Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice

Tajiri, Takashi; Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Yokomuro, Shigeki; Mizuguchi, Yoshiaki

doi:10.3748/wjg.14.3000

Cited by 15 publications

(16 citation statements)

References 66 publications

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“…Infection with O. viverrini can induce biliary stasis that, after long-standing obstruction, leads to infection by microorganisms from the intestine, resulting in ascending cholangitis (8). In a similar fashion, biliary blockage due to CCA also induces ascending cholangitis (9,(45)(46)(47). We anticipate that the potentially pathogenic microorganisms detected in our study obtained entry into the biliary tree during the migration of the liver fluke from the duodenum; these included Pseudomonas, Serratia, Leminorella, and Bartonella.…”

Section: Discussionmentioning

confidence: 68%

Infection with the carcinogenic liver fluke Opisthorchis viverrini modifies intestinal and biliary microbiome

et al. 2013

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Opisthorchis viverrini is a fish-borne trematode endemic in East Asia. Following ingestion, the flukes locate to the biliary tre where chronic infection frequently leads to cholangiocarcinoma (CCA). The mechanisms by which O. viverrini infection culminates in CCA remain unknown. An unexplored aspect is its influence on the host microbiome. In the hamster, infection with this pathogen reliably leads to CCA. Genomic DNAs of microbiota from colorectal contents and bile of hamsters and from whole O. viverrini were examined in this model of fluke-induced CCA. Microbial communities were characterized by high-throughput sequencing of variable regions 7-9 of prokaryotic 16S ribosomal DNA. Of ∼1 million sequences, 536,009 with useable reads were assignable to 29,776 operational taxonomy units (OTUs) and, in turn, to 20 phyla and 273 genera of Bacteria or Archaea. Microbial community analyses revealed that fluke infection perturbed the gastrointestinal tract microbiome, increasing Lachnospiraceae, Ruminococcaceae, and Lactobacillaceae, while decreasing Porphyromonadaceae, Erysipelotrichaceae, and Eubacteriaceae (P≤0.05). More than 60 OTUs were detected in the biliary system, which confirmed bacteriobilia and a noteworthy community of microbes associated with the parasites. The fluke-associated microorganisms included potential pathogens from the Enterobacteriaceae and Listeriaceae and others, including Cyanobacteria and Deinococci, usually found in external environments. Given that opisthorchiasis is distinguished from other helminth infections by a robust inflammatory phenotype with conspicuously elevated IL-6, and that inflammation of the biliary system leads to periductal fibrosis, which is a precursor of CCA, the flukes and their microbiota may together drive this distinctive immune response.

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Section: Discussionmentioning

confidence: 68%

Infection with the carcinogenic liver fluke Opisthorchis viverrini modifies intestinal and biliary microbiome

et al. 2013

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“…BTC arises from the biliary tract epithelia and frequently causes stricture or obstruction of the bile duct [2]. A consequence of this obstruction is the retention of bile, which leads to jaundice.…”

Section: Introductionmentioning

confidence: 99%

Real-Time PCR-Based Analysis of the Human Bile MicroRNAome Identifies miR-9 as a Potential Diagnostic Biomarker for Biliary Tract Cancer

et al. 2011

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Biliary tract cancer (BTC) is often difficult to diagnose definitively, even through histological examination. MicroRNAs (miRNAs) regulate a variety of physiological processes. In recent years, it has been suggested that profiles for circulating miRNAs, as well as those for tissue miRNAs, have the potential to be used as diagnostic biomarkers for cancer. The aim of this study was to confirm the existence of miRNAs in human bile and to assess their potential as clinical biomarkers for BTC. We sampled bile from patients who underwent biliary drainage for biliary diseases such as BTC and choledocholithiasis. PCR-based miRNA detection and miRNA cloning were performed to identify bile miRNAs. Using high-throughput real-time PCR-based miRNA microarrays, the expression profiles of 667 miRNAs were compared in patients with malignant disease (n = 9) and age-matched patients with the benign disease choledocholithiasis (n = 9). We subsequently characterized bile miRNAs in terms of stability and localization. Through cloning and using PCR methods, we confirmed that miRNAs exist in bile. Differential analysis of bile miRNAs demonstrated that 10 of the 667 miRNAs were significantly more highly expressed in the malignant group than in the benign group at P<0.0005. Setting the specificity threshold to 100% showed that some miRNAs (miR-9, miR-302c*, miR-199a-3p and miR-222*) had a sensitivity level of 88.9%, and receiver-operating characteristic analysis demonstrated that miR-9 and miR-145* could be useful diagnostic markers for BTC. Moreover, we verified the long-term stability of miRNAs in bile, a characteristic that makes them suitable for diagnostic use in clinical settings. We also confirmed that bile miRNAs are localized to the malignant/benign biliary epithelia. These findings suggest that bile miRNAs could be informative biomarkers for hepatobiliary disease and that some miRNAs, particularly miR-9, may be helpful in the diagnosis and clinical management of BTC.

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“…Diagnostic techniques for hepatobiliar y disease have improved recently, but advanced hepatic hilum malignancy is still encountered frequently [5][6][7] . Palliative treatment with a biliary stent is carried out in patients with inoperable malignancy in order to relieve symptoms related to obstructive jaundice [8] .…”

Section: Discussionmentioning

confidence: 99%

Placement of percutaneous transhepatic biliary stent using a silicone drain with channels

Yoshida¹,

Mamada²,

Taniai³

et al. 2009

WJG

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Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice

Cited by 15 publications

References 66 publications

Infection with the carcinogenic liver fluke Opisthorchis viverrini modifies intestinal and biliary microbiome

Infection with the carcinogenic liver fluke Opisthorchis viverrini modifies intestinal and biliary microbiome

Real-Time PCR-Based Analysis of the Human Bile MicroRNAome Identifies miR-9 as a Potential Diagnostic Biomarker for Biliary Tract Cancer

Placement of percutaneous transhepatic biliary stent using a silicone drain with channels

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