Aim: The aim of the study was to perform a comparative analysis of proliferative and apoptotic activity as well as of microvascular density (MVD) in metaplasia, dysplasia and gallbladder carcinoma.
Material And Method: There were investigated 10 cases of chronic cholecystitis associating premalignant lesions and 5 cases of gallbladder carcinoma developed on a chronic cholecystitis background. The immunohistochemical (IHC) staining was made using Ki-67, p53 and CD34 antibodies, and the streptavidin-biotin method. The semiquantitative analysis focused on the intensity of the IHC reaction for Ki-67 and p53 (on a scale from 0 to 4), the Ki-67 index and the percentage of p53 positive cell nuclei. The MVD was established on 5 representative fields as mean of the number of CD34 positive vessels.
Results: Ki-67 was positive in all 10 chronic cholecystitis cases (100%) and in all 5 carcinoma cases (100%), which is explainable by the selection manner of chronic cholecystitis associating premalignant lesions and by the invasive pattern of the carcinomas. Ki-67 index rose from 10% in simple dysplastic lesions associated with chronic cholecystitis to 20% in severe dysplastic lesions associated with chronic cholecystitis up until 90% in carcinoma. In all chronic cholecystitis, p53 was negative for normal gallbladder epithelium, in metaplastic territories and in those with mild dysplasia. In the dysplastic areas present in chronic cholecystitis, the positive reaction of p53 rose from 20% (in moderate dysplasia) to 80% (in severe dysplasia). All carcinoma cases were p53 positive (100%), its expression varying from 30% in papillary areas and 30-50% in undifferentiated adenocarcinoma to 80-100% in well differentiated type. In chronic cholecystitis MVD was of 5-9 vessels / field in areas adjacent to pyloric metaplasia and 10-20 vessels / field in severe dysplastic areas. Gallbladder carcinoma cases presented a MVD of 15-30 vessels / field.
Conclusions: The investigation of Ki-67, p53 and MVD brings important data regarding the carcinogenesis process in the gallbladder, initiated on the background of a chronic cholecystitis. The dynamics in the values for Ki-67, p53 and MDV followed from premalignant lesions to carcinoma sustains the hypothesis of the metaplasia-dysplasia-carcinoma sequence.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Navigating Limited Resources-Outpatient Pediatric Cholecystectomies at Rural Hospitals.
J Pediatr Surg
January 2025
Department of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 42, Torrance, CA 90502, USA; Division of Pediatric Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 77-123 CHS, Los Angeles, CA 90095, USA. Electronic address:
Background: Rural facilities that provide pediatric surgical services are a critical resource to local communities. Our aim was to characterize differences in outpatient pediatric cholecystectomy outcomes performed at rural and urban hospitals with the hypothesis that rural hospitals would have similar outcomes.
Methods: The Nationwide Ambulatory Surgery Sample (NASS), which contains ambulatory surgery encounters at hospital-owned facilities, was used to perform a retrospective cohort analysis of pediatric patients age 18-years and younger who had a cholecystectomy (n = 15,449) between 2016 and 2018.
Thick-walled Gallbladder: A Pragmatic Management Approach.
Euroasian J Hepatogastroenterol
December 2024
Department of General and Minimal Invasive Surgery, Sher-I-Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India.
Introduction: Thick-walled gallbladder (TWGB) is a common yet non-specific radiological finding associated with a wide range of gallbladder pathologies, including acute and chronic inflammation, infection, and malignancy. Among the inflammatory causes, xanthogranulomatous cholecystitis (XGC) is a rare but significant condition that often mimics gallbladder carcinoma. This paper presents a pragmatic approach to the diagnosis and management of TWGB, focusing on the complexities posed by XGC.
View Article and Find Full Text PDFHeterotopic pancreas of the gallbladder: A case report of a rare and commonly incidental finding.
Ann Hepatobiliary Pancreat Surg
January 2025
Northern Hospital, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia.
Heterotopic pancreas (HP) refers to the presence of ectopic pancreatic tissue located outside of the normal pancreatic location without anatomical or vascular continuity with the pancreas. HP within the gallbladder (HPGB) was first described by Otschkin in 1916. It remains an exceedingly rare pathology with few reported cases.
View Article and Find Full Text PDFArticle Synopsis
- Sarcoidosis is a multisystem disease that commonly affects African American women and people of Scandinavian descent, characterized by noncaseating granulomas.
- A 29-year-old African American male presented with recurrent symptoms related to gallstones, specifically right upper quadrant pain after eating, and was found to have cholelithiasis on imaging.
- During an elective surgery for gallbladder removal, liver lesions were discovered, and a biopsy revealed noncaseating granulomas consistent with sarcoidosis, indicating an unusual manifestation of the disease in the liver and lymph nodes.
Laparoscopic cholecystectomy with communicating accessory hepatic duct injury and management: A case report.
World J Gastrointest Surg
December 2024
Department of General Surgery II, The First Affiliated Hospital of Dali University, Dali 671000, Yunnan Province, China.
Background: Laparoscopic cholecystectomy is considered the gold standard for the treatment of patients with gallstones. However, bile duct injury is one of the most serious complications of this surgery, with an incidence rate of 0.3%-0.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!