Intrahepatic Cholangiocarcinomas Associated with Nonbiliary Cirrhosis

Terada, Tadashi; Kida, Tetsuji; Nakanuma, Yasuni; Kuroda, Hiroshi; Doishita, Kenji; Takayanagi, Nobutatsu

doi:10.1097/00004836-199406000-00016

Cited by 25 publications

(22 citation statements)

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“…The etiologic relationship may be clarified by showing HBV-DNAin CC tissue and surrounding liver tissue through PCRor in situ hybridization. Another possibility with such cases in individuals with HBV-associated cirrhosis is that CCcould develop as a consequence of necrosis and regeneration of bile ductal and bile ductular cells (7), similar to the hypothesis of HCCdevelopment. In the present case, non-cancerous tissue showed posthepatitic cirrhosis with pronounced proliferation of bile ductule, and CCcould have arisen from such proliferating cells.…”

Section: Discussionmentioning

confidence: 85%

“…Hepatocellular carcinoma (HCC) is frequently associated with liver cirrhosis, for example in 58-78% of cases in Japan (4)(5)(6). While only 1.8-30% of CC occur in cirrhotic livers (3)(4)(5)(6)(7)(8), recently, hepatitis virus-associated chronic hepatitis or cirrhosis have been suggested to be involved in the pathogenesis of this tumor (9,10). As patients with chronic hepatitis or cirrhosis are usually followed-up closely for the detection of HCC by ultrasonography, minute CC could be detected (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Cholangiocarcinoma with a Background of Hepatitis B Virus-associated Cirrhosis.

Takegoshi¹,

Omata³

et al. 2001

Intern. Med.

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Recently, hepatitis virus-associated chronic hepatitis or cirrhosis has been suggested to be involved in the pathogenesis of cholangiocarcinoma (CC). A 52-year-old manwas diagnosed as CCwith a background of hepatitis B virus (HBV)-dependent cirrhosis. A minute hepatic tumor was found during the follow-up, and was diagnosed as CC on percutaneous biopsy. The patient died of hepatic failure and an autopsy revealed the tumor to be a well to moderately differentiated adenocarcinoma. An immunohistological analysis of HBVX gene-encoded protein (HBX) was neither detected in the cancerous nor in the noncancerous tissue. Nooncogenic role of the virus was verified in this case. (Internal Medicine 40: 382-385, 2001)

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Cholangiocarcinoma with a Background of Hepatitis B Virus-associated Cirrhosis.

Takegoshi¹,

Omata³

et al. 2001

Intern. Med.

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“…Most cases of CC develop in an otherwise normal liver, although a few arise in livers with pathologic conditions, including hepatolithiasis, 1 ' 2 primary sclerosing cholangitis, 3 infestation with liver flukes, 4 biliary malformations, including biliary microhamartoma, 5 and thorotrast (thorium dioxide) exposure. 6 In addition, CCs arising from areas of nonbiliary cirrhosis have been noted, 7 " 9 and their prevalence in all CCs is reported to be 4.7%7 Nonbiliary cirrhosis is generally a precancerous condition associated with hepatocellular carcinoma (HCC) and combined hepatocellular-cholangiocellular carcinoma (HC-CC). 8,10 " 12 Although it seems reasonable that CC could arise in cirrhotic livers with ongoing active regeneration and proliferation of biliary cells, particularly bile ductular cells, the pathobiologic features and developmental process of CC in cirrhosis remain obscure.…”

mentioning

confidence: 99%

“…8,10 " 12 Although it seems reasonable that CC could arise in cirrhotic livers with ongoing active regeneration and proliferation of biliary cells, particularly bile ductular cells, the pathobiologic features and developmental process of CC in cirrhosis remain obscure. 7 Most CCs are adenocarcinomas, and mucin production is, thereby, an important and inherent characteristic of CCs. Mucin is generally a highly glycosylated glycoprotein and composed of an apomucin (mucin core protein) and abundant carbohydrates.…”

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confidence: 99%

Cholangiocarcinomas Arising in Cirrhosis and Combined Hepatocellular-Cholangiocellular Carcinomas Share Apomucin Profiles

Sasaki

Nakanuma

et al. 1998

Am J Clin Pathol

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Cholangiocarcinomas occasionally arise in the nonbiliary cirrhotic liver, but their pathobiologic features remain unsettled. To characterize such cholangiocarcinomas, we examined immunohistochemically the expression of MUC3, MUC5AC, MUC6, and MUC7 apomucins in hepatic tissue specimens from 4 patients with cholangiocarcinoma and viral cirrhosis, 24 patients with cholangiocarcinoma without cirrhosis, and 16 patients with combined hepatocellular-cholangiocellular carcinoma. The cholangiocarcinomas associated with cirrhosis and the cholangiocarcinoma elements of combined hepatocellular-cholangiocellular carcinoma rarely expressed MUC3 and MUC5AC, but the cholangiocarcinomas not associated with cirrhosis frequently expressed these apomucins. MTJC6 apomucin was widely expressed in cholangiocarcinomas, irrespective of the association with Intrahepatic cholangiocarcinoma (CC) is a malignant neoplasm arising from intrahepatic biliary epithelial cells. Cholangiocarcinoma may occur at any segment or level of the intrahepatic biliary tree, whereas the cell origin and the precursor lesions of CC remain largely uncharted in individual cases. Manuscript received January 14, 1997; revision accepted June 10,1997.Address reprint requests to Dr Sasaki: Department of Pathology (II), Kanazawa University School of Medicine, Kanazawa 920, Japan. cirrhosis and also in the cholangiocarcinoma elements of the combined hepatocellular-cholangiocellular carcinomas. MUC7 apomucin was expressed frequently in cholangiocarcinomas associated with cirrhosis and combined hepatocellular-cholangiocellular carcinomas and infrequently in cholangiocarcinomas without cirrhosis, particularly those arising at the hepatic hilus. The similarity of the apomucin profiles between cholangiocarcinomas associated with cirrhosis and the cholangiocarcinoma elements of combined hepatocellular-cholangiocellular carcinoma suggests a similar or common histogenesis and that cholangiocarcinoma associated with cirrhosis might be derived from the combined type.

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“…67 A number of risk factors have been established, including primary sclerosing cholangitis, liver fluke infestation, Caroli's disease, congenital choledochal cysts, chronic hepatolithiasis, and Thorotrast deposition. However, many patients who are diagnosed with cholangiocarcinoma have none of these factors in their history.…”

Section: Etiology and Pathogenesismentioning

confidence: 99%

Cancer of the Liver and Bile Ducts

Kendrick

Grambihler²,

Gores

et al.

Oncology

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Hepatocellular carcinoma (HCC) is the fifth most common neoplasm in the world and the third most common cause of cancer death worldwide.1 More than 500,000 deaths per year are attributed to HCC, representing 10% of all deaths from cancer. In select areas of Asia and Africa, HCC is the most common cause of death due to cancer. The incidence in Europe and the United States is relatively low but is increasing. In Europe, HCC is now the leading cause of death among patients with cirrhosis.2 In the United States, epidemiologic studies have demonstrated a doubling of HCC incidence over the past two decades.3 This increase, which has been attributed to the increasing prevalence of chronic hepatitis C virus (HCV) infection, is expected to continue over the next two decades, given the lag time between the onset of chronic hepatitis and development of HCC. EtiologyUnique among many other cancers, HCC has well-defined major risk factors. Cirrhosis is the strongest predisposing factor for development of HCC, present in 80% of patients. Chronic viral infection is the most frequent major risk factor for development of HCC. In Asia and Africa, hepatitis B viral (HBV) infection is common, whereas in the West and Japan, hepatitis C virus (HCV) is the main risk factor. The association of HCC and HBV infection is one of the most well recognized etiologic relationships in cancer biology. 4 In epidemiologic studies, the prevalence of HBV carriers correlates with incidence of HCC. Chronic HBV carriers have a 100-fold relative risk of developing HCC compared with noncarriers. 5Up to 40% of HBV carriers who develop HCC do not have evidence of cirrhosis, demonstrating the direct carcinogenic potential of HBV infection.6 Prevention of HBV infection reduces the incidence of HCC, as demonstrated in Taiwan, where vaccination of infants reduced the incidence of HBV carriers and simultaneously decreased the incidence of HCC by 60% compared with nonimmunized children. 7,8 In developed countries, HCC arises in cirrhotic livers as a result of HCV infection or excessive alcohol intake. Approximately 170 million people are infected with HCV.9 Vaccination for prevention of HCV infection is currently not available. Prevention is focused on preventing transmission by transfusion of blood products and in halting the progression of infected individuals to cirrhosis by antiviral regimens such as pegylated interferon and ribavirin. Cirrhosis independent of the etiology is thought in most instances to increase the risk of HCC. The degree of association between cirrhosis and HCC, however, is dependent on the primary condition. Cirrhosis from HCV, HBV, alcohol abuse, and hemochromatosis portends a greater risk for HCC than other conditions such as autoimmune hepatitis, primary biliary cirrhosis, a 1 -antitrypsin deficiency, and Wilson's disease, where HCC is uncommon.10

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Intrahepatic Cholangiocarcinomas Associated with Nonbiliary Cirrhosis

Cited by 25 publications

References 0 publications

Cholangiocarcinoma with a Background of Hepatitis B Virus-associated Cirrhosis.

Cholangiocarcinoma with a Background of Hepatitis B Virus-associated Cirrhosis.

Cholangiocarcinomas Arising in Cirrhosis and Combined Hepatocellular-Cholangiocellular Carcinomas Share Apomucin Profiles

Cancer of the Liver and Bile Ducts

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