Biliary intraepithelial neoplasia in patients without chronic biliary disease

Abstract

Absolute counting of total leukocytes or specific subsets within small amounts of whole blood is difficult due to a lack of techniques that enable separation of all leukocytes from limited amounts of whole blood. In this study, a microfluidic device equipped with a size‐controlled microcavity array for highly efficient separation of leukocytes from submicroliters of whole blood was developed. The microcavity array can separate leukocytes from whole blood based on differences in the size and deformability between leukocytes and other blood cells. Leukocytes recovered on aligned microcavities were continuously processed for image‐based immunophenotypic analysis. Our device successfully recovered over 90% of leukocytes in 1 µL of whole blood without pretreatment such as density gradient centrifugation or erythrocyte lysis. In addition, the proposed system successfully performed absolute enumeration of human CD4+ and CD8+ leukocytes from 1 µL of whole blood, and the obtained data showed good correlation with conventional flow cytometric analysis. Our microfluidic device has great potential as a tool for a point‐of‐care leukocyte analysis system. Biotechnol. Bioeng. 2012; 109:2017–2024. © 2012 Wiley Periodicals, Inc.

Chemotherapy for Inoperable Advanced or Metastatic Cholangiocarcinoma: Retrospective Analysis of 78 Cases in a Single Center over Four Years

“…diffuse disease with nodal involvement (46.7%) or metastasis (30.7%); (3) intrahepatic forms of cholangiocarcinoma predominated (73%), and (4) the percentage of patients with associated cirrhosis was high (n = 30/78, 38.5%), particularly among those with intrahepatic cholangiocarcinoma (43.8%, 25/57). These data are in line with the trend observed over the last 3 decades showing an increase in the incidence of intrahepatic cholangiocarcinoma [1,14] and also the more recently noted trend of a link between hepatic cirrhosis and biliary tract carcinoma, particularly intrahepatic cholangiocarcinoma [8,11,12]. Indeed, in our cohort, 25 of the 30 (83.5%) cholangiocarcinomas arising on cirrhotic liver were intrahepatic.…”

“…More recent studies show a statistically significant link between the development of intrahepatic cholangiocarcinoma and the presence of chronic liver disease related to viral hepatitis B or C, alcoholic hepatitis, dysmetabolic disease (nonalcoholic steatohepatitis, obesity/diabetes) or inflammatory bowel disease [7,8,9,10,11,12,13,14]. …”

Clinical and biological significance of precursor lesions of intrahepatic cholangiocarcinoma

“…BilIN is frequently diagnosed in cases of hepatolithiasis [17] , and primary sclerosing cholangitis and choledochal cyst have also been associated with BilIN [15,18] . BilIN has also been shown to arise in autoimmune pancreatitis, chronic hepatitis B and C, and alcoholic cirrhosis [19][20][21] . BilIN shares several molecular alterations with cholangiocarcinoma, and study of BilIN alongside cholangiocarcinoma has helped to elucidate several of the key molecular mechanisms in cholangiocarcinogenesis.…”

“…Histologically, the aforementioned fibrovascular cores are lined by any of four cell types: Pancreatobiliary, intestinal, gastric and oncocytic types, parallel to those defined in IPMN [10] . [1] No published data 9%-38% of bile duct carcinomas [28] 5.6% of adults, 0.9% of children (autopsy series) [40] 0.00008%-0.006% of patients (autopsy series) [52,53] Risk factors Chronic viral hepatitis, clonorchis, opistorchis, hepatolithiasis [1] Hepatolithiasis, primary sclerosing cholangitis, choledochal cyst, autoimmune pancreatitis, chronic viral hepatitis, alcoholic cirrhosis [15,[17][18][19][20][21] Hepatolithiasis, clonorchis [31,32] Congenital hepatic fibrosis, polycystic liver disease [40] No known risk factors…”

Alcohol consumption and digestive tract cancer

“…As in the stomach, H. pylori may be another contributing if not synergistic factor [63]. The contribution of alcohol may also be dependent on the location of cancers in the biliary tract: the effect on intrahepatic cholanciocarcinomas and preneoplastic lesions (biliary intraductal neoplasia) seems pronounced, at least in some populations (China) [64,65], whereas no association between alcohol and cholangiocarcinoma could be found in a British case-control study [66].…”