous cholecystitis. Acta Chir Iugosl; 2008;55(4):99-101
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  • [Title] Granular cell tumor of the common hepatic duct presenting as cholangiocarcinoma and acute acalculous cholecystitis.
  • Granular cell tumors (GCT) are rare benign tumors.
  • US and CT revealed dilatation of intrahepatic biliary tree and surgery was performed.
  • Firm tumor mass was found above the conjunction of cystic duct and common hepatic duct (CHD) that caused obstruction and gallblader empyema.
  • The patient underwent radical surgical procedure because Klatskin tumor was clinically suspected.
  • Patohystology and immunohistochemistry confirmed granular cell tumor.
  • [MeSH-major] Acalculous Cholecystitis / diagnosis. Bile Duct Neoplasms / diagnosis. Cholangiocarcinoma / diagnosis. Granular Cell Tumor / diagnosis. Hepatic Duct, Common
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans

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  • (PMID = 19245149.001).
  • [ISSN] 0354-950X
  • [Journal-full-title] Acta chirurgica Iugoslavica
  • [ISO-abbreviation] Acta Chir Iugosl
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Serbia
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38. Somorácz A, Tátrai P, Horváth G, Kiss A, Kupcsulik P, Kovalszky I, Schaff Z: Agrin immunohistochemistry facilitates the determination of primary versus metastatic origin of liver carcinomas. Hum Pathol; 2010 Sep;41(9):1310-9
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  • In addition, we proved the utility of agrin immumohistochemistry in discriminating between HCCs and benign parenchymal lesions.
  • Immunohistochemistry for agrin was performed on 25 HCC, 16 intrahepatic CCC, 20 colorectal cancer metastasis (CRCm), and 18 pancreatic ductal carcinoma metastasis (PDCm) samples and evaluated with both quantitative and qualitative methods.
  • Regardless of tumor grade, agrin immunostaining was strong in the microvessels of HCCs.
  • As opposed to HCC, agrin immunostaining was faint or nearly absent from the CD34-positive microvessels of CCC, CRCm, and PDCm; rather, it was detected in the basement membranes surrounding tumor cell pseudoglandules.
  • [MeSH-minor] Adult. Aged. Antigens, CD34 / metabolism. Bile Duct Neoplasms / genetics. Bile Duct Neoplasms / metabolism. Bile Duct Neoplasms / pathology. Bile Ducts, Intrahepatic / metabolism. Bile Ducts, Intrahepatic / pathology. Biomarkers, Tumor / genetics. Biomarkers, Tumor / metabolism. Carcinoma, Pancreatic Ductal / genetics. Carcinoma, Pancreatic Ductal / metabolism. Carcinoma, Pancreatic Ductal / secondary. Cholangiocarcinoma / genetics. Cholangiocarcinoma / metabolism. Cholangiocarcinoma / pathology. DNA, Neoplasm / analysis. Diagnosis, Differential. Endothelium, Vascular / metabolism. Endothelium, Vascular / pathology. Female. Gene Expression Regulation, Neoplastic. Hepatectomy. Humans. Male. Microvessels / metabolism. Microvessels / pathology. Middle Aged. Pancreatic Neoplasms / genetics. Pancreatic Neoplasms / metabolism. Pancreatic Neoplasms / pathology. RNA, Messenger / metabolism. Young Adult

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20471664.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Agrin; 0 / Antigens, CD34; 0 / Biomarkers, Tumor; 0 / DNA, Neoplasm; 0 / RNA, Messenger
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39. Liu L, Wang J, Liu B, Dai S, Wang X, Chen J, Huang L, Xiao X, He D: Serum levels of variants of transthyretin down-regulation in cholangiocarcinoma. J Cell Biochem; 2008 Jun 1;104(3):745-55
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  • BACKGROUND: Cholangiocarcinoma (CC) is devastating neoplasm and very few specific biomarkers could be used in clinical diagnosis.
  • ELISA assay indicated that TTR levels were consistent with SELDI analysis in CC compared with healthy control and benign diseases of hepatobiliary (P < 0.001).
  • TTR combining with CA19-9 to differentiate CC from benign hepatobiliary diseases showed sensitivity and specificity were 98.2% and 100%, respectively.
  • CONCLUSION: The levels of TTR were significantly down-regulated in sera of CC patients and may be complementary markers of CA19-9 in diagnosis for CC.
  • [MeSH-major] Bile Duct Neoplasms / blood. Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic / metabolism. Cholangiocarcinoma / blood. Cholangiocarcinoma / metabolism. Gene Expression Regulation, Neoplastic. Prealbumin / biosynthesis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor. CA-19-9 Antigen / biosynthesis. Case-Control Studies. Female. Humans. Male. Middle Aged


40. Gütgemann I, Haas S, Berg JP, Zhou H, Büttner R, Fischer HP: CD56 expression aids in the differential diagnosis of cholangiocarcinomas and benign cholangiocellular lesions. Virchows Arch; 2006 Apr;448(4):407-11
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  • [Title] CD56 expression aids in the differential diagnosis of cholangiocarcinomas and benign cholangiocellular lesions.
  • In this study, we systematically examined CD56 expression on 98 tumours arising from the biliary tree as well as intrahepatic conditions with reactive neoductules.
  • Reactive bile ductules adjacent to cirrhotic nodules as well as in focal nodular hyperplasia were CD56 positive.
  • Twelve of 17 (70.5%) bile duct adenomas were CD56 positive, whereas von Meyenburg complexes expressed CD56 only very focally in less than 5% of lesional cells.
  • Bile duct cysts were negative for CD56 with the exception of focally interspersed neuroendocrine cells, similar to that seen in segmental bile ducts.
  • Thus, if van Meyenburg complexes are excluded, CD56 can be used to differentiate intrahepatic non-neoplastic from neoplastic proliferations, which is a helpful diagnostic tool in small liver biopsies.
  • [MeSH-major] Antigens, CD56 / metabolism. Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic / metabolism. Biomarkers, Tumor / metabolism. Cholangiocarcinoma / metabolism. Cholangitis / metabolism
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / metabolism. Adenoma, Bile Duct / diagnosis. Adenoma, Bile Duct / metabolism. Bile Ducts, Extrahepatic / metabolism. Bile Ducts, Extrahepatic / pathology. Choledochal Cyst / diagnosis. Choledochal Cyst / metabolism. Cystadenoma, Mucinous / diagnosis. Cystadenoma, Mucinous / metabolism. Diagnosis, Differential. Humans. Immunohistochemistry. Liver Cirrhosis / diagnosis. Liver Cirrhosis / metabolism

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  • [ISSN] 0945-6317
  • [Journal-full-title] Virchows Archiv : an international journal of pathology
  • [ISO-abbreviation] Virchows Arch.
  • [Language] eng
  • [Publication-type] Journal Article
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41. Van Beers BE: Diagnosis of cholangiocarcinoma. HPB (Oxford); 2008;10(2):87-93
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  • [Title] Diagnosis of cholangiocarcinoma.
  • Cholangiocarcinoma is suspected based on signs of biliary obstruction, abnormal liver function tests, elevated tumor markers (carbohydrate antigen 19-9 and carcinoembryonic antigen), and ultrasonography showing a bile stricture or a mass, especially in intrahepatic cholangiocarcinoma.
  • Magnetic resonance imaging (MRI) or computed tomography (CT) is performed for the diagnosis and staging of cholangiocarcinomas.
  • Therefore, reasonable exclusion of an extrahepatic primary tumor should be performed.
  • Differentiating between benign and malignant bile duct stricture is also difficult, except when metastases are observed.
  • When the diagnosis of a biliary stenosis remains indeterminate at MRI or CT, endoscopic imaging (endoscopic or intraductal ultrasound, cholangioscopy, or optical coherence tomography) and tissue sampling should be carried out.
  • The diagnosis of cholangiocarcinoma is particularly challenging in patients with primary sclerosing cholangitis.
  • These patients should be followed with yearly tumor markers, CT, or MRI.

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  • (PMID = 18773062.001).
  • [ISSN] 1365-182X
  • [Journal-full-title] HPB : the official journal of the International Hepato Pancreato Biliary Association
  • [ISO-abbreviation] HPB (Oxford)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2504383
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42. Jesudian AB, Jacobson IM: Screening and diagnosis of cholangiocarcinoma in patients with primary sclerosing cholangitis. Rev Gastroenterol Disord; 2009;9(2):E41-7
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  • [Title] Screening and diagnosis of cholangiocarcinoma in patients with primary sclerosing cholangitis.
  • In addition, considerable overlap exists between the symptoms of CCA and those of benign dominant strictures encountered commonly in PSC.
  • Clinicians utilize a combination of serum tumor markers, cytology from bile duct brushings, and imaging in an attempt to screen for and detect CCA in patients with PSC, although the evidence for these modalities remains largely retrospective.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Duct Neoplasms / etiology. Bile Ducts, Intrahepatic. Cholangiocarcinoma / diagnosis. Cholangiocarcinoma / etiology. Cholangitis, Sclerosing / complications
  • [MeSH-minor] Biomarkers, Tumor / blood. Diagnosis, Differential. Diagnostic Imaging. Humans. In Situ Hybridization, Fluorescence. Liver Transplantation

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  • (PMID = 19668124.001).
  • [ISSN] 1949-4386
  • [Journal-full-title] Reviews in gastroenterological disorders
  • [ISO-abbreviation] Rev Gastroenterol Disord
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 55
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43. Siablis D, Papathanassiou ZG, Karnabatidis D, Christeas N, Vagianos C: Hemobilia secondary to hepatic artery pseudoaneurysm: an unusual complication of bile leakage in a patient with a history of a resected IIIb Klatskin tumor. World J Gastroenterol; 2005 Sep 7;11(33):5229-31
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  • [Title] Hemobilia secondary to hepatic artery pseudoaneurysm: an unusual complication of bile leakage in a patient with a history of a resected IIIb Klatskin tumor.
  • We report a case of a 74-year-old woman with a 16-year history of a double bilo-enteric anastomosis due to resected hilar cholangiocarcinoma (Type IIIb Klatskin tumor).
  • The patient presented with cholangitis secondary to benign anastomotic stenosis which resulted in a large intrahepatic biloma.
  • [MeSH-major] Aneurysm, False / complications. Bile / metabolism. Bile Duct Neoplasms / surgery. Hemobilia / etiology. Hepatic Artery. Hepatic Duct, Common. Klatskin Tumor / surgery. Postoperative Complications

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  • (PMID = 16127759.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
  • [Other-IDs] NLM/ PMC4320402
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44. Sotiropoulos GC, Kaiser GM, Lang H, Molmenti EP, Beckebaum S, Fouzas I, Sgourakis G, Radtke A, Bockhorn M, Nadalin S, Treckmann J, Niebel W, Baba HA, Broelsch CE, Paul A: Liver transplantation as a primary indication for intrahepatic cholangiocarcinoma: a single-center experience. Transplant Proc; 2008 Nov;40(9):3194-5
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  • [Title] Liver transplantation as a primary indication for intrahepatic cholangiocarcinoma: a single-center experience.
  • BACKGROUND: Intrahepatic cholangiocarcinoma (ICC) is not a widely accepted indication for orthotopic liver transplantation (OLT).
  • The present study describes our institutional experience with patients who underwent transplantation for ICC as well as those with ICC who underwent transplantation with the incorrect diagnosis of hepatocellular carcinoma (HCC).
  • Patients with hilar cholangiocarcinoma and incidentally found ICC after OLT for benign diseases were excluded from further consideration.
  • Those who underwent transplantation in the early period had a preoperative diagnosis of inoperable ICC (n = 4) and ICC in the setting of primary sclerosing cholangitis (n = 2).
  • In the latter period the subjects had a diagnosis of HCC in cirrhosis (n = 3) or recurrent ICC after an extended right hepatectomy (n = 1).
  • Two patients died of tumor recurrence at 18 and 21 months post-OLT, respectively.
  • [MeSH-major] Bile Duct Neoplasms / surgery. Bile Ducts, Intrahepatic / surgery. Cholangiocarcinoma / surgery. Liver Transplantation / physiology


45. Utispan K, Thuwajit P, Abiko Y, Charngkaew K, Paupairoj A, Chau-in S, Thuwajit C: Gene expression profiling of cholangiocarcinoma-derived fibroblast reveals alterations related to tumor progression and indicates periostin as a poor prognostic marker. Mol Cancer; 2010;9:13
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  • [Title] Gene expression profiling of cholangiocarcinoma-derived fibroblast reveals alterations related to tumor progression and indicates periostin as a poor prognostic marker.
  • Periostin (PN) is a multi-functional protein and has emerged as a promising marker for tumor progression.
  • Immunohistochemistry examination of a number of patients with intrahepatic CCA showed the expression of PN solely in stromal fibroblasts, but was expressed neither in cancer cells nor immune cells.
  • Low to no expression of PN was observed in tissues of benign liver disease and hepatocellular carcinoma.
  • [MeSH-major] Bile Duct Neoplasms / genetics. Bile Ducts, Intrahepatic / metabolism. Cell Adhesion Molecules / metabolism. Cholangiocarcinoma / genetics. Cholangiocarcinoma / pathology. Fibroblasts / metabolism. Gene Expression Profiling
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Carcinoma, Hepatocellular / metabolism. Carcinoma, Hepatocellular / pathology. Cell Line, Tumor. Cell Proliferation. Disease Progression. Gene Expression Regulation, Neoplastic. Gene Knockdown Techniques. Humans. Immunohistochemistry. Integrin alpha5 / metabolism. Liver / metabolism. Liver / pathology. Liver Neoplasms / metabolism. Liver Neoplasms / pathology. Neoplasm Invasiveness. Prognosis. Proportional Hazards Models. Reproducibility of Results. Reverse Transcriptase Polymerase Chain Reaction

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  • (PMID = 20096135.001).
  • [ISSN] 1476-4598
  • [Journal-full-title] Molecular cancer
  • [ISO-abbreviation] Mol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cell Adhesion Molecules; 0 / Integrin alpha5; 0 / POSTN protein, human
  • [Other-IDs] NLM/ PMC2841583
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46. Gamblin TC, Krasinskas AM, Slivka AS, Tublin ME, Demetris J, Shue E, Caro S, Marsh JW, James Moser A: Fibroinflammatory biliary stricture: a rare bile duct lesion masquerading as cholangiocarcinoma. J Gastrointest Surg; 2009 Apr;13(4):713-21
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  • [Title] Fibroinflammatory biliary stricture: a rare bile duct lesion masquerading as cholangiocarcinoma.
  • INTRODUCTION: Fibroinflammatory biliary stricture (FIBS) is a rare benign tumor-like process of the extrahepatic bile duct that masquerades as cholangiocarcinoma.
  • Preoperative evaluation included computed tomography scan and endoscopic retrograde cholangiopancreatography with benign brush cytology.
  • Surgical treatment included nine bile duct resections with five concurrent liver resections and two incisional biopsies.
  • CONCLUSION: FIBS is a rare myofibroblastic lesion with an immunohistochemical profile distinct from other epithelial and stromal neoplasms of the extrahepatic bile duct.
  • Because preoperative cytology is not diagnostic of FIBS, surgical resection remains the mainstay of diagnosis and treatment, while immunosuppression may reduce the risk of recurrence.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts, Extrahepatic / pathology. Bile Ducts, Intrahepatic. Cholangiocarcinoma / diagnosis

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  • (PMID = 19057967.001).
  • [ISSN] 1873-4626
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / DK-51485; United States / NICHD NIH HHS / HD / K12 HD 049109
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Actins
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47. Hatanaka K, Kudo M, Minami Y, Maekawa K: Sonazoid-enhanced ultrasonography for diagnosis of hepatic malignancies: comparison with contrast-enhanced CT. Oncology; 2008;75 Suppl 1:42-7
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  • [Title] Sonazoid-enhanced ultrasonography for diagnosis of hepatic malignancies: comparison with contrast-enhanced CT.
  • OBJECTIVE: The purpose of this study was to assess the usefulness of Sonazoid-enhanced ultrasonography (US) in the diagnosis of hepatic malignancies in comparison with contrast-enhanced CT findings.
  • These hepatic nodules were diagnosed by typical findings of imaging such as contrast-enhanced CT, dynamic MRI or Sonazoid-enhanced US, tumor markers and histological examinations after surgical resection or biopsy.
  • RESULTS: 108 nodules were diagnosed as malignant tumors (hepatocellular carcinoma: n = 90; metastasis: n = 16; intrahepatic cholangiocarcinoma: n = 2) and the remaining five tumors were diagnosed as benign tumors (dysplastic nodules: n = 5).
  • CONCLUSION: Sonazoid-enhanced US has a higher sensitivity and accuracy for the diagnosis of hepatic malignancies than contrast-enhanced CT.
  • [MeSH-major] Contrast Media. Ferric Compounds. Iron. Liver Neoplasms / diagnosis. Oxides. Tomography, X-Ray Computed. Ultrasonography / methods
  • [MeSH-minor] Aged. Aged, 80 and over. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Carcinoma, Hepatocellular / diagnosis. Cholangiocarcinoma / diagnosis. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged

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  • [Copyright] Copyright 2008 S. Karger AG, Basel.
  • (PMID = 19092271.001).
  • [ISSN] 1423-0232
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Ferric Compounds; 0 / Oxides; 0 / Sonazoid; E1UOL152H7 / Iron
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48. Ohtsuka M, Kimura F, Shimizu H, Yoshidome H, Kato A, Yoshitomi H, Furukawa K, Mitsuhashi N, Takeuchi D, Takayashiki T, Suda K, Miyazaki M: Surgical strategy for mucin-producing bile duct tumor. J Hepatobiliary Pancreat Sci; 2010 May;17(3):236-40
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  • [Title] Surgical strategy for mucin-producing bile duct tumor.
  • Tumors with copious mucin production within the intra- or extrahepatic bile ducts have been reported as mucin-producing bile duct tumors (MPBTs).
  • Because mucin produced by these tumors causes recurrent cholangitis and obstructive jaundice, surgical resection should be indicated even if these tumors are regarded as benign.
  • In order to choose the appropriate surgical procedure, exact preoperative assessment of tumor location and cancer extension is important, especially evaluation of the extent of superficial spreading through cholangioscopic observation and biopsy.
  • In principle, MPBTs should be resected in a manner similar to that employed for other types of bile duct carcinomas.
  • That is, major hepatectomy with or without extrahepatic bile duct resection or pancreaticoduodenectomy should be chosen as the surgical procedure, and intraoperative frozen section at the stumps of the bile duct is essential.
  • On the other hand, when precise diagnosis is completed preoperatively and the lesion is diagnosed as adenoma or carcinoma with invasion confined to the ductal wall and limited superficial spreading, limited resections preserving organ functions as much as possible can be considered as a choice among surgical procedures.
  • All ten patients with MPBT resected at our institution according to these strategies are still alive without tumor recurrence, with a median survival of 48.0 months.
  • [MeSH-major] Bile Duct Neoplasms / surgery. Mucins / secretion
  • [MeSH-minor] Bile Ducts, Extrahepatic / metabolism. Bile Ducts, Extrahepatic / pathology. Bile Ducts, Intrahepatic / metabolism. Bile Ducts, Intrahepatic / pathology. Digestive System Surgical Procedures. Hepatectomy. Humans. Neoplasm Invasiveness. Pancreaticoduodenectomy. Prognosis

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  • (PMID = 19649559.001).
  • [ISSN] 1868-6982
  • [Journal-full-title] Journal of hepato-biliary-pancreatic sciences
  • [ISO-abbreviation] J Hepatobiliary Pancreat Sci
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Mucins
  • [Number-of-references] 20
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49. Shiran MS, Isa MR, Sherina MS, Rampal L, Hairuszah I, Sabariah AR: The utility of hepatocyte paraffin 1 antibody in the immunohistological distinction of hepatocellular carcinoma from cholangiocarcinoma and metastatic carcinoma. Malays J Pathol; 2006 Dec;28(2):87-92
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  • Hepatocellular carcinoma (HCC) is the most common primary liver cancer and its diagnosis on routine stains is usually straightforward, except in some cases where there may be difficulty in distinguishing HCCs from metastatic carcinomas (MC) and cholangiocarcinomas (CC).
  • Hepatocyte Paraffin 1 antibody (Hep Par 1) is a new monoclonal antibody which reacts with normal and neoplastic hepatocytes, and this study aims to determine its specificity and sensitivity in distinguishing hepatocellular carcinoma (HCC) from cholangiocarcinoma (CC) and metastatic carcinomas (MC).
  • Hep Par 1 antibody was applied to 28 cases of HCC, 22 cases of MC from varying sites and 8 CCs, and produced a strong, diffuse, granular, cytoplasmic staining of all benign hepatocytes.
  • 23 out of 28 cases of HCC showed heterogeneously positive staining for Hep Par 1 irrespective of their degree of differentiation, while 2 out of 8 cases of cholangiocarcinoma were positive for Hep Par 1, and all 22 cases of metastatic carcinoma were negative.
  • The sensitivity and specificity of Hep Par 1 for HCC was 82.1% and 93.3% respectively; whereby the antibody was noted to show occasional false positivity in cases of cholangiocarcinoma and non-neoplastic bowel mucosa, while its variable staining in HCC produced false negative results in some small biopsies.
  • Thus, Hep Par 1 should be used in a panel with other antibodies to obtain useful information in distinguishing HCC from CC and MC.
  • [MeSH-major] Antibodies, Monoclonal / analysis. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic / pathology. Carcinoma, Hepatocellular / diagnosis. Cholangiocarcinoma / diagnosis. Liver Neoplasms / diagnosis
  • [MeSH-minor] Biomarkers, Tumor / analysis. Diagnosis, Differential. Hepatocytes / chemistry. Hepatocytes / pathology. Humans. Predictive Value of Tests. Sensitivity and Specificity. Staining and Labeling

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  • (PMID = 18376797.001).
  • [ISSN] 0126-8635
  • [Journal-full-title] The Malaysian journal of pathology
  • [ISO-abbreviation] Malays J Pathol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Malaysia
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Biomarkers, Tumor
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50. Sharif AW, Williams HR, Lampejo T, Khan SA, Bansi DS, Westaby D, Thillainayagam AV, Thomas HC, Cox IJ, Taylor-Robinson SD: Metabolic profiling of bile in cholangiocarcinoma using in vitro magnetic resonance spectroscopy. HPB (Oxford); 2010 Aug;12(6):396-402
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  • [Title] Metabolic profiling of bile in cholangiocarcinoma using in vitro magnetic resonance spectroscopy.
  • Magnetic resonance spectroscopy (MRS) of bile may provide insights into the pathogenesis of CCA and help identify novel diagnostic biomarkers.
  • The aim of this study was to compare the chemical composition of bile from patients with CCA with that of bile from patients with benign biliary disease.
  • METHODS: Magnetic resonance spectra were acquired from the bile of five CCA patients and compared with MRS of control bile from patients with benign biliary disease (seven with gallstones, eight with sphincter of Oddi dysfunction [SOD], five with primary sclerosing cholangitis [PSC]).
  • RESULTS: Univariate analysis showed that levels of glycine-conjugated bile acids were significantly increased in patients with CCA, compared with the benign disease groups (P= 0.002).
  • 7 beta primary bile acids were significantly increased (P= 0.030) and biliary phosphatidylcholine (PtC) levels were reduced (P= 0.010) in bile from patients with CCA compared with bile from gallstone patients.
  • CONCLUSIONS: These preliminary data suggest that altered bile acid and PtC metabolism play an important role in CCA aetiopathogenesis and that specific metabolites may have potential as future biomarkers.
  • [MeSH-major] Bile / metabolism. Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic / metabolism. Biomarkers, Tumor / metabolism. Cholangiocarcinoma / metabolism. Magnetic Resonance Spectroscopy. Metabolomics / methods
  • [MeSH-minor] Aged. Aged, 80 and over. Algorithms. Bile Acids and Salts / metabolism. Case-Control Studies. Female. Glycine / analogs & derivatives. Glycine / metabolism. Humans. London. Male. Middle Aged. Multivariate Analysis. Pattern Recognition, Automated. Phosphatidylcholines / metabolism. Principal Component Analysis. Prognosis

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  • (PMID = 20662790.001).
  • [ISSN] 1477-2574
  • [Journal-full-title] HPB : the official journal of the International Hepato Pancreato Biliary Association
  • [ISO-abbreviation] HPB (Oxford)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Bile Acids and Salts; 0 / Biomarkers, Tumor; 0 / Phosphatidylcholines; TE7660XO1C / Glycine
  • [Other-IDs] NLM/ PMC3028580
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51. Burgos San Juan L: [Cholangiocarcinoma]. Rev Med Chil; 2008 Feb;136(2):240-8
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  • Cholangiocarcinoma is a malignant lesion of the bile duct epithelium.
  • It is most frequently found in the confluence of the hepatic ducts, where it is called hilar cholangiocarcinoma or Klatskin tumor.
  • Its etiology is unknown but there are predisposing conditions and environmental risk factors such as primary sclerosing cholangitis, Caroli's disease, bile duct malformations, industrial toxins and parasitic infections.
  • These, in addition to laboratory exams, endoscopical and imaging procedures, lead to the diagnosis.
  • Hilar cholangiocarcinoma must be distinguished from other malignant or benign causes of biliary obstruction.
  • Cholangiocarcinoma of the distal common bile duct must be differentiated from other periampullary tumors and intrahepatic cholangiocarcinoma can be confused with a hepatocellular carcinoma.
  • The type and size of surgery depends on the location and extent of the tumor.
  • [MeSH-major] Bile Duct Neoplasms. Bile Ducts, Intrahepatic. Cholangiocarcinoma
  • [MeSH-minor] Humans. Neoplasm Staging / methods

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  • (PMID = 18483680.001).
  • [ISSN] 0034-9887
  • [Journal-full-title] Revista médica de Chile
  • [ISO-abbreviation] Rev Med Chil
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Chile
  • [Number-of-references] 43
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52. Park SM, Shin SM, Seo HE, Kim SH, Kim HS, Park JH, Kim JH, Sohn KR: [A case of sclerosed hemangioma mimicking intrahepatic cholangiocarcinoma]. Korean J Gastroenterol; 2009 Dec;54(6):399-403
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  • [Title] [A case of sclerosed hemangioma mimicking intrahepatic cholangiocarcinoma].
  • Hemangioma is one of the most frequently encountered benign hepatic neoplasm which can develop secondary degeneration.
  • Its differential diagnosis is very difficult.
  • It should be included in the differential diagnosis of other hepatic lesions such as hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and metastatic hepatic tumor.
  • Abdominal ultrasonography revealed GB stone, dilated common bile duct with bile duct stone, and a 4.6 cm sized hyperechoic mass at segment 5 and 6 of the liver.
  • Abdominal dynamic computed tomography demonstrated dilated intrahepatic bile ducts and a 5 x 5 cm sized mass which showed minimally delayed enhancement.
  • We removed common bile duct stone with endoscopic retrograde cholangiopancreatography then decided to undergo right lower segmentectomy of liver due to possibility of cholangiocarcinoma.
  • [MeSH-major] Hemangioma / diagnosis. Liver Neoplasms / diagnosis
  • [MeSH-minor] Aged. Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Cholangiocarcinoma / diagnosis. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed. Ultrasonography


53. Imura S, Miyake K, Ikemoto T, Morine Y, Fujii M, Sano N, Shimada M: Rapid-growing solitary necrotic nodule of the liver. J Med Invest; 2006 Aug;53(3-4):325-9
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  • The characteristic features of this benign lesion on the imaging modalities are similar to the metastatic tumor.
  • Despite some examinations by imaging modalities to confirm the preoperative diagnosis, we were unable to visually confirm.
  • Several histological examinations using a needle biopsy specimen were performed, but the diagnosis was all necrotic tissue.
  • We consider that permanent histology of the entire lesion is possibly the only accurate method of diagnosis.
  • [MeSH-major] Cell Proliferation. Liver Diseases / diagnosis. Liver Diseases / pathology
  • [MeSH-minor] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Biopsy, Needle. Cholangiocarcinoma / diagnosis. Diagnosis, Differential. Female. Hepatectomy. Humans. Liver / pathology. Liver / surgery. Middle Aged. Necrosis. Renal Dialysis. Renal Insufficiency / therapy

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  • (PMID = 16953073.001).
  • [ISSN] 1343-1420
  • [Journal-full-title] The journal of medical investigation : JMI
  • [ISO-abbreviation] J. Med. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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54. Li YG, Zhang N: Clinical significance of serum tumour M2-PK and CA19-9 detection in the diagnosis of cholangiocarcinoma. Dig Liver Dis; 2009 Aug;41(8):605-8
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  • [Title] Clinical significance of serum tumour M2-PK and CA19-9 detection in the diagnosis of cholangiocarcinoma.
  • BACKGROUND/AIMS: To investigate the clinical significance of serum Tu M2-PK and CA19-9 detection in the diagnosis of cholangiocarcinoma.
  • METHODS: The tumour markers (Tu M2-PK and CA19-9) in 115 patients with cholangiocarcinoma, 85 patients with benign disease and 120 blood donors were detected by ELISA.
  • CONCLUSIONS: Tu M2-PK may be used as a valuable diagnosis marker in cholangiocarcinoma.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic. Biomarkers, Tumor / blood. CA-19-9 Antigen / blood. Cholangiocarcinoma / diagnosis. Pyruvate Kinase / blood

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  • (PMID = 19168405.001).
  • [ISSN] 1878-3562
  • [Journal-full-title] Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • [ISO-abbreviation] Dig Liver Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen; 0 / Isoenzymes; EC 2.7.1.40 / Pyruvate Kinase
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55. van Gulik TM, Kloek JJ, Ruys AT, Busch OR, van Tienhoven G, Lameris JS, Rauws EA, Gouma DJ: [Improved treatment results in hilar cholangiocarcinoma after transition to more extensive procedure: 20 years experience AMC]. Ned Tijdschr Geneeskd; 2010;154:A1815
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  • OBJECTIVE: To determine the result of surgical treatment of patients with hilar cholangiocarcinoma (HCCA) before and after the transition from predominantly local bile duct resections to more extensive resections including partial liver resection in order to achieve complete tumour resection in the Academic Medical Center, Amsterdam (The Netherlands).
  • A more extended multidisciplinary surgical approach combining bile duct resection with partial liver resection was applied as of 1998.
  • RESULTS: In 18 patients (15.3%) a benign lesion was found in the resection specimen.
  • Among the other 99 patients with microscopically confirmed HCCA, 21 (72%) of 29 patients had undergone bile duct resection in combination with partial liver resection in period 2 as compared to 17 (24%) of 70 patients in period 1.
  • The margin tumour free resection rate increased from 20% in period 1 to 59% in period 2.
  • [MeSH-major] Bile Duct Neoplasms / surgery. Bile Ducts, Intrahepatic / surgery. Cholangiocarcinoma / surgery
  • [MeSH-minor] Adult. Aged. Biliary Tract Surgical Procedures. Female. Follow-Up Studies. Humans. Klatskin Tumor / mortality. Klatskin Tumor / surgery. Male. Middle Aged. Retrospective Studies. Risk Factors. Survival Analysis. Time Factors. Treatment Outcome. Young Adult

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  • (PMID = 20858305.001).
  • [ISSN] 1876-8784
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Netherlands
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56. Mosnier JF, Kandel C, Cazals-Hatem D, Bou-Hanna C, Gournay J, Jarry A, Laboisse CL: N-cadherin serves as diagnostic biomarker in intrahepatic and perihilar cholangiocarcinomas. Mod Pathol; 2009 Feb;22(2):182-90
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  • [Title] N-cadherin serves as diagnostic biomarker in intrahepatic and perihilar cholangiocarcinomas.
  • As a definite immunoprofile of this tumor is missing, the histopathologic diagnosis of intrahepatic cholangiocarcinoma is difficult.
  • The aim of this study was to explore E- and N-cadherin expressions in intrahepatic bile duct tumors, and to determine their potential interest in differential diagnosis.
  • Normal liver tissue, 5 cirrhosis with ductular reaction, 5 focal nodular hyperplasia, 5 bile duct hamartomas, 5 bile duct adenomas, and 45 intrahepatic cholangiocarcinomas from Caucasian patients were studied.
  • Immunohistochemistry was performed using E-cadherin, N-cadherin, NCAM, Hep Par1, and cytokeratins 7, 19 and 20.
  • In normal liver, epithelial cells of intrahepatic bile ducts, whatever their caliber, as well as hepatocytes, coexpressed E- and N-cadherins at their plasma membranes.
  • All the benign lesions and 30 of the 45 intrahepatic cholangiocarcinomas (23/29 peripheral and 7/16 hilar) also expressed N-cadherin.
  • The expression of N-cadherin at the plasma membrane of tumor cells was significantly more frequent in peripheral than in hilar intrahepatic cholangiocarcinomas (P=0.003).
  • Among noncholangiocarcinomas, only 1% gastric and 66% gallbladder adenocarcinomas and all the hepatocellular carcinomas expressed N-cadherin at the membrane of tumor cells.
  • Finally, for the diagnosis of intrahepatic cholangiocarcinomas, the specificity value of membranous expression of N-cadherin was 88%, whereas that of the combination cytokeratin 7/membranous N-cadherin was 98%.
  • In the gastrointestinal and liver tract, membranous N-cadherin is restricted to the hepatocytes and intrahepatic biliary cells.
  • In combination with cytokeratin 7 and Hep Par1, N-cadherin is a reliable tool for the histopathological diagnosis of primary hepatic tumors.
  • [MeSH-major] Antigens, CD / analysis. Bile Duct Neoplasms / immunology. Bile Ducts, Intrahepatic / immunology. Biomarkers, Tumor / analysis. Cadherins / analysis. Cholangiocarcinoma / immunology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. France. Humans. Immunoblotting. Immunohistochemistry. Keratin-7 / analysis. Male. Middle Aged. Predictive Value of Tests. Reproducibility of Results. Tissue Array Analysis

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  • (PMID = 18622386.001).
  • [ISSN] 1530-0285
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Biomarkers, Tumor; 0 / CDH1 protein, human; 0 / CDH2 protein, human; 0 / Cadherins; 0 / KRT7 protein, human; 0 / Keratin-7
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57. Wang WB, Li YH, Liu B, Wang HS, Cui AR, Zhnag XH: [Correlation between PPARgamma and VEGF-C expression in extrahepatic cholangioadenocarcinoma (EHCAC) and their prognostic significance]. Zhonghua Zhong Liu Za Zhi; 2009 Oct;31(10):773-7
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  • METHODS: The expressions of PPARgamma and VEGF-C were detected by immunohistochemistry in 69 cases of EHCAC, 12 cases of non-tumor bile duct epithelium, and their relationship to clinicopathological parameters and follow-up were analyzed.
  • RESULTS: The positive rate of PPARgamma expression in 69 cases of EHCAC was 59.4%, significantly higher than that in 12 cases of non-tumor bile duct epithelium (0%), (P < 0.01).
  • The positive rate of VEGF-C in 69 cases of EHCAC was 84.1%, also significantly higher than 16.7% in 12 cases of benign bile duct epithelium (P < 0.05).
  • [MeSH-major] Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic. Cholangiocarcinoma / metabolism. PPAR gamma / metabolism. Vascular Endothelial Growth Factor C / metabolism
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Survival Rate

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  • (PMID = 20021832.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / PPAR gamma; 0 / VEGFC protein, human; 0 / Vascular Endothelial Growth Factor C
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58. Ito K, Taira K, Arii S: Intrahepatic bile duct dilatation with a liver cyst and hemangioma: report of a case. Surg Today; 2009;39(3):256-60
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  • [Title] Intrahepatic bile duct dilatation with a liver cyst and hemangioma: report of a case.
  • We report a case of intrahepatic bile duct dilatation with a liver cyst and hemangioma.
  • A 58-year-old woman was referred for investigation of a cystic lesion and peripheral intrahepatic bile duct dilatation in the left lateral segment of the liver.
  • Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) showed dilatation of the intrahepatic bile ducts in the left lateral segment, near a 4.5-cm cystic lesion.
  • Microscopically, the cyst was lined with a single layer of flattened epithelial cells and a spongy tumor was diagnosed as cavernous hemangioma, which compressed the bile duct.
  • The histopathological diagnosis was biliary stenosis associated with cavernous hemangioma of the liver.
  • Invasive surgery may be avoided by awareness of this unusual benign pathology.
  • [MeSH-major] Bile Ducts, Intrahepatic / pathology. Cysts / pathology. Hemangioma / pathology. Liver Diseases / pathology. Liver Neoplasms / pathology


59. John AR, Haghighi KS, Taniere P, Esmat ME, Tan YM, Bramhall SR: Is a raised CA 19-9 level diagnostic for a cholangiocarcinoma in patients with no history of sclerosing cholangitis ? Dig Surg; 2006;23(5-6):319-24
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  • These patients were compared with patients who had benign liver tumours (n = 25) and benign bile duct strictures (n = 13) who also had their CA 19-9 concentration measured.
  • RESULTS: Sensitivity and specificity of CA 19-9 in the diagnosis of a cholangiocarcinoma were 77.9 and 76.3%, respectively, when using a cut-off value of 35 kU/l, while sensitivity and specificity were 67.5 and 86.8%, respectively, when the cut-off value was raised to 100 kU/l.
  • CONCLUSIONS: This study demonstrates that CA 19-9 is a useful adjunct in the diagnosis of cholangiocarcinomas without primary sclerosing cholangitis, especially in the diagnosis of peripheral cholangiocarcinomas.
  • [MeSH-major] Bile Duct Neoplasms / blood. Bile Ducts, Intrahepatic. CA-19-9 Antigen / blood. Cholangiocarcinoma / blood
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / blood. Biopsy. Cholangitis, Sclerosing. Humans. Middle Aged. Prospective Studies. Sensitivity and Specificity

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  • [Copyright] Copyright 2006 S. Karger AG, Basel.
  • (PMID = 17170527.001).
  • [ISSN] 0253-4886
  • [Journal-full-title] Digestive surgery
  • [ISO-abbreviation] Dig Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen
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