Intestinal metaplasia in gallbladders
prevalence study
Keywords:
Lithiasis, Cholecystitis, Gallbladder, Metaplasia, CholecystectomyAbstract
CONTEXT AND OBJECTIVE: Gallbladder cancer is usually diagnosed at a late stage and generally results in death. Discovery of predisposing factors for this neoplasia could prevent this outcome. In this study, we assess the presence of one of these factors: intestinal metaplasia in gallbladders with stones and infl ammatory processes. DESIGN AND SETTING: Cross-sectional study in Hospital do Servidor Público Estadual de São Paulo. METHOD: The fi rst 80 gallbladders from patients who underwent elective cholecystectomy between April and August 2002, presenting stones and chronic infl ammation, were studied. The patients were divided into groups according to their age: CC1, from 15 to 40 years; CC2, from 41 to 60 years; and CC3, from 61 to 85 years. RESULTS: Twenty-one patients (26%) were male, while 59 (74%) were female. In the group CC1, intestinal metaplasia was present in 85.71% of the 21 patients studied; in CC2, in 79.41% of 34 patients; and in CC3, in 56.00% of 25 patients. These differences presented statistical signifi cance (p = 0.04542). CONCLUSION: Intestinal metaplasia is extremely frequent in gallbladders with infl ammation and lithiasis, especially in younger patients.
Downloads
References
Maringhini A, Moreau JA, Melton LJ 3rd, Hench VS, Zins- meister AR, DiMagno EP. Gallstones, gallbladder cancer, and other gastrointestinal malignancies. An epidemiologic study in Rochester, Minnesota. Ann Intern Med. 1987;107(1):30-5.
Yamamoto M, Nakajo S, Tahara E. Carcinoma of the gallbladder: the correlation between histogenesis and prognosis. Virchows Arch A Pathol Anat Histopathol. 1989;414(2):83-90.
Zatonski WA, Lowenfels AB, Boyle P, et al. Epidemiologic as- pects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer. J Natl Cancer Inst. 1997;89(15):1132-8.
Sheth S, Bedford A, Chopra S. Primary gallbladder cancer: recognition of risk factors and the role of prophylactic chole- cystectomy. Am J Gastroenterol. 2000;95(6):1402-10.
Nervi Oddone F. Cáncer de la vesícula biliar en Chile. [Gallblad- der cancer in Chile]. Rev Med Chile. 2001;129(9):979-81.
Dowling GP, Kelly JK. The histogenesis of adenocarcinoma of the gallbladder. Cancer. 1986;58(8):1702-8.
Yamagiwa H, Tomiyama H. Intestinal metaplasia-dysplasia- carcinoma sequence of the gallbladder. Acta Pathol Jpn. 1986;36(7):989-97.
Mukhopadhyay S, Landas SK. Putative precursors of gallbladder dysplasia: a review of 400 routinely resected specimens. Arch Pathol Lab Med. 2005;129(3):386-90.
Jukemura J. Colelitíase e risco de câncer de vesícula biliar. [Thesis]. São Paulo: Faculdade de Medicina da Universidade de São Paulo; 1996.
Duarte I, Llanos O, Domke H, Harz C, Valdivieso V. Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. Cancer. 1993;72(6):1878-84.
Khanna R, Chansuria R, Kumar M, Shukla HS. Histological changes in gallbladder due to stone disease. Indian J Surg. 2006;68(4):201-4. Available from: http://www.indianjsurg.com/temp/IndianJSurg684201_105709.pdf. Accessed in 2008 (May 6).
Yamagiwa H. Mucosal dysplasia of gallbladder: isolated and ad- jacent lesions to carcinoma. Jpn J Cancer Res. 1989;80(3):238- 43.
Suzuki RK, Fernandes JEV, Mattos N, Franco MIF, Bromberg SH. Metaplasia antral na vesícula biliar. [Antral gland metaplasia in gallbladder]. Einstein (São Paulo). 2005;3(3):190-4.
Laitio M. Early carcinoma of the gallbladder. Beitr Pathol. 1976;158(2):159-72.
Albores-Saavedra J, Alcántra-Vazquez A, Cruz-Ortiz H, Her- rera-Goepfert R. The precursor lesions of invasive gallbladder carcinoma. Hyperplasia, atypical hyperplasia and carcinoma in situ. Cancer. 1980;45(5):919-27.
Kijima H, Watanabe H, Iwafuchi M, Ishihara N. Histogenesis of gallbladder carcinoma from investigation of early carcinoma and microcarcinoma. Acta Pathol Jpn. 1989;39(4):235-44.
Csendes A, Smok G, Burdiles P, Díaz JC, Maluenda F, Korn O. Histological findings of gallbladder mucosa in 95 control subjects and 80 patients with asymptomatic gallstones. Dig Dis Sci. 1998;43(5):931-4.
Obesidade: resultados de estudo em Santos são um alerta ao País. Santos.sp.gov.br. Available from: http://www.santos.sp.gov.br/cgi-bin/comunicacao/listanoticias.pl?17309. Accessed in 2008 (May 28).
Saul SH. Gallbladder and extrahepatic biliary tree. In: Sternberg SS, editor. Diagnostic surgical pathology. 2nd ed. New York: Raven Press; 1994. p. 1581-612.
Perpetuo MD, Valdivieso M, Heilbrun LK, Nelson RS, Con- nor T, Bodey GP. Natural history study of gallbladder cancer: a review of 36 years experience at M. D. Anderson Hospital and Tumor Institute. Cancer. 1978;42(1):330-5.
Järvi O, K Laurén P. Intestinal metaplasia in the mucosa of the gallbladder and common bile duct with additional ob- servations on pancreas heterotopy. Ann Med Exp Biol Fenn. 1967;45(2):213-23.
Kozuka S, Kurashina M, Tsubone M, Hachisuka K, Yasui A. Significance of intestinal metaplasia for the evolution of cancer in the biliary tract. Cancer 1984;54(10):2277-85.
Yamagiwa H. Dysplasia of gallbladder. Its pathological signifi- cance. Acta Pathol Jpn. 1987;37(5):747-54.
Sasatomi E, Tokunaga O, Miyazaki K. Precancerous condi- tions of gallbladder carcinoma: overview of histopathologic characteristics and molecular genetic findings. J Hepatobiliary Pancreat Surg. 2000;7(6):556-67.
Menezes HL, Egawa A, Soares AL, et al. Incidência de neoplasias da vesícula biliar em colecistite aguda e crônica. [Incidence of cancer of the gallbladder in acute and chronic cholecystitis]. An Paul Med Cir. 1995;122(3):90-3.
