Conjugated Bile Acids in Gallbladder Bile and Serum as Potential Biomarkers for Cholesterol Polyps and Adenomatous Polyps

Zhao, Ming; Huang, Peng; Ge, Chunlin; Sun, Tung‐Tien; Ma, Zhi-Gang; Ye, Fei-Fei

doi:10.5301/jbm.5000173

Cited by 23 publications

(18 citation statements)

References 16 publications

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“…BA hydrophobicity is implicated in the promotion of CRC [ 61 ]. Furthermore, studies have revealed that colon polyps arising from the glandular epithelium, another major cause of CRC [ 62 ], are also positively affected by secondary BAs [ 63 , 64 ]. Hence, these interrelated pathways represent the possible effects of cholecystectomy on CRC.…”

Section: Discussionmentioning

confidence: 99%

Cholecystectomy can increase the risk of colorectal cancer: A meta-analysis of 10 cohort studies

Zhang

Líu

et al. 2017

PLoS ONE

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ObjectiveThis study aimed to elucidate the effects of cholecystectomy on the risk of colorectal cancer (CRC) by conducting a meta-analysis of 10 cohort studies.MethodsThe eligible cohort studies were selected by searching the PubMed and EMBASE databases from their origination to June 30, 2016, as well as by consulting the reference lists of the selected articles. Two authors individually collected the data from the 10 papers. When the data showed marked heterogeneity, we used a random-effects model to estimate the overall pooled risk; otherwise, a fixed effects model was employed.ResultsThe final analysis included ten cohort studies. According to the Newcastle-Ottawa Scale (NOS), nine papers were considered high quality. After the data of these 9 studies were combined, an increased risk of CRC was found among the individuals who had undergone cholecystectomy (risk ratio (RR) 1.22; 95% confidence interval (CI) 1.08–1.38). In addition, we also found a promising increased risk for colon cancer (CC) (RR 1.30, 95% CI 1.07–1.58), but no relationship between cholecystectomy and rectum cancer (RC) (RR 1.09; 95% CI 0.89–1.34) was observed. Additionally, in the sub-group analysis of the tumor location in the colon, a positive risk for ascending colon cancer (ACC) was found (RR 1.18, 95% CI 1.11–1.26). After combining the ACC, transverse colon cancer (TCC), sigmoid colon cancer (SCC) and descending colon cancer (DCC) patients, we found a positive relationship with cholecystectomy (RR 1.18, 95% CI 1.11–1.26). Furthermore, after combining the ACC and DCC patients, we also found a positive relationship with cholecystectomy (RR 1.28; 95% CI 1.11–1.26) in the sub-group analysis. In an additional sub-group analysis of patients from Western countries, there was a positive relationship between cholecystectomy and the risk of CRC (RR 1.20; 95% CI 1.05–1.36). Furthermore, a positive relationship between female gender and CRC was also found (RR 1.17; 95% CI 1.03–1.34). However, there was no relationship between gender and CC or RC. Furthermore, no publication bias was observed, and the sensitivity analysis indicated stable results.ConclusionsThis meta-analysis of 10 cohort studies revealed that cholecystectomy is associated with an increased risk for CRC, CC and ACC, particularly in Western countries. No relationship between cholecystectomy and RC was observed. There was no relationship between gender and either CC or RC, but a positive relationship between female gender and CRC was observed.

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Section: Discussionmentioning

confidence: 99%

Cholecystectomy can increase the risk of colorectal cancer: A meta-analysis of 10 cohort studies

Zhang

Líu

et al. 2017

PLoS ONE

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“…The change in GCDCA is particularly pronounced in non-neoplastic polyps. Levels of these conjugated BAs are of great value for the identification of cholesterol polyps and adenomatous polyps [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in plasma bile acids are associated with gallbladder stones and polyps

Yin-ping

Zhu

et al. 2020

BMC Gastroenterol

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Background The development of gallbladder disease (GBD) is related to bile acid (BA) metabolism, and the rate of BA circulation increases the risk of biliary cancer. However, it is unclear whether patterns of circulating bile acids (BAs) change in patients with benign GBDs such as gallbladder stones and polyps. Herein, we compared and characterised plasma BA profiles in patients with cholecystolithiasis and non-neoplastic polyps with healthy controls, and explored relationships between plasma BA profiles, demographics, and laboratory test indices. Methods A total of 330 subjects (13 healthy controls, 292 cholecystolithiasis and 25 non-neoplastic polyps) were recruited and plasma BA profiles including 14 metabolites from patients with pathologically confirmed cholecystolithiasis and non-neoplastic polyps were compared with controls. BAs were quantitated by liquid chromatography and mass spectrometry, and statistical and regression analyses of demographics and laboratory test indices were performed. Results Females displayed a higher burden of GBD than males (63.36% cholecystolithiasis, 60% non-neoplastic polyps). Cholecystolithiasis and non-neoplastic polyps were associated with increased plasma total secondary BAs, while levels of primary BAs were lower than in healthy controls. Plasma ursodeoxycholic acid (UDCA), tauroursodeoxycholic acid (TUDCA), glycyurdeoxycholic acid (GUDCA), taurochenodeoxycholic acid (TCDCA) and glycochenodeoxycholic acid (GCDCA) were decreased significantly in GBDs, and ursodeoxycholic acid (UDCA) was negatively correlated with white blood cell count and neutrophil percentage. Conclusions Secondary BA levels were higher in patients with cholecystolithiasis and non-neoplastic polyps. White blood cell count and percentage of neutrophil in peripheral blood were negatively correlated with UDCA, indicating an anti-inflammation effect of UDCA.

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“…This physiological change in the hepatic cholesterol mechanism could then promote cholesterol polyp formation. Zhao et al [6] reported that the accumulation of cholesterol esters in epithelial cells of the submucosa of the gallbladder is thought to be a key factor in this association. The accumulated substances in the gallbladder submucosa are phagocytized by macrophages and generate foam cells.…”

Section: Discussionmentioning

confidence: 99%

“…However, cholesterol polyps are generally characterized by cholesterol-laden foamy histiocytes, a lipid component that is very distinct from the components of adenomatous polyps. Previous studies reported that cholesterol polyps were significantly associated with alterations in bile acid secretion that is different from the mechanism of adenoma formation [6]. Therefore, the differences in these polyp traits and bile components can be helpful to more specifically distinguish premalignant lesions from benign lesions.…”

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confidence: 99%

Bile cholesterol and viscosity, the keys to discriminating adenomatous polyps from cholesterol polyps by a novel predictive scoring model

Kim

Hong

2020

BMC Gastroenterol

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Background: Adenomatous gallbladder polyps, premalignant lesions of the gallbladder, have fatal outcomes, whereas cholesterol polyps have benign features. Herein, we proposed a novel, predictive scoring model of adenomatous polyps to distinguish them from cholesterol polyps, by analyzing bile components and bile viscosity. Methods: Patients with gallbladder polyp pathologically confirmed after cholecystectomies were analyzed. After dividing patients into two groups (adenomatous or cholesterol polyps), the clinicopathologic profiles and bile nature, including components and viscosity were compared and a predictive scoring model for adenomatous polyps was assessed. Results: Eleven adenomatous polyps and 96 cholesterol polyps were analyzed. The variables significantly associated with adenomatous polyps were age > 55 years (OR = 23.550, p = 0.020), bile viscosity< 7.5 s − 1 (OR = 22.539, p = 0.012), and bile cholesterol< 414.5 mg/dl (OR = 10.004, p = 0.023) and the points for each variable in the predictive scoring model were allocated as 3, 3, and 2, respectively. Final scores ranged from 0 to 8 points and the best performance of model at a cutoff of ≥6 points had 90.9% of sensitivity and 80.2% of specificity. Conclusions: Bile viscosity and bile cholesterol accompanied by age were revealed as significant predictors of adenomatous polyps, distinguishing them from cholesterol polyps of gallbladder. It can be the cornerstone for creating accurate guidelines for preoperatively determining treatment strategies of gallbladder polyps.

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Conjugated Bile Acids in Gallbladder Bile and Serum as Potential Biomarkers for Cholesterol Polyps and Adenomatous Polyps

Abstract: The levels of serum GCA, GCDCA and TCDCA may be valuable for differentiation of APs and CPs.

Cited by 23 publications

References 16 publications

Cholecystectomy can increase the risk of colorectal cancer: A meta-analysis of 10 cohort studies

Cholecystectomy can increase the risk of colorectal cancer: A meta-analysis of 10 cohort studies

Changes in plasma bile acids are associated with gallbladder stones and polyps

Bile cholesterol and viscosity, the keys to discriminating adenomatous polyps from cholesterol polyps by a novel predictive scoring model

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