Gallbladder cancer risk factors: Difference between revisions

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=== Common Risk Factors ===
=== Common Risk Factors ===
Common risk factors in the development of gallbladder cancer include:
* Common risk factors in the development of [[gallbladder cancer]] include:
 
** '''Gallstones:''' [[Gallstones]] are found in 70 to 90 percent of patients with [[gallbladder cancer]](GBC), With an 8.3x higher danger than the overall population.<ref name="pmid28400123">{{cite journal |vauthors=Muszynska C, Lundgren L, Lindell G, Andersson R, Nilsson J, Sandström P, Andersson B |title=Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease: Results from a population-based gallstone surgery registry |journal=Surgery |volume=162 |issue=2 |pages=256–263 |year=2017 |pmid=28400123 |doi=10.1016/j.surg.2017.02.009 |url=}}</ref><ref name="pmid18000509">{{cite journal |vauthors=Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS, Shen MC, Zhang BH, Niwa S, Chen J, Fraumeni JF |title=Gallstones and the risk of biliary tract cancer: a population-based study in China |journal=Br. J. Cancer |volume=97 |issue=11 |pages=1577–82 |year=2007 |pmid=18000509 |pmc=2360257 |doi=10.1038/sj.bjc.6604047 |url=}}</ref>
'''Gallstones:''' Gallstones are found in 70 to 90 percent of patients with gallbladder Cancer (GBC) and a history of gallstones appears to be one of the strongest risk factors for the development of GBC, With an 8.3x higher danger than the overall population.<ref name="pmid18000509">{{cite journal |vauthors=Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS, Shen MC, Zhang BH, Niwa S, Chen J, Fraumeni JF |title=Gallstones and the risk of biliary tract cancer: a population-based study in China |journal=Br. J. Cancer |volume=97 |issue=11 |pages=1577–82 |year=2007 |pmid=18000509 |pmc=2360257 |doi=10.1038/sj.bjc.6604047 |url=}}</ref>In spite of the increased risk of GBC in patients with [[Gallstone disease|gallstones]], the general occurrence of GBC in patients with [[cholelithiasis]] is only 0.5 percent.<ref name="pmid28400123">{{cite journal |vauthors=Muszynska C, Lundgren L, Lindell G, Andersson R, Nilsson J, Sandström P, Andersson B |title=Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease: Results from a population-based gallstone surgery registry |journal=Surgery |volume=162 |issue=2 |pages=256–263 |year=2017 |pmid=28400123 |doi=10.1016/j.surg.2017.02.009 |url=}}</ref> The larger the stones are the higher the risk of gallbladder cancer in patients with gall stones. Patients with stones larger than 3 cm had a 10-fold higher chance of GBC in comparison with people with stones <1 cm.
** '''Porcelain gallbladder:'''In 95 % of the cases, the [[porcelain gallbladder]] is associated with [[gallstones]].The incidence of GBC in patients with a [[porcelain gallbladder]] levels about 2 to 3 percent..<ref name="pmid22006872">{{cite journal |vauthors=Khan ZS, Livingston EH, Huerta S |title=Reassessing the need for prophylactic surgery in patients with porcelain gallbladder: case series and systematic review of the literature |journal=Arch Surg |volume=146 |issue=10 |pages=1143–7 |year=2011 |pmid=22006872 |doi=10.1001/archsurg.2011.257 |url=}}</ref>
 
** '''Gallbladder polyps:''' Around 5% of all adults have [[Gallbladder polyp|gallbladder polyps]].<ref name="pmid26421012">{{cite journal |vauthors=Kanthan R, Senger JL, Ahmed S, Kanthan SC |title=Gallbladder Cancer in the 21st Century |journal=J Oncol |volume=2015 |issue= |pages=967472 |year=2015 |pmid=26421012 |pmc=4569807 |doi=10.1155/2015/967472 |url=}}</ref>
'''Porcelain gallbladder:''' Porcelain gallbladder is characterized by intramural [[calcification]] of the gallbladder wall and it is a rare manifestation of chronic [[cholecystitis]].In 95 % of the cases, the procelain gallbladder is associated with gallstones.The incidence of GBC in patients with a porcelain gallbladder levels about 2 to 3 percent and this  increased risk can be restricted to patients with selective mucosal calcification.<ref name="pmid22006872">{{cite journal |vauthors=Khan ZS, Livingston EH, Huerta S |title=Reassessing the need for prophylactic surgery in patients with porcelain gallbladder: case series and systematic review of the literature |journal=Arch Surg |volume=146 |issue=10 |pages=1143–7 |year=2011 |pmid=22006872 |doi=10.1001/archsurg.2011.257 |url=}}</ref>
 
'''Gallbladder polyps:''' Around 5% of all adults have [[Gallbladder polyp|gallbladder polyps]], These are the outgrowths of mucosa of the gallbladder which are found accidently on [[ultrasound]].The classification of the gallbladder polyps are [[benign]] or [[malignant]].Differentiating non-neoplastic from [[neoplastic]] polyps is important.<ref name="pmid26421012">{{cite journal |vauthors=Kanthan R, Senger JL, Ahmed S, Kanthan SC |title=Gallbladder Cancer in the 21st Century |journal=J Oncol |volume=2015 |issue= |pages=967472 |year=2015 |pmid=26421012 |pmc=4569807 |doi=10.1155/2015/967472 |url=}}</ref>
{| class="wikitable"
{| class="wikitable"
| style="background:#4479BA; color: #FFFFFF;" + |'''Benign polyps'''
! style="background:#4479BA; color: #FFFFFF;" + |'''Benign polyps'''
| style="background:#4479BA; color: #FFFFFF;" + |'''Malignant polyps'''
! style="background:#4479BA; color: #FFFFFF;" + |'''Malignant polyps'''
|-
|-
|[[Cholesterol]] polyps (60%)
![[Cholesterol]] polyps (60%)
|[[Adenocarcinoma]] (80%)
| rowspan="3" |[[Adenocarcinoma]] (80%)
|-
|-
|Adenomyomas (25%)
!Adenomyomas (25%)
|
|-
|-
|[[Inflammation|Inflammatory]] polyps (10%)
![[Inflammation|Inflammatory]] polyps (10%)
|
|-
|-
|[[Adenoma|Adenomas]] (4%)
![[Adenoma|Adenomas]] (4%)
|
| rowspan="2" |Miscellaneous (20%)
Mucinous cystadenomas, [[Squamous cell carcinoma]], and adenoacanthomas
|-
|-
|Miscellaneous (1%)
!Miscellaneous (1%)


Leiomyomas, Fibromas, and [[Lipoma|Lipomas]]
Leiomyomas, Fibromas, and [[Lipoma|Lipomas]]
|Miscellaneous (20%)
Mucinous cystadenomas, [[Squamous cell carcinoma]], and adenoacanthomas
|}
|}
* '''Primary sclerosing cholangitis (PSC):''' PSC is a chronic [[Inflamation|inflammatory]] disease and is associated with increased risk of [[gallbladder cancer]](GBC).<ref name="pmid24634588">{{cite journal |vauthors=Hundal R, Shaffer EA |title=Gallbladder cancer: epidemiology and outcome |journal=Clin Epidemiol |volume=6 |issue= |pages=99–109 |year=2014 |pmid=24634588 |pmc=3952897 |doi=10.2147/CLEP.S37357 |url=}}</ref>


'''Primary sclerosing cholangitis (PSC):''' PSC is a chronic [[Inflamation|inflamatory]] disease and is assosciated with increased risk of Gallbladder cancer (GBC).It is therefore advicesed that patients with PSC should undergo yearly [[gallbladder]] [[Screening (medicine)|screening]] with [[ultrasound]] for the detection of any [[abnormal]] [[Lesion|lesions]].<ref name="pmid24634588">{{cite journal |vauthors=Hundal R, Shaffer EA |title=Gallbladder cancer: epidemiology and outcome |journal=Clin Epidemiol |volume=6 |issue= |pages=99–109 |year=2014 |pmid=24634588 |pmc=3952897 |doi=10.2147/CLEP.S37357 |url=}}</ref>
* '''Cigarette smoking:''' [[cigarette]] [[smoking]] is one the important [[risk factor]] in causing [[gallbladder cancer]].
 
* '''Chronic infection:'''
'''Chronic infection'''
** '''Helicobacter:''' Exact mechanism is poorly understood but it is thought that [[gallbladder cancer]] may be related to the bacterial-induced [[degradation]] of bile acids.
 
** '''Liver flukes:''' [[Liver flukes]] especially ''[[Clonorchis sinensis]]'' and'' [[Opisthorchis viverrini]]'' are related in the [[gallbladder cancer]].<ref name="pmid246345882">{{cite journal |vauthors=Hundal R, Shaffer EA |title=Gallbladder cancer: epidemiology and outcome |journal=Clin Epidemiol |volume=6 |issue= |pages=99–109 |year=2014 |pmid=24634588 |pmc=3952897 |doi=10.2147/CLEP.S37357 |url=}}</ref>
'''Helicobacter:''' Exact mechanism is poorly understood but it is thought that gallbladder cancer may be related to the bacterial-induced [[degradation]] of bile acids.
** '''Salmonella''': Several reports and a [[meta-analysis]] of  [[case-control]] and [[Cohort study|cohort studies]] advocate an association among chronic S. typhi carriage and increased hazard of GBC
 
=== Less common risk factors ===
'''Liver flukes:''' Liver flukes especially ''[[Clonorchis sinensis]]'' and'' [[Opisthorchis viverrini]]'' are related in the gallbladder cancer.<ref name="pmid246345882">{{cite journal |vauthors=Hundal R, Shaffer EA |title=Gallbladder cancer: epidemiology and outcome |journal=Clin Epidemiol |volume=6 |issue= |pages=99–109 |year=2014 |pmid=24634588 |pmc=3952897 |doi=10.2147/CLEP.S37357 |url=}}</ref>
Less common risk factors in the development of [[Gallbladder cancer|gallbladder carcinoma]] include:
 
* '''Pancreaticobiliary maljunction (PBM):''' PBM is due to failure of migration of embryological ducts into the [[duodenum]].[[Gallbladder carcinoma]] is the most common [[Cancer|malignancy]] seen in patients with a pancreaticobiliary maljunction problem.
'''Salmonella''': Several reports and a [[meta-analysis]] of  [[case-control]] and [[Cohort study|cohort studies]] advocate an association among chronic S. typhi carriage and increased hazard of GBC
 
'''Congenital biliary cysts:''' Biliary [[Cyst|cysts]] are cystic dilatations in the [[bile duct]]<nowiki/>s.They were originally coined as choledochal cysts .Biliary cysts are more  frequently seen in Asian populations. An abnormal pancreaticobiliary duct junction is present in approximately 70 percent of patients with biliary cysts.Particularly [[cholangiocarcinoma]] is assciated with increased risk with [[biliary]] cysts.<ref name="pmid264210122">{{cite journal |vauthors=Kanthan R, Senger JL, Ahmed S, Kanthan SC |title=Gallbladder Cancer in the 21st Century |journal=J Oncol |volume=2015 |issue= |pages=967472 |year=2015 |pmid=26421012 |pmc=4569807 |doi=10.1155/2015/967472 |url=}}</ref>
 
'''Pancreaticobiliary maljunction (PBM):''' It's a rare anatomical abnormality in which the [[Pancreas|pancreatic]] duct drains into the [[common bile duct]], which results in a long common duct. PBM is due to failure of migration of [[Embryology|embryological]] ducts into the [[duodenum]].PDM has most commonly seen in Japanese population.<ref name="pmid11555095">{{cite journal |vauthors=Kaushik SP |title=Current perspectives in gallbladder carcinoma |journal=J. Gastroenterol. Hepatol. |volume=16 |issue=8 |pages=848–54 |year=2001 |pmid=11555095 |doi= |url=}}</ref>The abnormally long common channel may lead to [[reflux]] of pancreatic [[Secretion|secretions]] into the [[biliary tree]]. This results in increased [[amylase]] levels in the bile, intraductal secretion and activation of [[proteolytic]] [[enzymes]], changes in bile composition, and may be [[biliary]] [[Epithelium|epithelial]] damage, [[inflammation]], ductal [[distension]], and [[cyst]] formation. is the most common malignancy seen in patients with an anomalous pancreaticobiliary duct junction. is the most common malignancy seen in patients with an anomalous pancreaticobiliary duct junction. Gallbladder carcinoma is the most common malignancy seen in patients with a Pancreaticobiliary maljunction problem.<ref name="pmid246345883">{{cite journal |vauthors=Hundal R, Shaffer EA |title=Gallbladder cancer: epidemiology and outcome |journal=Clin Epidemiol |volume=6 |issue= |pages=99–109 |year=2014 |pmid=24634588 |pmc=3952897 |doi=10.2147/CLEP.S37357 |url=}}</ref>


'''Cigarette smoking:''' [[cigarette]] [[smoking]] is one the important [[risk factor]] in causing [[gallbladder cancer]].
* <nowiki/><nowiki/><nowiki/><nowiki/><nowiki/> '''Congenital biliary cysts:''' Biliary [[Cyst|cysts]] are cystic dilatations in the [[bile duct]]<nowiki/>s.They were originally coined as choledochal cysts .Biliary cysts are more  frequently seen in Asian populations. An abnormal pancreaticobiliary duct junction is present in approximately 70 percent of patients with biliary cysts.Particularly [[cholangiocarcinoma]] is associated with increased risk with [[biliary]] cysts.<ref name="pmid264210122">{{cite journal |vauthors=Kanthan R, Senger JL, Ahmed S, Kanthan SC |title=Gallbladder Cancer in the 21st Century |journal=J Oncol |volume=2015 |issue= |pages=967472 |year=2015 |pmid=26421012 |pmc=4569807 |doi=10.1155/2015/967472 |url=}}</ref><ref name="pmid246345883">{{cite journal |vauthors=Hundal R, Shaffer EA |title=Gallbladder cancer: epidemiology and outcome |journal=Clin Epidemiol |volume=6 |issue= |pages=99–109 |year=2014 |pmid=24634588 |pmc=3952897 |doi=10.2147/CLEP.S37357 |url=}}</ref><ref name="pmid11555095">{{cite journal |vauthors=Kaushik SP |title=Current perspectives in gallbladder carcinoma |journal=J. Gastroenterol. Hepatol. |volume=16 |issue=8 |pages=848–54 |year=2001 |pmid=11555095 |doi= |url=}}</ref> <nowiki/><nowiki/>


==References==
==References==

Latest revision as of 00:10, 13 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

The most potent risk factor in the development of gallbladder carcinoma is gallstones. Other risk factors include Porcelain gallbladder, gallbladder polyps, Primary sclerosing cholangitis, chronic infection, pancreaticobiliary maljunction (PBM) and biliary cysts.

Risk factors

Common Risk Factors

Benign polyps Malignant polyps
Cholesterol polyps (60%) Adenocarcinoma (80%)
Adenomyomas (25%)
Inflammatory polyps (10%)
Adenomas (4%) Miscellaneous (20%)

Mucinous cystadenomas, Squamous cell carcinoma, and adenoacanthomas

Miscellaneous (1%)

Leiomyomas, Fibromas, and Lipomas

Less common risk factors

Less common risk factors in the development of gallbladder carcinoma include:

  • Pancreaticobiliary maljunction (PBM): PBM is due to failure of migration of embryological ducts into the duodenum.Gallbladder carcinoma is the most common malignancy seen in patients with a pancreaticobiliary maljunction problem.
  • Congenital biliary cysts: Biliary cysts are cystic dilatations in the bile ducts.They were originally coined as choledochal cysts .Biliary cysts are more frequently seen in Asian populations. An abnormal pancreaticobiliary duct junction is present in approximately 70 percent of patients with biliary cysts.Particularly cholangiocarcinoma is associated with increased risk with biliary cysts.[7][8][9]

References

  1. ↑ Muszynska C, Lundgren L, Lindell G, Andersson R, Nilsson J, Sandström P, Andersson B (2017). "Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease: Results from a population-based gallstone surgery registry". Surgery. 162 (2): 256–263. doi:10.1016/j.surg.2017.02.009. PMID 28400123.
  2. ↑ Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS, Shen MC, Zhang BH, Niwa S, Chen J, Fraumeni JF (2007). "Gallstones and the risk of biliary tract cancer: a population-based study in China". Br. J. Cancer. 97 (11): 1577–82. doi:10.1038/sj.bjc.6604047. PMC 2360257. PMID 18000509.
  3. ↑ Khan ZS, Livingston EH, Huerta S (2011). "Reassessing the need for prophylactic surgery in patients with porcelain gallbladder: case series and systematic review of the literature". Arch Surg. 146 (10): 1143–7. doi:10.1001/archsurg.2011.257. PMID 22006872.
  4. ↑ Kanthan R, Senger JL, Ahmed S, Kanthan SC (2015). "Gallbladder Cancer in the 21st Century". J Oncol. 2015: 967472. doi:10.1155/2015/967472. PMC 4569807. PMID 26421012.
  5. ↑ Hundal R, Shaffer EA (2014). "Gallbladder cancer: epidemiology and outcome". Clin Epidemiol. 6: 99–109. doi:10.2147/CLEP.S37357. PMC 3952897. PMID 24634588.
  6. ↑ Hundal R, Shaffer EA (2014). "Gallbladder cancer: epidemiology and outcome". Clin Epidemiol. 6: 99–109. doi:10.2147/CLEP.S37357. PMC 3952897. PMID 24634588.
  7. ↑ Kanthan R, Senger JL, Ahmed S, Kanthan SC (2015). "Gallbladder Cancer in the 21st Century". J Oncol. 2015: 967472. doi:10.1155/2015/967472. PMC 4569807. PMID 26421012.
  8. ↑ Hundal R, Shaffer EA (2014). "Gallbladder cancer: epidemiology and outcome". Clin Epidemiol. 6: 99–109. doi:10.2147/CLEP.S37357. PMC 3952897. PMID 24634588.
  9. ↑ Kaushik SP (2001). "Current perspectives in gallbladder carcinoma". J. Gastroenterol. Hepatol. 16 (8): 848–54. PMID 11555095.


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