scholarly journals Role of Tumour Markers Carbohydrate Antigen 19-9, Carcinoembryonic Antigen, & Alpha Fetoprotein in Carcinoma Gall Bladder

2021 ◽  
Vol 10 (10) ◽  
pp. 719-723
Author(s):  
Saurabh Rai ◽  
Chandra Shekhar ◽  
Osman Musa ◽  
Nisar Ansari ◽  
Rahul Agrawal ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Carcinoembryonic Antigen ◽  
Bladder Carcinoma ◽  
Carbohydrate Antigen ◽  
Tumour Markers ◽  
Alpha Fetoprotein ◽  
Advanced Stage ◽  
Gall Bladder Carcinoma ◽  
Carcinoma Gall Bladder

BACKGROUND Gallbladder cancer is recognised as an irreversible malignancy with a high fatality rate. The highest incidence of gall bladder carcinoma is seen in India and Chile, and relatively low level in many Western countries. Gall bladder carcinoma has an extremely poor prognosis, increasing incidence, and diagnosed at an advanced stage despite recent advances in diagnostic modalities. Considering the high rate of mortality attributable mainly to late detection of disease at an advanced stage, early diagnosis remains to be one of the most important determinants of the outcome. This study was conducted to assess the role of tumour markers, namely carbohydrate antigen (CA 19-9), carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) in the diagnosis of gall bladder carcinoma. We wanted to assess the diagnostic role of tumour markers in carcinoma gall bladder. METHODS Patients with radiologically and histopathologically confirmed diagnosis of carcinoma gall bladder were invited to participate in the study. A thorough history was taken, and relevant examination done as per protocol. All necessary laboratory and radiologic investigations were done according to study design. Assessment of the tumour markers CA19-9, CEA and AFP was done, and values compared with carcinoma gall bladder patients. RESULTS The diagnostic value of tumour markers has been studied in context with histopathological grade as all the cases were histopathologically proven cases of carcinoma gall bladder (Ca GB). CONCLUSIONS The present study showed that CA 19-9 was most effective with regard to its ability to differentiate between different grades of gall bladder carcinoma. KEY WORDS CA 19-9, CEA, AFP, Carcinoma Gallbladder

scholarly journals Role of PET CT scan in redefining treatment of incidental gall bladder carcinoma

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e110
Author(s):  
A. Tamhankar ◽  
M. Goel ◽  
V. Rangarajan ◽  
S. Patkar ◽  
M. Ramadwar ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Ct Scan ◽  
Bladder Carcinoma ◽  
Gall Bladder Carcinoma ◽  
Pet Ct ◽  
Pet Ct Scan

scholarly journals EGFR and HER2neu Expression in Gall Bladder Carcinoma and Its Association with Clinicopathological Parameters - An Institutional Experience from North India

2021 ◽  
Vol 6 (1) ◽  
pp. 57-65
Author(s):  
Inara Abeer ◽  
Sabina Khan ◽  
Mohd. Jaseem Hasan ◽  
Musharraf Hussain
Keyword(s):  
Gall Bladder ◽  
Bladder Carcinoma ◽  
North India ◽  
Clinicopathological Parameters ◽  
Advanced Stage ◽  
Gall Bladder Carcinoma ◽  
Egfr Expression ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Biliary Tract Malignancy

Objective: Gallbladder cancer (GBC) is the most common biliary tract malignancy found worldwide with very high incidence in North India especially Delhi region. It is characterized by poor prognosis and ineffective treatment especially in advanced stage. The aim of this study was to evaluate EGFR and HER2/neu immunoexpression in cancer patients and to correlate it with the clinicopathological parameters so as to identify GBC patients who can benefit from targeted therapy.Methods: Present study was conducted in the Department of Pathology, Hamdard Institute of Medical Sciences & Research, New Delhi. A total of 40 cases of Gallbladder carcinoma (GBC) were evaluated for Immunohistochemical expression of EGFR and HER2/neu. Clinicopathological parameters of GBC were studied and correlated with immunoexpression of EGFR and HER2 /neu. Result: The mean age of the GBC patients was 55.9 years with 90% being females. On histopathology, 34(85%) cases were conventional adenocarcinoma. The EGFR expression was positive in 29/40 cases (72.5%). It was significantly more positive in poorly differentiated grade and advanced stages of gall bladder carcinoma (P<0.05). The expression of HER2/neu was positive in 13/40 cases (32.5%). It was significantly more positive in well differentiated gall bladder carcinoma (P<0.05). Immunoexpression of EGFR was inversely related with HER2/neu expression and this association was statistically significant.Conclusion: Among GBC patients, EGFR expression and HER2/neu expression was 72.5% and 32.5%, respectively. Significant EGFR expression was seen in poorly differentiated and advanced stage cancers while significant HER2/neu expression was seen in well differentiated gall bladder carcinomas. To conclude, these two markers HER2/neu and EGFR can be used as predictive and prognostic markers respectively, with rationale to further explore the use of anti-HER2 and anti- EGFR therapy in gall bladder cancer.

Clinicopathological study of gall bladder carcinoma: Our experience from Patan Hospital, Patan Academy of Health Sciences

2019 ◽  
Vol 22 (2) ◽  
pp. 4-10
Author(s):  
Sanjaya Paudyal ◽  
Shiva Raj K.C. ◽  
Shanta Bir Maharjan ◽  
Surendra Shah ◽  
Niraj Giri
Keyword(s):  
Gall Bladder ◽  
Bladder Carcinoma ◽  
Advanced Disease ◽  
Radical Surgery ◽  
Curative Treatment ◽  
Common Disease ◽  
Radical Excision ◽  
Gall Bladder Carcinoma ◽  
Surgical Department ◽  
Carcinoma Gall Bladder

Introduction: Gall bladder carcinoma is not a common disease. The overall prevalence is low worldwide. It is a highly malignant tumor with a poor prognosis. The outcome of gallbladder carcinoma is poor, and the overall 5-year survival rate is less than 5%. The carcinoma gall bladder is 2-6 times more common in females compared to males and its incidence increases with increasing age. Aggressive surgical management and preoperative adjuvant therapy have helped to prolong survival in patients with gallbladder cancer. We conducted a study with an aim to evaluate the clinicopathological aspect of the disease in patients of gall bladder cancer managed in our surgical department. Methods: Data were recorded retrospectively by reviewing the charts of the patients who were diagnosed and treated for carcinoma gall bladder in Patan hospital from Aug 2017 to Aug 2019. Results: Thirty patients were included in the study. Twenty (66.7%) were female and ten (33.33%) were males. Age ranged from 36 to 83 years with the median age of presentation at 63.5 yrs. Curative treatment was possible in 43.33% of the patients, among them 12 had radical surgery and one had cholecystectomy alone for the T1a stage.  All other (56.6%) required palliative treatment. One patient developed liver metastasis within six months of radical excision. Conclusions: The majority of the patients present with an advanced disease which makes it less chance for curative surgical resection. Since only palliative care is possible in an advanced stage, early detection and curative treatment are advisable.

scholarly journals Role of ultrasonography in the diagnosis of gall-bladder carcinoma: A boon for low-resource settings

2018 ◽  
Vol 04 (01) ◽  
pp. 001-005
Author(s):  
Sachin Khanduri ◽  
Aakshit Goyal ◽  
Tarim Usmani ◽  
Shreshtha Jain ◽  
Arun Goyal ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Bladder Carcinoma ◽  
False Positive ◽  
Imaging Modality ◽  
Advanced Stage ◽  
Gall Bladder Carcinoma ◽  
Predictive Values ◽  
Low Resource Settings ◽  
Low Resource ◽  
Early Stages

Abstract Purpose: The present study was done with an aim to evaluate the usefulness of ultrasonography (USG) in early diagnosis of gall-bladder carcinoma for low-resource settings. Materials and Methods: A total of 264 clinically suspicious cases were enrolled in the study. The patients underwent USG followed by computed tomography (CT). Histopathological specimens were obtained from 208 cases. Final diagnosis was confirmed histopathologically/CT. Sensitivity, specificity, positive predictive, and negative predictive values of USG were calculated. Results: A total of 29 cases were confirmed as gall-bladder carcinoma, 58.6% were diagnosed at advanced stage (Stage III/IV). USG diagnosed 42 cases as neoplastic, however, 24 were true positive and 18 were false positive. USG was 82.8% sensitive and 92.5% specific. The positive and negative predictive values were 57.1% and 97.8%, respectively, diagnostic efficacy was 91.5%. 94.1% advanced stage gall bladder cancers were diagnosed correctly by USG. Sensitivity for early stages was promising (61.9%), however false positive was higher. Cost of USG was nearly five times lesser as compared to that of CT. Conclusion: USG was a useful economical imaging modality for the screening of gall bladder cancer in low-resource settings, especially for advanced stages. However, for early stages too, it seemed useful. We recommend to encourage the use of USG in early detection of gall-bladder carcinoma in socially and economically disadvantaged settings.

scholarly journals Role of Ultrasound in the Diagnosis and Management of Gall Bladder Diseases

2019 ◽  
Vol 7 (1-2) ◽  
pp. 70-75
Author(s):  
Md Abul Hasanat ◽  
Farida Yasmin Shelly ◽  
Monowara Begum ◽  
Md Durul Huda ◽  
Md Masudul Hasan Khan
Keyword(s):  
Gall Bladder ◽  
Diagnostic Accuracy ◽  
Bladder Carcinoma ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Gall Bladder Carcinoma ◽  
Gallbladder Diseases ◽  
Medical College ◽  
Bladder Diseases

Background & objective: The majority of published data on the sensitivity and specificity of ultrasound (US) in the diagnosis of gallbladder pathology was conducted over 30 years ago. Since then the quality and resolution of ultrasonography has improved significantly. It is, therefore, essential to asses afresh whether the progression in technology has translated into improved diagnostic accuracy. The present study was undertaken to find the usefulness of US in diagnosing gallbladder diseases with particular reference to cholecystitis and gall bladder carcinoma. Methods: This cross-sectional observational study was conducted at the Department of Radiology and Imaging, Rajshahi Medical College, Rajshahi in collaboration with the Departments of General Surgery and Histopathology of the same Medical College between July 2016 to June 2018. A total of 128 patients were initially included on the basis of signs and symptoms of gallbladder diseases. All these patients were subjected to abdominal US to achieve a ultrasonic diagnosis of gall bladder disease followed by histopathological examination of biopsy material taken from the gall bladder or specimen of the operated gall bladder. The accuracy of ultrasound in the diagnosis of gall bladder diseases was determined by comparing the ultrasound sound diagnosis with that of histopathological diagnosis. In particular, the role of ultrasound was evaluated in the differentiation of benign gall bladder diseases from those of malignant ones. Result: Age distribution of the patients shows that over one-third (35.9%) was ≥50 years old followed by 24.9% 40-50 years, 21.9% 30 - 40 years and 16.4% 20 – 30 years old with mean age of the patients being 43.8(range: 18-80) years. Females outnumbered males by roughly 11:9. In terms of BMI, 6.2% were underweight, 16.4% overweight, and 4.7% obese. The predominant complaints reported by the patients were pain in the right upper abdomen (95.3%), epigastric pain (94.7%), abdominal discomfort (96.9%) followed by nausea (75%), low-grade fever (37.5%), jaundice (26.6%) and vomiting (26.6%). Approximately 44% of the patients exhibited anaemia. Nearly half (46.1%) of the patients exhibited sonographic Murphy’s sign. Hyperechoic echo character was invariably obtained with 12.5% cases having hypoechoeic character as well. Over 90% of the patients had gall-stones, 62.5% cholecystitis (thickened gall-bladder wall). Ultrasound comment on the type of diseases revealed that 112(87.5%) were benign diseases and 16(12.5%) malignant cases. Approximately 55% of the gall bladder diseases diagnosed by histopathology were cholecystitis. Histopathological comment shows that about 90% of the diseases were benign and the rest (10.2%) were malignant. The sensitivity of ultrasound in diagnosing cholecystitis was 85.9%, while the specificity of the test was 60.9% with overall diagnostic accuracy of the test being 73.4%. The US had a optimum sensitivity (84.6%) and high specificity (95.6%) in diagnosing gall-bladder carcinoma. Conclusion: The study concluded that US could be considered as the preferred initial imaging technique for patients who are clinically suspected of having acute calculous cholecystitis. It is also a useful imaging modality for diagnosing gall-bladder malignancy. Thus, US can be dependably used in the primary evaluation of heptobilliary pathology. Ibrahim Card Med J 2017; 7 (1&2): 70-75

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