title: p53 gene mutation and p53 protein overexpression in a patient with simultaneous double cancer of the gallbladder and bile duct associated with pancreaticobiliary maljunction.
abstract: Pancreaticobiliary maljunction (PBM) is associated with the occurrence of biliary cancer due to pancreatobiliary reflux. We present a case of simultaneous double cancer of the gallbladder and bile duct. A 77-year-old woman who had jaundice, intra- and extra-hepatic biliary ductal dilatation and a space-occupying lesion in the gallbladder and lower bile duct underwent pancreatoduodenectomy. The gallbladder cancer showed papillary carcinoma without mutation of the K-ras gene and with p53 non-sense mutation of CCA (Pro) to CA (Stop) on codon 301 in exon 8. The bile duct cancer revealed a well-differentiated adenocarcinoma without mutation of the K-ras gene and with p53 miss-sense mutation of GTG (Val) to GAG (Glu) on codon 272 in exon 8. There were no mutations of either the K-ras or p53 gene in non-cancerous epithelia. In contrast, only the mucosa of the common channel had p53 protein accumulation and high cell proliferation activity. Therefore, the genetic pathway might be the same in both the gallbladder and bile duct cancer, and a high potential for carcinogenesis might be present in the epithelium of the common channel in patients with PBM.
authors.affiliation: Third Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. kasuya-k@jcom.home.ne.jp
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kasuya
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nagakawa
authors.forename: Takaaki
authors.initials: T
authors.lastname: Matsudo
authors.forename: Takashi
authors.initials: T
authors.lastname: Ozawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tsuchida
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000473:pathology / Q000601:surgery; D000368:Aged; D001650:Bile Duct Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D001652:Bile Ducts / Q000002:abnormalities*; D001707:Biopsy, Needle; D002291:Carcinoma, Papillary / Q000235:genetics / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D015972:Gene Expression Regulation, Neoplastic; D016158:Genes, p53 / Q000235:genetics*; D011905:Genes, ras / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D020125:Mutation, Missense; D009378:Neoplasms, Multiple Primary / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D010183:Pancreatic Ducts / Q000002:abnormalities; D016577:Pancreaticoduodenectomy / Q000379:methods; D016133:Polymerase Chain Reaction; D018570:Risk Assessment; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000032:analysis* / Q000235:genetics
chemical_list: D016159:Tumor Suppressor Protein p53