Gallbladder Cancer and Gallstone
Gallbladder cancer is a relatively rare neoplasm that differs from other cancers of the digestive tract. Therefore, the epidemiology has not well progressed and the risk factors have not been fully elucidated. With respect to the association between gallbladder cancer and gallstones, this review art...
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| Published in | Tando Vol. 26; no. 2; pp. 205 - 211 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan Biliary Association
2012
一般社団法人 日本胆道学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-0077 1883-6879 |
| DOI | 10.11210/tando.26.205 |
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| Abstract | Gallbladder cancer is a relatively rare neoplasm that differs from other cancers of the digestive tract. Therefore, the epidemiology has not well progressed and the risk factors have not been fully elucidated. With respect to the association between gallbladder cancer and gallstones, this review article introduced the data on the meta-analysis of the published findings that were conducted abroad, and those on the results of the Japan Public Health Center-Based Prospective Study, an epidemiological study based on the prospective follow-up of a large number of the Japanese population that has recently been reported from the Ministry of Health, Welfare, and Labor. This review also refers to the natural history of gallstone disease. There has been a consensus that a prophylactic cholecystectomy for subjects with asymptomatic gallstones does not improve their survival outcome throughout a decreased number of mortality, because of gallbladder cancer. It may not be true that all subjects with asymptomatic gallstones carry a high risk of gallbladder cancer. In the future, in order to focus attention on the high risk subjects, exploration and development of useful biomarkers is desired for the detection of gallstone-associated chronic inflammation and persistent biliary epithelial injury, which in turn are closely related to gallbladder carcinogenesis. |
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| AbstractList | Gallbladder cancer is a relatively rare neoplasm that differs from other cancers of the digestive tract. Therefore, the epidemiology has not well progressed and the risk factors have not been fully elucidated. With respect to the association between gallbladder cancer and gallstones, this review article introduced the data on the meta-analysis of the published findings that were conducted abroad, and those on the results of the Japan Public Health Center-Based Prospective Study, an epidemiological study based on the prospective follow-up of a large number of the Japanese population that has recently been reported from the Ministry of Health, Welfare, and Labor. This review also refers to the natural history of gallstone disease. There has been a consensus that a prophylactic cholecystectomy for subjects with asymptomatic gallstones does not improve their survival outcome throughout a decreased number of mortality, because of gallbladder cancer. It may not be true that all subjects with asymptomatic gallstones carry a high risk of gallbladder cancer. In the future, in order to focus attention on the high risk subjects, exploration and development of useful biomarkers is desired for the detection of gallstone-associated chronic inflammation and persistent biliary epithelial injury, which in turn are closely related to gallbladder carcinogenesis.
要旨：胆石の既往が胆嚢がんのリスクを高めることが以前より知られている．胆嚢がんは他の癌腫と比較して発生数が少ないことより，その疫学研究はあまり進んでおらず，要因の解明も不十分である．本総説では，胆石と胆嚢がんとの関連性について，海外より報告された疫学研究のmeta-analysisの解析結果と，本邦で行われた大規模住民集団の追跡研究である「多目的コホート研究」の検討結果を紹介する．また，胆石の自然史（転帰）についても言及する．無症候性胆石に対する予防的な胆嚢摘出術を施行することは胆嚢がんによる死亡を含めた上で生命予後の改善は認められないとのコンセンサスが得られている．すべての無症候性胆石が胆嚢がんの高危険群ではない．今後は高危険群を絞り込むために，胆石の保有に関連した慢性炎症と持続性の胆道上皮障害の存在を正確に反映するようなバイオマーカーの探索とその開発が望まれる． Gallbladder cancer is a relatively rare neoplasm that differs from other cancers of the digestive tract. Therefore, the epidemiology has not well progressed and the risk factors have not been fully elucidated. With respect to the association between gallbladder cancer and gallstones, this review article introduced the data on the meta-analysis of the published findings that were conducted abroad, and those on the results of the Japan Public Health Center-Based Prospective Study, an epidemiological study based on the prospective follow-up of a large number of the Japanese population that has recently been reported from the Ministry of Health, Welfare, and Labor. This review also refers to the natural history of gallstone disease. There has been a consensus that a prophylactic cholecystectomy for subjects with asymptomatic gallstones does not improve their survival outcome throughout a decreased number of mortality, because of gallbladder cancer. It may not be true that all subjects with asymptomatic gallstones carry a high risk of gallbladder cancer. In the future, in order to focus attention on the high risk subjects, exploration and development of useful biomarkers is desired for the detection of gallstone-associated chronic inflammation and persistent biliary epithelial injury, which in turn are closely related to gallbladder carcinogenesis. |
| Author | Shoda, Junichi Kawamoto, Toru |
| Author_FL | 正田 純一 川本 徹 |
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| References | 17) Lowenfels AB, Walker AM, Althaus DP, et al. Gallstone growth, size, and risk of gallbladder cancer: an interracialstudy. Int J Epidemiol 1989; 18: 50-54 23) Khan ZR, Neugut AI, Ahsan H, et al. Risk factors for biliary tract cancers. Am J Gastroenterol 1999; 94: 149-152 19) WHO. Combined oral contraceptives and gallbladder cancer. The WHO collaborative study of neoplasia and steroid contraceptives. Int J Epidemiol 1989; 18: 309-314 24) Novacek G. Gender and gallstone disease. Wien Med Wochenschr 2006; 156: 527-533 37) 日本消化器病学会. 胆石症診療ガイドライン. 南江堂, 2009 40) Stephen AE, Berger D. Carcinoma in the porcelain gallbladder: A relationship revisited. Surgery 2001; 129: 699-703 13) Wu GS, et al. Bile from a patient with anomalous pancreaticobiliary ductal union promotes the proliferation of human cholangiocarcinoma cells via COX-2 pathway. World J Gastroenterol 2003; 9: 1094-1097 28) Gracie WA, Ransohoff DF. The natural history of silent gallstones: the innocent gallstone is not a myth. N Eng J Med 1982; 302: 798-800 38) Fendrick AM, Gleeson SP, Cabana MD, et al. Asymptomatic gallstones revisited. Is there a role for laparoscopic cholecystectomy? Arch Fam Med 1993; 2: 959-968 34) 乾 和郎, 中澤三郎, 芳野純治, ほか. 無症状胆石と胆嚢癌に関する臨床的検討. 胆と膵 1998; 19: 283-286 20) Kato K, Akai S, Tominaga S, et al. A case-control study of biliary tract cancer in Niigata Prefecture, Japan. Jpn J Cancer Res 1989; 80: 932-938 26) Comfort MW, Gray HK, et al. The silent gallstone: a ten to twenty year follow-up study of 112 cases. Ann Surg 1948; 128: 931-937 7) Lazcano-Ponce EC, Miquel JF, Munoz N, et al. Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin 2008; 51: 349-364 12) Marketa H, et al. Expression of COX-2 is associated with p53 accumulation in premalignant and malignant gallbladder lesions. Eur J Gastroenterol & Hepatol 2008; 20: 732-739 36) 胆道癌診療ガイドライン 作成出版委員会 編. エビデンスに基づいた胆道癌診療ガイドライン. 東京: 医学図書出版, 2007 2) Hsing AW, et al. Family history of gallstones and the risk of biliary tract cancer and gallstones: a population-based study in Shanghai, China. Int J Cancer 2007; 121: 832-838 18) Nervi F, Duarte I, Gomez G, et al. Frequency of gall- bladder cancer in Chile, a high-risk area. Int J Cancer 1988; 41: 657-660 11) Pinlaor S, Hiraku Y, Ma N, et al. Mechanism of NO-mediated oxidative and nitrative DNA damage in hamsters infected with Opisthorchis viverrini: a model of inflammation-mediated carcinogenesis. Nitric Oxide 2004; 11: 175-183 30) Friedman GD, Raviola CA, Fireman B. Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization. J Clin Epidemiokogy 1989; 42: 127-136 4) 厚生労働省大臣官房統計情報部: 人口動態統計. 厚生労働省ホームページ http://www.mhlw.go.jp/toukei/saikin/index.html 9) 正田純一. 胆道癌発生の分子機序. Annual Review消化器2011. 東京: 中外医学社, 2010: 293-299 35) 竹内文康, 堀口祐爾, 今井英夫, ほか. 無症状胆石の取り扱いとその転帰. 胆と膵 1998; 19: 297-301 16) Chow WH, Johansen C, Gridley G, et al. Gallstones, cholecystectomy and risk of cancers of the liver, biliary tract and pancreas. Br J Cancer 1999; 79: 640-644 39) Lowenfels AB, Walker AM, Althaus DP, et al. Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol 1989; 18: 50-54 15) Maringhini A, Moreau JA, Melton LJ III, et al. Gallstones, gallbladder cancer, and other gastrointestinal malignancies. An epidemiologic study in Rochester, Minnesota. Ann Intern Med 1987; 107: 30-35 14) Randi G, Franceschi S, Vecchia CL. Gallbladder cancer world wide: Geographical distibution and risk factors. Int J Cancer 2006; 118: 1591-1602 33) 阿部朝美, 杉浦信之, 積田玲子, ほか. 無症状胆石の自然史に基づく治療法の選択. 胆と膵 1998; 19: 283-286 25) Grodstein F, Colditz GA, Hunter DJ, et al. A prospective study of symptomatic gallstones in women: relation with oral contraceptives and other risk factors. Obstet Gynecol 1994; 84: 207-214 1) Sheth S, et al. Primary gallbladder cancer: recognition of risk factors and the role of prophylactic cholecystectomy. Am J Gastroenterol 2000; 95: 1402-1410 22) Okamoto M, Okamoto H, Kitahara F, et al. Ultrasonographic evidence of association of polyps and stones with gallbladder cancer. Am J Gastroenterol 1999; 94: 446-450 32) 和田浩一, 和田孝次, 今村敏郎. 無症状胆石の自然経過. 日本臨床 1993; 7: 1737-1743 8) 正田純一. 胆道癌の発癌・進展過程における分子メカニズムと分子標的治療の可能性について. 胆道 2009; 23: 762-774 10) Shoda J, Kawamoto T, Yamamoto M. Gallbladder Cancer -Pathogenesis and Molecular Targeting Strategies for Therapeutic Options. In: Aiello CV, ed. Gallbladder Cancer. New York: NOVA Science Publishers, 2011, In press 31) Thistle JL, Cleary PA, Lachin JM, et al. The national history of cholelithiasis: the National Cooperative Gallstone Study. Ann Intern Med 1984; 101: 171-175 3) Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalence Worldwide. IARC Cancer Base No. 5, version 2.0. Lyon: IARC oress, 2004 29) McSherry CK, Ferstenberg H, Calhoun WF, et al. The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients. Ann Surg 1987; 202: 59-63 5) Ishiguro S, Inoue M, Kurahashi N, et al. Risk factors of biliary tract cancer in a large-scale population-based cohort study in Japan (JPHC study); with special focus on cholelithiasis, body mass index, and their effect modification. Cancer Causes Control 2008; 19: 33-41 6) Yagyu K, Lin Y, Obata Y, et al; JACC Study Group. Bowel movement frequency, medical history and the risk of gallbladder cancer death: A cohort study in Japan. Cancer Sci 2004; 95: 674-678 21) Zatonski WA, Lowenfels AB, Boyle P, et al. Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer. J Natl Cancer Inst 1997; 89: 1132-1138 27) Lund J. Surgical indications in cholelithiasis: prophylactic cholecystectomy elucidated on the basis of long-term follow up on 526 nonoperated cases. Ann Surg 1960; 151: 153-161 |
| References_xml | – reference: 13) Wu GS, et al. Bile from a patient with anomalous pancreaticobiliary ductal union promotes the proliferation of human cholangiocarcinoma cells via COX-2 pathway. World J Gastroenterol 2003; 9: 1094-1097 – reference: 29) McSherry CK, Ferstenberg H, Calhoun WF, et al. The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients. Ann Surg 1987; 202: 59-63 – reference: 14) Randi G, Franceschi S, Vecchia CL. Gallbladder cancer world wide: Geographical distibution and risk factors. Int J Cancer 2006; 118: 1591-1602 – reference: 21) Zatonski WA, Lowenfels AB, Boyle P, et al. Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer. J Natl Cancer Inst 1997; 89: 1132-1138 – reference: 30) Friedman GD, Raviola CA, Fireman B. Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization. J Clin Epidemiokogy 1989; 42: 127-136 – reference: 31) Thistle JL, Cleary PA, Lachin JM, et al. The national history of cholelithiasis: the National Cooperative Gallstone Study. Ann Intern Med 1984; 101: 171-175 – reference: 15) Maringhini A, Moreau JA, Melton LJ III, et al. Gallstones, gallbladder cancer, and other gastrointestinal malignancies. An epidemiologic study in Rochester, Minnesota. Ann Intern Med 1987; 107: 30-35 – reference: 9) 正田純一. 胆道癌発生の分子機序. Annual Review消化器2011. 東京: 中外医学社, 2010: 293-299 – reference: 32) 和田浩一, 和田孝次, 今村敏郎. 無症状胆石の自然経過. 日本臨床 1993; 7: 1737-1743 – reference: 36) 胆道癌診療ガイドライン 作成出版委員会 編. エビデンスに基づいた胆道癌診療ガイドライン. 東京: 医学図書出版, 2007 – reference: 33) 阿部朝美, 杉浦信之, 積田玲子, ほか. 無症状胆石の自然史に基づく治療法の選択. 胆と膵 1998; 19: 283-286 – reference: 3) Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalence Worldwide. IARC Cancer Base No. 5, version 2.0. Lyon: IARC oress, 2004 – reference: 11) Pinlaor S, Hiraku Y, Ma N, et al. Mechanism of NO-mediated oxidative and nitrative DNA damage in hamsters infected with Opisthorchis viverrini: a model of inflammation-mediated carcinogenesis. Nitric Oxide 2004; 11: 175-183 – reference: 8) 正田純一. 胆道癌の発癌・進展過程における分子メカニズムと分子標的治療の可能性について. 胆道 2009; 23: 762-774 – reference: 16) Chow WH, Johansen C, Gridley G, et al. Gallstones, cholecystectomy and risk of cancers of the liver, biliary tract and pancreas. Br J Cancer 1999; 79: 640-644 – reference: 28) Gracie WA, Ransohoff DF. The natural history of silent gallstones: the innocent gallstone is not a myth. N Eng J Med 1982; 302: 798-800 – reference: 6) Yagyu K, Lin Y, Obata Y, et al; JACC Study Group. Bowel movement frequency, medical history and the risk of gallbladder cancer death: A cohort study in Japan. Cancer Sci 2004; 95: 674-678 – reference: 18) Nervi F, Duarte I, Gomez G, et al. Frequency of gall- bladder cancer in Chile, a high-risk area. Int J Cancer 1988; 41: 657-660 – reference: 35) 竹内文康, 堀口祐爾, 今井英夫, ほか. 無症状胆石の取り扱いとその転帰. 胆と膵 1998; 19: 297-301 – reference: 40) Stephen AE, Berger D. Carcinoma in the porcelain gallbladder: A relationship revisited. Surgery 2001; 129: 699-703 – reference: 1) Sheth S, et al. Primary gallbladder cancer: recognition of risk factors and the role of prophylactic cholecystectomy. Am J Gastroenterol 2000; 95: 1402-1410 – reference: 23) Khan ZR, Neugut AI, Ahsan H, et al. Risk factors for biliary tract cancers. Am J Gastroenterol 1999; 94: 149-152 – reference: 26) Comfort MW, Gray HK, et al. The silent gallstone: a ten to twenty year follow-up study of 112 cases. Ann Surg 1948; 128: 931-937 – reference: 39) Lowenfels AB, Walker AM, Althaus DP, et al. Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol 1989; 18: 50-54 – reference: 19) WHO. Combined oral contraceptives and gallbladder cancer. The WHO collaborative study of neoplasia and steroid contraceptives. Int J Epidemiol 1989; 18: 309-314 – reference: 7) Lazcano-Ponce EC, Miquel JF, Munoz N, et al. Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin 2008; 51: 349-364 – reference: 37) 日本消化器病学会. 胆石症診療ガイドライン. 南江堂, 2009 – reference: 2) Hsing AW, et al. Family history of gallstones and the risk of biliary tract cancer and gallstones: a population-based study in Shanghai, China. Int J Cancer 2007; 121: 832-838 – reference: 25) Grodstein F, Colditz GA, Hunter DJ, et al. A prospective study of symptomatic gallstones in women: relation with oral contraceptives and other risk factors. Obstet Gynecol 1994; 84: 207-214 – reference: 17) Lowenfels AB, Walker AM, Althaus DP, et al. Gallstone growth, size, and risk of gallbladder cancer: an interracialstudy. Int J Epidemiol 1989; 18: 50-54 – reference: 22) Okamoto M, Okamoto H, Kitahara F, et al. Ultrasonographic evidence of association of polyps and stones with gallbladder cancer. Am J Gastroenterol 1999; 94: 446-450 – reference: 5) Ishiguro S, Inoue M, Kurahashi N, et al. Risk factors of biliary tract cancer in a large-scale population-based cohort study in Japan (JPHC study); with special focus on cholelithiasis, body mass index, and their effect modification. Cancer Causes Control 2008; 19: 33-41 – reference: 12) Marketa H, et al. Expression of COX-2 is associated with p53 accumulation in premalignant and malignant gallbladder lesions. Eur J Gastroenterol & Hepatol 2008; 20: 732-739 – reference: 10) Shoda J, Kawamoto T, Yamamoto M. Gallbladder Cancer -Pathogenesis and Molecular Targeting Strategies for Therapeutic Options. In: Aiello CV, ed. Gallbladder Cancer. New York: NOVA Science Publishers, 2011, In press – reference: 27) Lund J. Surgical indications in cholelithiasis: prophylactic cholecystectomy elucidated on the basis of long-term follow up on 526 nonoperated cases. Ann Surg 1960; 151: 153-161 – reference: 20) Kato K, Akai S, Tominaga S, et al. A case-control study of biliary tract cancer in Niigata Prefecture, Japan. Jpn J Cancer Res 1989; 80: 932-938 – reference: 4) 厚生労働省大臣官房統計情報部: 人口動態統計. 厚生労働省ホームページ http://www.mhlw.go.jp/toukei/saikin/index.html – reference: 24) Novacek G. Gender and gallstone disease. Wien Med Wochenschr 2006; 156: 527-533 – reference: 34) 乾 和郎, 中澤三郎, 芳野純治, ほか. 無症状胆石と胆嚢癌に関する臨床的検討. 胆と膵 1998; 19: 283-286 – reference: 38) Fendrick AM, Gleeson SP, Cabana MD, et al. Asymptomatic gallstones revisited. Is there a role for laparoscopic cholecystectomy? Arch Fam Med 1993; 2: 959-968 |
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