Value of Multislice Spiral CT in Differential Diagnosis of Thick-Wall Gallbladder Carcinoma and Chronic Cholecystitis

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Abstract

To summarize the value of multislice spiral CT (MSCT) in the differential diagnosis of thick-wall gallbladder carcinoma (TWGC) and chronic cholecystitis (CC), the clinical data of 36 patients with TWGC and 60 patients with chronic cholecystitis who were treated in our hospital from January 2017 to May 2021 were retrospectively analyzed, and the CT image features and diagnostic accuracy of the patients were summarized. Compared with the CC group, the proportions of disruption of gallbladder mucosa line, blurred gallbladder outline, high obstruction of biliary tract, lymphomegaly, adjacent invasion, peritoneal effusion, wall nodules, and the gallbladder wall thickness in the TWGC group were higher, with statistical significance ( P < 0.05). Thirty-four patients with TWGC and 62 patients with chronic cholecystitis were diagnosed by MSCT. The sensitivity and specificity of MSCT in diagnosing TWGC were 86.11% and 95.00%, respectively. The positive likelihood ratio was 17.222 and the negative likelihood ratio was 0.1462. The positive prediction rate was 91.18%, the negative prediction rate was 91.94%, and the correct rate was 91.67%. MSCT can show the characteristic difference between TWGC and chronic cholecystitis, which can be used for differential diagnosis.

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RIP1 regulates TNF-α-mediated lymphangiogenesis and lymphatic metastasis in gallbladder cancer by modulating the NF-κB-VEGF-C pathway

Cheng-Zong Li, Xiao-Jie Jiang, Bin Lin … (2018)

Background Tumor necrosis factor alpha (TNF-α) enhances lymphangiogenesis in gallbladder carcinoma (GBC) via activation of nuclear factor (NF-κB)-dependent vascular endothelial growth factor-C (VEGF-C). Receptor-interacting protein 1 (RIP1) is a multifunctional protein in the TNF-α signaling pathway and is highly expressed in GBC. However, whether RIP1 participates in the signaling pathway of TNF-α-mediated VEGF-C expression that enhances lymphangiogenesis in GBC remains unclear. Methods The RIP1 protein levels in the GBC-SD and NOZ cells upon stimulation with increasing concentrations of TNF-α as indicated was examined using Western blot. Lentiviral RIP1 shRNA and siIκBα were constructed and transduced respectively them into NOZ and GBC-SD cells, and then PcDNA3.1-RIP1 vectors was transduced into siRIP1 cell lines to reverse RIP1 expression. The protein expression of RIP1, inhibitor of NF-κB alpha (IκBα), p-IκBα, TAK1, NF-κB essential modulator were examined through immunoblotting or immunoprecipitation. Moreover, VEGF-C mRNA levels were measured by quantitative real-time polymerase chain reaction, VEGF-C protein levels were measured by immunoblotting and enzyme-linked immunosorbent assay, and VEGF-C promoter and NF-κB activities were quantified using a dual luciferase reporter assay. The association of NF-κB with the VEGF-C promoter was analysed by chromatin immunoprecipitation assay. A three-dimensional coculture method and orthotopic transplantation nude mice model were used to evaluate lymphatic tube-forming and metastasis ability in GBC cells. The expression of RIP1 protein, TNF-α protein and lymphatic vessels in human GBC tissues was examined by immunohistochemistry, and the dependence between RIP1 protein with TNF-α protein and lymphatic vessel density was analysed. Results TNF-α dose- and time-dependently increased RIP1 protein expression in the GBC-SD and NOZ cells of GBC, and the strongest effect was observed with a concentration of 50 ng/ml. RIP1 is fundamental for TNF-α-mediated NF-κB activation in GBC cells and can regulate TNF-α-mediated VEGF-C expression at the protein and transcriptional levels through the NF-κB pathway. RIP1 can regulate TNF-α-mediated lymphatic tube formation and metastasis in GBC cells both in vitro and vivo. The average optical density of RIP1 was linearly related to that of TNF-α protein and the lymphatic vessel density in GBC tissues. Conclusion We conclude that RIP1 regulates TNF-α-mediated lymphangiogenesis and lymph node metastasis in GBC by modulating the NF-κB-VEGF-C pathway.

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The Relationship between Helicobacter pylori Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis

Liang Wang, Junyin Chen, Wenxi Jiang … (2021)

Helicobacter pylori (H. pylori) is proved to be the main pathogenic agent of various diseases, including chronic gastritis, gastric ulcer, duodenal ulcer, and gastric cancer. In addition, chronic cholecystitis and cholelithiasis are common worldwide, which are supposed to increase the total mortality of patients. Epidemiologic evidence on the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis still remains unclear. We conducted a systematic review and meta-analysis of overall studies to investigate the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis. Two researchers searched PubMed, Embase, and Cochrane Library databases to obtain all related and eligible studies published before July 2020. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated by the random-effects model. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also conducted. Twenty studies were included in the meta-analysis, involving 1735 participants and 1197 patients with chronic cholecystitis/cholelithiasis. Helicobacter species infection of the gallbladder was positively correlated with increased risk of chronic cholecystitis and cholelithiasis, especially H. pylori (OR = 3.05; 95% CI, 1.81–5.14; I 2 = 23.5%). Besides, country-based subgroup analysis also showed a positive correlation between the gallbladder H. pylori positivity and chronic cholecystitis/cholelithiasis risk. For Asian and non-Asian country studies, the ORs were 4.30 (95% CI, 1.76–10.50; I 2 = 37.4%) and 2.13 (95% CI, 1.23–3.70; I 2 = 0.0%), respectively. The association was more obvious using the bile sample and urease gene primer. In conclusion, this meta-analysis provided evidence that there is a positive correlation between H. pylori infection in the gallbladder and increased risk of chronic cholecystitis and cholelithiasis.

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Stent placement combined with intraluminal radiofrequency ablation and hepatic arterial infusion chemotherapy for advanced biliary tract cancers with biliary obstruction: a multicentre, retrospective, controlled study

Qing Gou, Lingeng Wu, Wei Cui … (2021)

Objective To evaluate the efficacy and safety of stent placement combined with intraluminal radiofrequency ablation (intra-RFA) and hepatic arterial infusion chemotherapy (HAIC) for patients with advanced biliary tract cancers (Ad-BTCs) and biliary obstruction (BO). Methods We retrospectively reviewed data for patients with Ad-BTCs and BO who underwent stent placement with or without intra-RFA and HAIC in three centres between November 2013 and November 2018. The stent patency time (SPT), overall survival (OS), and adverse events (AEs) were analysed. Results Of the 135 enrolled patients, 64 underwent stent placement combined with intra-RFA and HAIC, while 71 underwent only stent placement. The median SPT was significantly longer in the combination group (8.2 months, 95% confidence interval [CI]: 7.1–9.3) than in the control group (4.3 months, 95% CI: 3.6–5.0; p < 0.001). A similar result was observed for OS (combination: 13.2 months, 95% CI: 11.1–16.5; control: 8.5 months, 95% CI: 7.6–9.6; p < 0.001). The incidence of AEs related to biliary tract operation was not significantly different between the two groups ( p > 0.05). The most common AE and serious AE related to HAIC were alanine aminotransferase elevation (24/64; 37.5%) and thrombocytopenia (8/64; 12.5%), respectively. All AEs were tolerable, and there was no death from AEs. Conclusions Stent placement combined with intra-RFA and HAIC may be a safe, potential treatment strategy for patients with Ad-BTCs and BO. Key Points • Advanced biliary cancers (Ad-BTCs) with biliary obstruction (BO) can rapidly result in liver failure and cachexia with an extremely poor prognosis. • Stent placement combined with intraluminal radiofrequency ablation and hepatic arterial infusion chemotherapy may be safe and effective for patients with Ad-BTCs and BO. • The long-term efficacy and safety of the combined treatment is promising.

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Author and article information

Contributors

Hua Han:

ORCID: https://orcid.org/0000-0001-6149-3687

Journal

Journal ID (nlm-ta): Contrast Media Mol Imaging

Journal ID (iso-abbrev): Contrast Media Mol Imaging

Journal ID (publisher-id): CMMI

Title: Contrast Media & Molecular Imaging

Publisher: Hindawi

ISSN (Print): 1555-4309

ISSN (Electronic): 1555-4317

Publication date Collection: 2022

Publication date (Electronic): 6 May 2022

Volume: 2022

Electronic Location Identifier: 5459779

Affiliations

¹Department of Radiology, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning, China

²Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China

Author notes

Academic Editor: Yuvaraja Teekaraman

Author information

Hua Han https://orcid.org/0000-0001-6149-3687

Article

DOI: 10.1155/2022/5459779

PMC ID: 9106503

SO-VID: 29ef4751-c1c8-403d-84b2-92062e3f8fc7

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This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 3 March 2022

Date revision received : 2 April 2022

Date accepted : 8 April 2022

Value of Multislice Spiral CT in Differential Diagnosis of Thick-Wall Gallbladder Carcinoma and Chronic Cholecystitis

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Most cited references 19

RIP1 regulates TNF-α-mediated lymphangiogenesis and lymphatic metastasis in gallbladder cancer by modulating the NF-κB-VEGF-C pathway

The Relationship between Helicobacter pylori Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis

Stent placement combined with intraluminal radiofrequency ablation and hepatic arterial infusion chemotherapy for advanced biliary tract cancers with biliary obstruction: a multicentre, retrospective, controlled study

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