Intestinal metaplasia in gallbladders: prevalence study

Fernandes, José Eduardo; Franco, Maria Isete Fares; Suzuki, Reinaldo Kenji; Tavares, Nelson Mattos; Bromberg, Sansom Henrique

doi:10.1590/s1516-31802008000400004

Cited by 20 publications

(13 citation statements)

References 18 publications

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“…In this same age group, they observed a greater number of cases of intestinal and pyloric metaplasia. Duarte and associates and Fernandes and associates also observed a bigger incidence of pyloric and intestinal metaplasia within patients over 50 years of age 19,32…”

Section: Discussionmentioning

confidence: 91%

Are histological alterations observed in the gallbladder precancerous lesions?

Meirelles-Costa

Bresciani

Perez

et al. 2010

Clinics

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INTRODUCTIONGallbladder cancer, which is characterized by rapid progression and a poor prognosis, is a complex disease to treat. Unfortunately, little is known currently about its etiology or pathogenesis. A better understanding of its carcinogenesis and determining risk factors that lead to its development could help improve the available treatment options.METHODBased on this better understanding, the histological alterations (such as acute cholecystitis, adenomyomatosis, xanthogranulomatous cholecystitis, polyps, pyloric metaplasia, intestinal metaplasia, dysplasia, cancer and others) in gallbladders from 1,689 patients who underwent laparoscopic cholecystectomy for cholecystolithiasis were analyzed. The association of these gallbladder histological alterations with clinical data was studied.RESULTSGender analysis revealed a greater incidence of inflammatory changes in males, while dysplasia and cancer were only found in women. The incidence of cholesterolosis was greater in the patients 60 years of age and under, and the incidence of adenomyomatosis and gangrene was greater in the elderly patients. A progressive increase in the average age was observed as alterations progressed through pyloric metaplasia, intestinal metaplasia, dysplasia and then cancer, suggesting that the metaplasia-dysplasia-carcinoma sequence may occur in gallbladder cancer. Gallbladder histological alterations were also observed in asymptomatic patients.CONCLUSIONThe results of this study suggest that there could be an association between some histological alterations of gallbladder and cancer, and they also suggest that the metaplasia-dysplasia-carcinoma sequence could in fact be true in the case of gallbladder cancer. Nevertheless, further studies directed towards a perfect understanding of gallbladder carcinogenesis are required.

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Section: Discussionmentioning

confidence: 91%

Are histological alterations observed in the gallbladder precancerous lesions?

Meirelles-Costa

Bresciani

Perez

et al. 2010

Clinics

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“…Metaplasia is believed to be a strong histological sign for diagnosis of moderate or severe chronic cholecystitis because it is rarely observed in gallbladder autospy in which only mild inflammatory changes present. [36] Misra et al [37] found that H. pylori colonises areas of metaplasia in gallbladder producing histological changes very similar to those seen in gastric mucosa. Chen et al [38] demonstrated that metaplasia may provide suitable conditions for H. pylori colonization in the gallbladder.…”

Section: Discussionmentioning

confidence: 95%

A Comparative Study of Clinicopathological Features between Chronic Cholecystitis Patients with and without Helicobacter pylori Infection in Gallbladder Mucosa

et al. 2013

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Background Helicobacter pylori has been isolated from 10%–20% of human chronic cholecystitis specimens but the characteristics of “Helicobacter pylori positive cholecystitis” remains unclear. This study aims to compare the clinicopathological features between chronic cholecystitis patients with and without Helicobacter pylori infection in gallbladder mucosa.MethodsThree hundred and twenty-six chronic cholecystitis patients were divided into two groups according to whether Helicobacter pylori could be detected by culture, staining or PCR for Helicobacter 16s rRNA gene in gallbladder mucosa. Positive samples were sequenced for Helicobacter pylori-specific identification. Clinical parameters as well as pathological characteristics including some premalignant lesions and the expression levels of iNOS and ROS in gallbladder were compared between the two groups.Results Helicobacter pylori infection in gallbladder mucosa was detected in 20.55% of cholecystitis patients. These patients had a higher prevalence of acid regurgitation symptoms (p = 0.001), more histories of chronic gastritis (p = 0.005), gastric ulcer (p = 0.042), duodenal ulcer (p = 0.026) and higher presence of Helicobacter pylori in the stomach as compared to patients without Helicobacter pylori infection in the gallbladder mucosa. Helicobacter pylori 16s rRNA in gallbladder and gastric-duodenal mucosa from the same individual patient had identical sequences. Also, higher incidences of adenomyomatosis (p = 0.012), metaplasia (p = 0.022) and higher enhanced expressions of iNOS and ROS were detected in Helicobacter pylori infected gallbladder mucosa (p<0.05).Conclusions Helicobacter pylori infection in gallbladder mucosa is strongly associated with Helicobacter pylori existed in stomach. Helicobacter pylori is also correlated with gallbladder premalignant lesions including metaplasia and adenomyomatosis. The potential mechanism might be related with higher ROS/RNS production but needs further investigation.

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“…Cellular differentiation begins in the GB due to inflammation and other factors added to the GB, resulting in intestinal metaplasia (IM). Increased cell damage causes dysplasia and ultimately carcinoma in situ [10, 11]. Development of dysplasia-carcinoma in the GB is a long process.…”

Section: Introductionmentioning

confidence: 99%

Preneoplastic and neoplastic gallbladder lesions detected after cholecystectomy

Kocaöz¹,

Turan

2019

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IntroductionGallbladder cancer (GBC) is diagnosed often incidentally after cholecystectomies, with a rate of 0.1–3%.AimTo review the clinical and morphological aspects of GBC and pre-neoplastic lesions in patients who underwent cholecystectomy.Material and methodsA total of 5026 patients who underwent cholecystectomy between January 1, 2012 and December 31, 2017 were included in the study. Histological changes (acute cholecystitis, adenomyomatosis, xanthogranulomatous cholecystitis (XGC), polyps, antral metaplasia, intestinal metaplasia (IM), dysplasia, cancer, and others) in gallbladders (GB) from 5029 patients who underwent cholecystectomy for cholelithiasis were analysed.ResultsGallbladder cancer was more common in women than in men (14/4 = 3.5). A significant relation was found between cholelithiasis and GBC (p = 0.031). Of the patients with GBC, six had stage 1a (T1a + T1b), five had stage 1b (T2N0), two had stage 2 (T3N0), three had stage 2b (T1-3 N1), one had stage 3 (T4 N0), and one had stage 4 (T3N1M1). The IM was more common in females than in males (K/E = 3.3). A significant relationship was found between cholecystitis and IM (p < 0.001). A significant association was observed between IM and adenomyomatosis hyperplasia (p = 0.016).ConclusionsIn this study, it was observed that adenomyomatous hyperplasia and adenomatous polyp were associated with metaplastic changes in the GB pathologies, including XGC and follicular cholecystitis. It is thought that metaplasia-dysplasia may be associated with GBC. However, further studies on GB carcinogenesis are needed.

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Intestinal metaplasia in gallbladders: prevalence study

Cited by 20 publications

References 18 publications

Are histological alterations observed in the gallbladder precancerous lesions?

Are histological alterations observed in the gallbladder precancerous lesions?

A Comparative Study of Clinicopathological Features between Chronic Cholecystitis Patients with and without Helicobacter pylori Infection in Gallbladder Mucosa

Preneoplastic and neoplastic gallbladder lesions detected after cholecystectomy

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