title: Precancerous mucosal changes in the gallbladder of patients with occult pancreatobiliary reflux.
abstract: BACKGROUND
  Pancreatobiliary reflux can occur even if the pancreaticobiliary junction is normal (occult pancreatobiliary reflux), and it may be associated with gallbladder carcinoma. The aim of the present study was to examine precancerous mucosal changes in the gallbladder from patients with occult pancreatobiliary reflux.
  
  
  METHODS
  The mucosa of the gallbladder from 13 patients who underwent cholecystectomy was examined histopathologically. These patients had an anatomically normal pancreatobiliary junction and a biliary amylase concentration greater than 10,000 IU/L. The gallbladder of patients without carcinoma was further examined by using immunohistochemical techniques to detect Ki-67, and the results were compared with those from control patients.
  
  
  RESULTS
  Of the 13 patients, 5 (38%) had gallbladder carcinoma and 8 (62%) did not. Of the 8 patients without carcinoma, 4 (50%) had dysplasia accompanied by hyperplasia, and 2 (25%) had hyperplasia alone of the gallbladder mucosa. The Ki-67 labeling index was significantly higher in hyperplastic and dysplastic mucosa than in control gallbladder mucosa (p < 0.0004).
  
  
  CONCLUSIONS
  Occult pancreatobiliary reflux could be associated with precancerous mucosal changes in the gallbladder, such as hyperplasia and dysplasia with increased cellular proliferation, and could be a possible risk factor for gallbladder carcinoma.
authors.forename: Jin Kan
authors.initials: JK
authors.lastname: Sai
authors.forename: Masafumi
authors.initials: M
authors.lastname: Suyama
authors.forename: Bunsei
authors.initials: B
authors.lastname: Nobukawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kubokawa
authors.forename: Kazuko
authors.initials: K
authors.lastname: Yokomizo
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Sato
mesh_terms: D000368:Aged; D001655:Bile Reflux / Q000473:pathology*; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010182:Pancreatic Diseases / Q000473:pathology*; D011230:Precancerous Conditions