Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document

Khan, Shahid A.; Davidson, Brian R; Goldin, Robert; Pereira, Stephen P.; Rosenberg, William; Taylor-Robinson, Simon D; Thillainayagam, Andrew V.; Thomas, Howard; Thursz, Mark; Wasan, Harpreet

doi:10.1136/gut.51.suppl_6.vi1

Cited by 487 publications

(445 citation statements)

References 44 publications

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“…The present case of IHC was difficult to differentiate from HCC, metastatic liver tumor, and other types of tumor such as pseudo-inflammatory tumor. It has been reported that delayed phase-contrast enhancement within the lesion on CT may be indicative of IHC, which was consistent with our case (2,9). On the other hand, the decreasing signal intensity on T2-weighted imaging of the enhanced MRI, which may indicate IHC, was not apparent in this case (10).…”

Section: Discussionsupporting

confidence: 90%

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Intrahepatic Cholangiocarcinoma Associated with Central Calcification and Arterio-portal Shunt

et al. 2005

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Section: Discussionsupporting

confidence: 90%

“…Representative biopsies can also be difficult to obtain, even if IHC is suspected (7)(8)(9). The present case of IHC was difficult to differentiate from HCC, metastatic liver tumor, and other types of tumor such as pseudo-inflammatory tumor.…”

Section: Discussionmentioning

confidence: 68%

Intrahepatic Cholangiocarcinoma Associated with Central Calcification and Arterio-portal Shunt

et al. 2005

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“…The curative treatment of cholangiocarcinoma is surgical resection. More than two-thirds of patients with cholangiocarcinoma are not resectable at the time of initial diagnosis (Khan et al, 2002), because it is clinically silent until it has become an advanced disease with obstructive symptoms. Chemotherapy for cholangiocarcinoma is carried out for those patients who are inoperable or who have recurrent disease, but the results tend to be disappointing (Olnes and Erlich, 2004;Khan et al, 2005).…”

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confidence: 99%

CEACAM6 gene expression in intrahepatic cholangiocarcinoma

et al. 2006

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The purpose of this study was to investigate the clinicopathological and biological significance of human carcinoembryonic antigenrelated cell adhesion molecule 6 (CEACAM6) gene expression in human intrahepatic cholangiocarcinoma. CEACAM6 is reported to be involved in human malignancies. However, in cholangiocarcinoma expression of CEACAM6 and its clinicopathological significance have not been investigated. CEACAM6 expression status was determined and analysed with respect to various clinicopathological parameters in 23 intrahepatic cholangiocarcinomas. Additionally, we investigated effects of CEACAM6 gene in the cholangiocarcinoma cell lines. CEACAM6 gene expression in cancer tissues was higher than in noncancerous tissues in 16 of the 23 cases; however, it was not statistically significant. The tumours with elevated CEACAM6 expression showed a tendency to be associated with lymphatic invasion and stage of the disease. Interestingly, patients with high CEACAM6 expression showed a significantly poorer disease-free survival rate than those with low CEACAM6 expression. We demonstrated that CEACAM6-transfected cells were more proliferative, more invasive and more chemoresistant to gemcitabine compared to mock-transfected cells. Furthermore, CEACAM6 gene silencing by CEACAM6-specific siRNA resulted in higher chemosensitivity to gemcitabine. CEACAM6 is a potential prognostic indicator and potential chemoresistant marker to gemcitabine for patients with intrahepatic cholangiocarcinoma.

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“…The incidence of ICC exhibits wide geographical variations that range from 5% to 30% of primary liver cancers. 1 Various predisposing factors, including liver fluke infestation, hepatolithiasis, primary sclerosing cholangitis, choledochocyst, and Caroli's disease, have been implicated. [1][2][3] In Taiwan, ICC was found in 5% to 10% of patients with hepatolithiasis.…”

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confidence: 99%

“…1 Various predisposing factors, including liver fluke infestation, hepatolithiasis, primary sclerosing cholangitis, choledochocyst, and Caroli's disease, have been implicated. [1][2][3] In Taiwan, ICC was found in 5% to 10% of patients with hepatolithiasis. 3,4 Based on gross morphology, ICC can be divided into three types (mass-forming, periductalinfiltrating, and intraductal growth [IG]-type).…”

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confidence: 99%

Characterization of intrahepatic cholangiocarcinoma of the intraductal growth-type and its precursor lesions

et al. 2005

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A cohort of patients with intraductal growth-type intrahepatic cholangiocarcinoma (IG-ICC) and its precursor lesions, collectively termed intraductal papillary neoplasm of the liver (IPNL), was characterized with respect to demographics, clinical manifestations, perioperative management, long-term survival, and molecular features associated with carcinogenesis. A total of 122 patients with IPNL types 1 through 4, 108 patients with non-IG-ICC and 210 patients with hepatolithiasis alone were studied. Expression of CDX2, TFF1, MUC1, MUC2, MUC5AC, EGFR, and p53 was determined by using immunohistochemistry. Females predominated in those with hepatolithiasis alone and IPNL. The mean age of patients with hepatolithiasis alone was 6 to 8 years younger than that of those with IPNL. The association with hepatolithiasis in patients with IPNL types 1 and 2, IPNL types 3 and 4, and non-IG-ICC was 100%, 79%, and 64%, respectively. Mucobilia, anemia, and elevated serum carcinoembryonic antigen levels were helpful in distinguishing IG-ICC and its precursor lesions. The mean survival of patients with IPNL type 3, IPNL type 4, and non-IG-ICC was 55.5 months, 36.9 months, and 15.8 months, respectively. The incidence of expression of CDX2 and TFF1 was maximal in IPNL type 3. Expression and cellular distribution of MUC2 and CDX2 were similar. MUC5AC was strongly expressed in all patients with IPNL; EGFR and p53 were rarely expressed in patients with IPNL. In conclusion, hepatolithiasis appears to be a precipitating factor in the development of IPNL. Signs of mucobilia were specific for the diagnosis of IPNL. Expression of CDX2 and MUC2 are helpful in differentiating IPNL and non-IG-ICC. Significant differences in survival associated with the various lesions studied warrants a more aggressive surgical strategy in their management. ( I ntrahepatic cholangiocarcinoma (ICC) is a primary adenocarcinoma originating from the second or higher order branches of hepatic bile ducts. The incidence of ICC exhibits wide geographical variations that range from 5% to 30% of primary liver cancers. 1 Various predisposing factors, including liver fluke infestation, hepatolithiasis, primary sclerosing cholangitis, choledochocyst, and Caroli's disease, have been implicated. [1][2][3] In Taiwan, ICC was found in 5% to 10% of patients with hepatolithiasis. 3,4 Based on gross morphology, ICC can be divided into three types (mass-forming, periductalinfiltrating, and intraductal growth [IG]-type). 1 The IG-ICC is the least common type but is associated with the most favorable outcome. 1,5 Biliary papillomatosis, intraductal growth-type cholangiocarcinoma (IG-ICC), and mucin-producing ICC constitute essentially the same disease entity. [5][6][7] This category of papillary biliary neoplasm resembles intraductal papillary mucinous neoplasm of the pancreas histologically. 8 We recently proposed the term intraductal papillary neoplasm of the liver (IPNL) for such lesions, which include both IG-ICC and its precursor lesions. 6,9 Phenotypes of gastrointestinal meta...

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Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document

Cited by 487 publications

References 44 publications

Intrahepatic Cholangiocarcinoma Associated with Central Calcification and Arterio-portal Shunt

Intrahepatic Cholangiocarcinoma Associated with Central Calcification and Arterio-portal Shunt

CEACAM6 gene expression in intrahepatic cholangiocarcinoma

Characterization of intrahepatic cholangiocarcinoma of the intraductal growth-type and its precursor lesions

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