Case series of 17 patients with cholangiocarcinoma among young adult workers of a printing company in Japan

Kubo, Shoji; Nakanuma, Yasuni; Takemura, Shigekazu; Sakata, Chikaharu; Urata, Yoshishige; Nozawa, Akio; Nishioka, Takayoshi; Kinoshita, Masahiko; Hamano, Genya; Terajima, Hiroaki; Tachiyama, Gorou; Matsumura, Yuichi; Yamada, Terumasa; Tanaka, Hiromu; Nakamori, Shoji; Arimoto, Akira; Kawada, Norifumi; Fujikawa, Masahiro; Fujishima, Hiromitsu; Sugawara, Yasuhiko; Tanaka, Shogo; Toyokawa, Hideyoshi; Kuwae, Yuko; Ohsawa, Masahiko; Uehara, Shinichiro; Satō, Kyoko; Hayashi, Tomoshige; Endo, Ginji

doi:10.1002/jhbp.86

Cited by 93 publications

(158 citation statements)

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“…Similar findings were observed in other patients with occupational cholangiocarcinoma 2) . Pathological examination showed that the dilated bile ducts were related to chronic bile duct injury and neoplastic lesions, such as BilIN and IPNB.…”

Section: Discussionsupporting

confidence: 90%

“…In a study including all 17 patients with occupational cholangiocarcinoma, the serum levels of γ -GTP were elevated in all patients, and chronic bile duct injury was observed in all 8 patients for which pathological examination could be performed 2) . These findings indicate that an elevated serum level of γ -GTP might be related to chronic bile duct injury resulting from exposure to DCP.…”

Section: Discussionmentioning

confidence: 97%

“…Among former and current workers of the offset color proof-printing department of a Japanese printing company, cholangiocarcinoma developed at an extremely high incidence 1,2) . These workers were exposed to high concentrations of chlorinated organic solvents for a prolonged period.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to monitor diagnostic imaging presentation and laboratory test results in workers with extended exposure to organic solvents. Recently, a cholangiocarcinoma outbreak among former and current workers of an offset color proofprinting department of a printing company was reported in Japan 1,2) . The disease was diagnosed in relatively young workers from 25 to 45 years old with a mean age of 36 years, and the observed incidence was unusually high in the abovementioned department (17 of 111 workers diagnosed) 2) .…”

mentioning

confidence: 99%

“…Recently, a cholangiocarcinoma outbreak among former and current workers of an offset color proofprinting department of a printing company was reported in Japan 1,2) . The disease was diagnosed in relatively young workers from 25 to 45 years old with a mean age of 36 years, and the observed incidence was unusually high in the abovementioned department (17 of 111 workers diagnosed) 2) . In that department, various chemicals including organic solvents, such as 1,1,1-trichloroethane, dichloromethane, and 1,2-dichloromethane (DCP), were used to clean ink residues.…”

mentioning

confidence: 99%

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Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma

Kubo

Takemura

Sakata

et al. 2014

Journal of Occupational Health

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Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma: Shoji KUBO, et al. Department of Hepato‐Biliary‐Pancreatic Surgery, Osaka City University Graduate School of Medicine— Objectives A cholangiocarcinoma outbreak among workers of an offset color proof‐printing department in a printing company was recently reported. It is important to understand the clinical course leading to occupational cholangiocarcinoma development for investigation of the carcinogenesis process and for surveillance and early detection. We evaluated the changes in laboratory test results and diagnostic imaging presentation before the detection of cholangiocarcinoma. Methods We investigated the changes in laboratory test results and diagnostic imaging presentation before the detection of cholangiocarcinoma in 2 patients because the data were available. Results The clinical courses observed in the 2 participating patients showed persistent elevation of serum γ‐glutamyl transpeptidase levels with or without elevated serum levels of alanine aminotransferase and/or aspartate aminotransferase before cholangiocarcinoma detection. Dilatation of the bile ducts without tumor‐induced stenosis was observed several years before cholangiocarcinoma detection and progressed gradually in both patients. The serum concentration of carbohydrate 19‐9 also increased prior to cholangiocarcinoma detection in both patients. Eventually, observation of stenosis of the bile duct and a space‐occupying lesion strongly suggested cholangiocarcinoma. Pathological examination of the resected specimens showed chronic bile duct injury and neoplastic lesions, such as “biliary intraepithelial neoplasia” and “intraductal papillary neoplasm of the bile duct” in various sites of the bile ducts, particularly in the dilated bile ducts. Conclusions The changes in laboratory test results and diagnostic imaging might be related to the development of cholangiocarcinoma. It is important to monitor diagnostic imaging presentation and laboratory test results in workers with extended exposure to organic solvents.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma

Kubo

Takemura

Sakata

et al. 2014

Journal of Occupational Health

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Occupational cholangiocarcinoma caused by exposure to 1,2‐dichloropropane and/or dichloromethane

Kubo

Takemura

Tanaka

et al. 2017

Annals of Gastroent Surgery

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A cluster of cholangiocarcinoma among printing company workers who were exposed to 1,2‐dichloropropane and/or dichloromethane was classified by the Ministry of Health, Labour and Welfare of Japan on 1 October 2013 as “occupational cholangiocarcinoma”. At the time of the diagnosis of cholangiocarcinoma, levels of γ‐glutamyl transferase, and aspartate and alanine aminotransferases were elevated, and had been elevated in some patients several years prior to the diagnosis. Regional dilatation of intrahepatic bile ducts without tumor‐induced obstruction was characteristic in diagnostic imaging. Pathological examination found chronic bile duct injury with DNA damage, precancerous/preinvasive lesions such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct in various sites of the large bile ducts, and invasive cholangiocarcinoma such as mass‐forming type and intraductal growth‐type intrahepatic cholangiocarcinoma and mainly papillary‐type extrahepatic cholangiocarcinoma. Whole‐exome analysis of the cancerous tissues showed hypermutation, substantial strand bias, and unique trinucleotide mutational changes. Patients seemed to suffer high incidence of postoperative complications including intra‐abdominal, which might be related to chronic bile duct injury. Postoperative recurrence from multicentric origins occurred in some patients, as DNA‐injured bile ducts have high carcinogenic potential. Aggressive treatment, including second resections for such multicentric recurrences, appeared to be effective. In 2014, the International Agency for Research on Cancer classified 1,2‐dichloropropane as Group 1 (carcinogenic to humans) and dichloromethane as Group 2A (probably carcinogenic to humans) carcinogens.

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Digestive tract neoplasms in young individuals: Demographics, staging and risk factors

Tasneem

Luck

2020

Cancer Reports

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Background Digestive tract neoplasms (DTN) have become increasingly common worldwide among young individuals (YIs) over the last few decades. Aim Aim of this research was to study the types, demographics, stage at presentation and risk factors of digestive tract neoplasms in young individuals. Methods and results In this cross‐sectional study, YI (ie, ≤40 years) presenting with any DTN including gastrointestinal neoplasms (GIN), hepatobiliary neoplasms (HBN), periampullary neoplasms (PAN) and others from June 2016 to May 2020 were included. Baseline laboratory tests, tissue diagnosis and staging were performed while risk factors were documented. A total of 163 patients were included in the study, of whom 82 (50.3%) were males. Mean age was 29.9 (±9.57) (range: 8 months‐40 years). Most DTN (93.3%; n = 152) were malignant. The commonest neoplasms were lower GIN (LGIN) 52 (31.9%), followed by HBN 46 (28.2%), upper GIN (UGIN) 44 (27%) and PAN 18 (11%). Commonest among LGIN were rectal 37; among HBN: hepatocellular cancer (HCC) 9, cholangiocarcinoma (CC) 9; and among UGIN: esophageal 25 and stomach 14. Rectal cancers were mostly sporadic (82.7%) with frequent signet ring cell histology (40.5%), and affected relatively younger ages compared to upper GIN and PAN. GIN were mostly locally advanced with higher resectability (LGIN 90.4%; UGIN 79.5%) while HBN were more advanced with lower resectability (HCC [44.4%]; CC [33.3%]). Poor dietary habits and poor socioeconomic status were common with UGIN (63.6%, 50%) and HBN (56.5%, 54.3%), respectively. Conclusion The commonest DTN among YI were LGIN followed by HBN, UGIN and PAN. Rectal cancers affected relatively younger ages and were mostly sporadic. HBN were more advanced in stage and unresectable compared to GIN. Poor dietary habits and poor socioeconomic status may be important contributors in carcinogenesis.

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Case series of 17 patients with cholangiocarcinoma among young adult workers of a printing company in Japan

Abstract: The present results showed that cholangiocarcinomas occurred at a high incidence in relatively young workers of a printing company, who were exposed to chemicals including chlorinated organic solvents.

Cited by 93 publications

References 20 publications

Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma

Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma

Occupational cholangiocarcinoma caused by exposure to 1,2‐dichloropropane and/or dichloromethane

Digestive tract neoplasms in young individuals: Demographics, staging and risk factors

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