The rational diagnostic of cholangiocarcinoma

Česká verzia

Authors: Martin Rydlo ¹; Jana Dvořáčková ²; Tomáš Kupka ¹; Pavel Klvaňa ¹; Jaroslav Havelka ³; Magdalena Uvírová ⁴; Edvard Geryk ⁵; Daniel Czerný ³; Tomáš Jonszta ³; Martina Bojková ¹; Vladimír Hrabovský ¹; Veronika Jelínková ¹; Arnošt Martínek ¹; Petr Dítě ¹
Authors place of work: Interní klinika LF OU a FN Ostrava ¹; Ústav patologie LF OU a FN Ostrava ²; Ústav radiodiagnostický LF OU a FN Ostrava ³; CGB laboratoř, Ostrava ⁴; Oddělení pro vědu a výzkum FN Brno ⁵
Published in the journal: Vnitř Lék 2016; 62(2): 125-133
Category: Reviews

Summary

Cholangiocarcinoma (CC) is a rare malignant tumour arising from cholangiocytes, and its prognosis is usually unfavourable, mostly as a result of late diagnosis of the tumour. The current incidence of cholangiocarcinoma in the Czech Republic is 1.4/100,000 inhabitants per year; in less than 30 % of patients with CC, one of the known risk factors can be identified, most frequently, primary sclerosing cholangitis. Only patients with early diagnosed and surgically amenable cholangiocarcinoma are likely to have a longer survival time; in their case, survival for more than five years has been achieved in 20 % to 40 %. From the perspective of the need for early diagnosis of CC, a significant part is played by imaging and histopathologic evaluation; the early diagnostic significance of oncomarkers is limited. The rational early diagnosis of CC consists in effective use of differentiated advantages of different imaging modalities – MRI with DSA appears to be the optimal method, endosonography is a sensitive method for the identification of malignancy in the hepatic hilum or distal common bile duct, MRCP (magnetic resonance cholangiopancreatography) is used to display pathological changes in the biliary tree, ERCP (endoscopic retrograde cholangiopancreatography) allows material removal for histopathological examination. Other new approaches are also beneficial, such as IDUS – intraductal ultrasonography of biliary tract or SPY-GLASS, enabling examination of the bile ducts by direct view with the possibility of taking targeted biopsies. Sensitivity and specificity of histology and cytology can be increased by using the molecular cytogenetic FISH method, i.e. fluorescence in situ by hybridization, with a specificity of 97 %.

Key words:
epidemiology – cholangiokarcinoma – rational diagnostic – risk factors

Zdroje

1. Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liv Dis 2004; 24(2): 115–125.

2. Patel T. Increase incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology 2001; 33(6): 1353–1357.

3. Shaib YH, Davila JA, Mc Glynn K et al. Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase? J Hepatol 2004; 40(3): 472–477.

4. Taylor-Robinson SD, Toledano MB, Arora S et al. Increase in mortality rates from intrahepatic cholangiocarcinoma in England and Wales 1968–1998. Gut 2001; 48(6): 816–820.

5. ÚZIS. Novotvary ČR 1991–2010. Zdravotnická statistika. Ediční řada. ÚZIS ČR: Praha. Dostupné z WWW: http://www.uzis.cz/katalog/zdravotnicka-statistika/novotvary.

6. Blechacz B, Komuta M, Roskams T et al. Clinical diagnosis and staging of cholangiocarcinoma. Nat Rev Gastroenterol Hepatol 2011; 8(9): 512–522.

7. Tyson GL, El-Serag HB. Risk factors for cholangiocarcinoma. Hepatology 2011; 54(1): 173–184.

8. Khan SA, Thomas HC, Davidson BR et al. Cholangiocarcinoma. Lancet 2005; 366(9493): 1303–1314. Erratum in Lancet 2006; 367(9523): 1656.

9. Khan SA, Toledano MB, Taylor-Robinson SD. Epidemiology, risk factors, and pathogenesis of cholangiocarcinoma. HPB (Oxford) 2008; 10(2): 77–82.

10. Khan SA, Davidson BR, Goldin RD et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update. Gut 2012; 61(12): 1657–1669.

11. Adenugba A, Khan SA, Taylor-Robinson SD et al. Polychlorinated biphenyls in bile of patients with biliary tract cancer. Chemosphere 2009; 76(6): 841–846.

12. Claessen MM, Vleggaar FP, Tytgat KM et al. High lifetime risk of cancer in primary sclerosing cholangitis. J Hepatol 2009; 50(1): 158–164.

13. Abbas G, Lindor KD. Cholangiocarcinoma in primary sclerosing cholangitis. J Gastrointest Cancer 2009; 40(1–2): 19–25.

14. Bismuth H, Castaing D. Hepatobiliary malignancy. Edward Arnold: London 1994.

15. Deoliveira ML, Schulick RD, Nimura Y et al. New staging system and a registry for perihilar cholangiocarcinoma. Hepatology 2011; 53(4): 1363–1371.

16. Endo I, Gonen M, Yopp AC et al. Intrahepatic cholangiocarcinoma: rising frequency, improved survival, and determinants of outcome after resection. Ann Surg 2008; 248(1): 84–96.

17. Khan SA, Davidson BR, Goldin R et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut 2002; 51(Suppl 6): VI1-VI9.

18. Skipworth JR, Keane MG, Pereira SP. Update on the management of cholangiocarcinoma. Dig Sci 2014; 32(5): 570–578.

19. Ehrmann J, Hůlek P et al. Hepatologie. Grada: Praha 2014: 602–604. ISBN 978–80–247–5510–6.

20. Patel AH, Harnois DM, Klee GG et al. The utility of CA 19–9 in the diagnoses of cholangiocarcinoma in patiens without primary sclerosing cholangitis. Am J Gastroenterol 2000; 95(1): 204–207.

21. Bonney GK, Craven RA, Prasad R et al. Circulating markers of biliary malignancy: opportunities in proteomics? Lancet Oncol 2008; 9(2): 149–158.

22. Hultcrantz R, Olsson R, Danielsson A et al. A 3-year prospective study on serum tumor markers used for detecting cholangiocarcinoma in patients with primary sclerosing cholangitis. J Hepatol 1999; 30(4): 669–673.

23. Charatcharoenwitthaya P, Enders FB, Halling KC et al. Utility of serum tumor markers, imaging, and biliary cytology for detecting cholangiocarcinoma in primary sclerosing cholangitis. Hepatology 2008; 48(4): 1106–1117.

24. Ghazale A, Chari ST, Zhang L et al. Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy. Gastroenterology 2008; 134(3): 706–715.

25. Kuszyk BS, Soyer P, Bluemke DA et al. Intrahepatic cholangiocarcinoma: the role of imaging in detection and staging. Crit Rev Diagn Imaging 1997; 38(1): 59–88.

26. Kluge R, Schmidt F, Caca K et al. Positron emission tomography with [(18)F]fluoro-2-deoxy-D-glucose for diagnosis and staging of bile duct cancer. Hepatology 2001; 33(5): 1029–1035.

27. Kim JY, Kim MH, Lee TY et al. Clinical role of 18F-FDG PET-CT in suspected and potentially operable cholangiocarcinoma: a prospective study compared with conventional imaging. Am J Gastroenterol 2008; 103(5): 1145–1151.

28. Maccioni F, Martinelli M, Al Ansari N et al. Magnetic resonance cholangiography: past, present and future: a review. Eur Rev Med Pharmacol Sci 2010; 14(8): 721–725.

29. Romagnuolo J, Bardou M, Rahme E et al. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease. Ann Intern Med 2003; 139(7): 547–557.

30. Corvera CU, Blumgart LH, Akhurst T et al. 18F-Fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer. J Am Coll Surg 2008; 206(1): 57–65.

31. Furukawa H, Ikuma H, Asakura K et al. Prognostic importace of standardized uptake value on F-18 fluorodeoxyglucose-positron emission tomography in biliary tract carcinoma. J Surg Oncol 2009; 100(6): 494–499.

32. Weynand B, Deprez P. Endoscopic ultrasound guided fine needle aspiration in biliary and pancreatic diseases: pitfalls and performances. Acta Gastroenterol Belg 2004; 67(3): 294–300.

33. Chen YK, Parsi MA, Binmoeller KF et al. Single-operator cholangioscopy in patiens requiring evaluation of bile duct disease or therapy of biliary stones (with videos). Gastrointest Endosc 2011; 74(4): 805–814.

34. Sharma AK. Role of MRCP versus ERCP in bile duct cholangiocarcinoma and benign stricture. Biomed Imaging Interv J 2007; 3(1): e12-e545.

35. DeWitt J, Misra VL, Leblanc JK et al. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest Endosc 2006; 64(3): 325–333.

36. Urban O, Arnelo U, Kliment M et al. Cholangiopankreatoskopie pomocí SpyGlassTM direct visualization system: seznámení s metodou a první vlastní zkušenosti. Gastroent Hepatol 2013; 67(2): 124–126.

37. Bosman FT, Carneiro F, Hruban RH et al. WHO classification of tumours of the digestive system. 4th ed. IARC: Lyon 2010. ISBN 9789283224327.

38. Akiba J, Nakashima O, Hattori S et al. Clinicopathologic analysis of combined hepatocellular-cholangiocarcinoma according to the latest WHO classification. Am J Surg Pathol 2013; 37(4): 496–505.

39. Hytiroglou P, Theise ND. Differential diagnosis of hepatocellular nodular lesions. Semin Diagn Pathol 1998; 15(4): 285–299.

40. Gores GJ. Cholangiocarcinoma: current concepts and insights. Hepatology 2003; 37(5): 961–969.

41. Honsová E. Úloha patologa v diagnostice a léčbě onemocnění v hepatobiliární oblasti. Bulletin HPB 2004; 12(1–2): 1–2.

42. Honsová E. Histopatologická diagnóza hepatocelulárního karcinomu. Gastroent Hepatol 2012; 66(2): 93–98.

43. Levy MJ, Baron TH, Clayton AC et al. Prospective evaluation of advanced molecular markers and imaging techniques in patients with indeterminace bile duct strictures. Am J Gastroenterol 2008; 103(5): 1263–1273.

44. Gonda TA, Glick MP, Sethi A et al. Polysomy and p16 deletion by fluorescence in situ hybridization in the diagnosis of indeterminate biliary strictures. Gastrointest Endosc 2012; 75(1): 74–79.

45. Atlas of Genetics and Cytogenetics in Oncology and Haematology. Dostupné z WWW: http://atlasgeneticsoncology.org/.

46. Cheng L, Eble JN. Molecular surgical patology. Springer: New York 2013. ISBN 978–1461448990.

47. Rizvi S, Gores GJ. Molecular pathogenesis of cholangiocarcinoma. Dig Dis 2014; 32(5): 564–569.