Human Pathology
Volume 40, Issue 12 , Pages 1762-1767 , December 2009

Intestinal metaplasia in gallbladder correlates with high amylase levels in bile in patients with a morphologically normal pancreaticobiliary duct

  • Hirotsugu Sakamoto, MD

      Affiliations

    • Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi 329-0498, Japan
    • ,
  • Hiroyuki Mutoh, MD, PhD

      Affiliations

    • Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi 329-0498, Japan
    • Corresponding Author InformationCorresponding author.
    • ,
  • Kenichi Ido, MD, PhD

      Affiliations

    • Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi 329-0498, Japan
    • ,
  • Shin Satoh, MD

      Affiliations

    • Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi 329-0498, Japan
    • ,
  • Machio Kumagai, MD

      Affiliations

    • Department of Surgery, Imaichi Hospital, Tochigi 321-1261, Japan
    • ,
  • Hiroko Hayakawa, MS

      Affiliations

    • Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi 329-0498, Japan
    • ,
  • Kiichi Tamada, MD, PhD

      Affiliations

    • Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi 329-0498, Japan
    • ,
  • Kentaro Sugano, MD, PhD

      Affiliations

    • Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi 329-0498, Japan

Received 22 April 2009 ,Revised 4 June 2009 ,Accepted 11 June 2009.

References 

  1. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process—First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992;52:6735–6740
  2. Morson BC. Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa. Br J Cancer. 1955;9:377–385
  3. Stemmermann GN, Hayashi T. Intestinal metaplasia of the gastric mucosa: a gross and microscopic study of its distribution in various disease states. J Natl Cancer Inst. 1968;41:627–634
  4. You WC, Blot WJ, Li JY, et al. Precancerous gastric lesions in a population at high risk of stomach cancer. Cancer Res. 1993;53:1317–1321
  5. Mutoh H, Hakamata Y, Sato K, et al. Conversion of gastric mucosa to intestinal metaplasia in Cdx2-expressing transgenic mice. Biochem Biophys Res Commun. 2002;294:470–479
  6. Mutoh H, Sakurai S, Satoh K, et al. Development of gastric carcinoma from intestinal metaplasia in Cdx2-transgenic mice. Cancer Res. 2004;64:7740–7747
  7. Osawa H, Kita H, Satoh K, et al. Aberrant expression of CDX2 in the metaplastic epithelium and inflammatory mucosa of the gallbladder. Am J Surg Pathol. 2004;28:1253–1254
  8. Sakamoto H, Mutoh H, Ido K, et al. A close relationship between intestinal metaplasia and Cdx2 expression in human gallbladders with cholelithiasis. Hum Pathol. 2007;38:66–71
  9. Tashiro S, Imaizumi T, Ohkawa H, et al. Pancreaticobiliary maljunction: retrospective and nationwide survey in Japan. J Hepatobiliary Pancreat Surg. 2003;10:345–351
  10. Sai JK, Suyama M, Kubokawa Y, et al. Occult pancreatobiliary reflux in patients with a normal pancreaticobiliary junction. Gastrointest Endosc. 2003;57:364–368
  11. Itokawa F, Itoi T, Nakamura K, et al. Assessment of occult pancreatobiliary reflux in patients with pancreaticobiliary disease by ERCP. J Gastroenterol. 2004;39:988–994
  12. Horaguchi J, Fujita N, Noda Y, et al. Amylase levels in bile in patients with a morphologically normal pancreaticobiliary ductal arrangement. J Gastroenterol. 2008;43:305–311
  13. Beltran MA, Vracko J, Cumsille MA, et al. Occult pancreaticobiliary reflux in gallbladder cancer and benign gallbladder diseases. J Surg Oncol. 2007;96:26–31
  14. Itoi T, Tsuchida A, Itokawa F, et al. Histologic and genetic analysis of the gallbladder in patients with occult pancreatobiliary reflux. Int J Mol Med. 2005;15:425–430
  15. Duarte I, Llanos O, Domke H, et al. Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. Cancer. 1993;72:1878–1884
  16. Donaldson LA, Joffe SN, McIntosh W, et al. Amylase activity in human bile. Gut. 1979;20:216–218
  17. Sugiyama M, Atomi Y. Periampullary diverticula cause pancreatobiliary reflux. Scand J Gastroenterol. 2001;36:994–997
  18. Sai JK, Suyama M, Nobukawa B, et al. Precancerous mucosal changes in the gallbladder of patients with occult pancreatobiliary reflux. Gastrointest Endosc. 2005;61:264–268
  19. Eda A, Osawa H, Yanaka I, et al. Expression of homeobox gene CDX2 precedes that of CDX1 during the progression of intestinal metaplasia. J Gastroenterol. 2002;37:94–100
  20. Satoh K, Mutoh H, Eda A, et al. Aberrant expression of CDX2 in the gastric mucosa with and without intestinal metaplasia: effect of eradication of Helicobacter pylori. Helicobacter. 2002;7:192–198
  21. Eda A, Osawa H, Satoh K, et al. Aberrant expression of CDX2 in Barrett's epithelium and inflammatory esophageal mucosa. J Gastroenterol. 2003;38:14–22
  22. Almeida R, Silva E, Santos-Silva F, et al. Expression of intestine-specific transcription factors, CDX1 and CDX2, in intestinal metaplasia and gastric carcinomas. J Pathol. 2003;199:36–40
  23. Bai YQ, Yamamoto H, Akiyama Y, et al. Ectopic expression of homeodomain protein CDX2 in intestinal metaplasia and carcinomas of the stomach. Cancer Lett. 2002;176:47–55
  24. Mukhopadhyay S, Landas SK. Putative precursors of gallbladder dysplasia: a review of 400 routinely resected specimens. Arch Pathol Lab Med. 2005;129:386–390
  25. Yamagiwa H, Tomiyama H. Intestinal metaplasia-dysplasia-carcinoma sequence of the gallbladder. Acta Pathol Jpn. 1986;36:989–997
  26. Wu XS, Akiyama Y, Igari T, et al. Expression of homeodomain protein CDX2 in gallbladder carcinomas. J Cancer Res Clin Oncol. 2005;131:271–278
  27. Kushima R, Lohe B, Borchard F. Differentiation towards gastric foveolar, mucopeptic and intestinal goblet cells in gallbladder adenocarcinomas. Histopathology. 1996;29:443–448
  28. Maesawa C, Ogasawara S, Yashima-Abo A, et al. Aberrant maspin expression in gallbladder epithelium is associated with intestinal metaplasia in patients with cholelithiasis. J Clin Pathol. 2006;59:328–330
  29. Sai K, Kajiwara H. An immunohistochemical study of metaplastic endocrine cells in human gallbladder cancer. J Hepatobiliary Pancreat Surg. 2001;8:453–460
  30. Sasaki M, Yamato T, Nakanuma Y, et al. Expression of MUC2, MUC5AC and MUC6 apomucins in carcinoma, dysplasia and non-dysplastic epithelia of the gallbladder. Pathol Int. 1999;49:38–44
  31. Tsutsumi Y, Nagura H, Osamura Y, et al. Histochemical studies of metaplastic lesions in the human gallbladder. Arch Pathol Lab Med. 1984;108:917–921
  32. Kozuka S, Kurashina M, Tsubone M, et al. Significance of intestinal metaplasia for the evolution of cancer in the biliary tract. Cancer. 1984;54:2277–2285

PII: S0046-8177(09)00222-6

doi: 10.1016/j.humpath.2009.06.008

Human Pathology
Volume 40, Issue 12 , Pages 1762-1767 , December 2009

Article Tools

* Image Usage & Resolution