A Case of Gallbladder Carcinoma Diagnosed Preoperatively by the Detection of Human Telomerase Reverse Transcriptase mRNA in Endoscopically Obtained Gallbladder Bile

 

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It is difficult to accurately diagnose the nature of polypoid lesions in the gallbladder. To increase diagnostic accuracy, we have developed an endoscopic technique for obtaining gallbladder bile, termed endoscopic transpapillary catheterization into the gallbladder (ETCG). We describe here a case of gallbladder carcinoma diagnosed preoperatively by the detection of human telomerase reverse transcriptase (hTERT) mRNA, a catalytic subunit of telomerase, in gallbladder bile obtained using the ETCG technique. A patient with a polypoid lesion 15 mm in diameter in the gallbladder was admitted to our hospital for further examinations. Gallbladder bile collected by the ETCG technique was evaluated cytologically and also analyzed for telomerase activity and hTERT mRNA. Although the results for cytology and telomerase activity were negative, that for hTERT mRNA was positive. Open surgery was carried out and it was confirmed that the lesion was an adenocarcinoma invading the subserosa. The molecular biological analysis of gallbladder bile collected using the ETCG technique was shown to be effective for diagnosing the nature of the polypoid lesion in the gallbladder.

References

• 1 Harley C B, Futcher A B, Greider C W. Telomeres shorten during aging of human fibroblast.  Nature. 1990;  345 458-460
  CrossrefPubMedGoogle Scholar
• 2 Shay J W, Bacchetti S. A survey of telomerase activity in human cancer.  Eur J Cancer. 1997;  33 787-791
  CrossrefPubMedGoogle Scholar
• 3 Hiyama E, Kodama T, Shinbara K. et al . Telomerase activity is detected in pancreatic cancer but not in benign tumors.  Cancer Res. 1997;  57 326-331
  PubMedGoogle Scholar
• 4 Morales C P, Burdick J S, Saboorian M H. et al . In situ hybridization for telomerase RNA in routine cytologic brushings for the diagnosis of pancreaticobiliary malignancies.  Gastrointest Endosc. 1998;  48 402-405
  PubMedGoogle Scholar
• 5 Hirabayashi S, Nakatsu T, Nishioka M. The double contrast method by endoscopic transpapillary catheterization in the gallbladder.  Dig Endosc. 1990;  2 40-46
  PubMedGoogle Scholar
• 6 Wada E, Hisatomi H, Moritoyo T. et al . Genetic diagnostic test of hepatocellular carcinoma by telomerase catalytic subunit mRNA.  Oncol Rep. 1998;  5 1407-1412
  PubMedGoogle Scholar
• 7 Yahata N, Nagao K, Ohyashiki J. et al . Improvement in detecting telomerase activity using silica-based resin treatment: an experience of urine in bladder carcinoma.  Int J Oncol. 1999;  14 709-712
  PubMedGoogle Scholar
• 8 Hisatomi H, Nagao K, Kanamaru T. et al . Levels of telomerase catalytic subunit mRNA as a predictor of potential malignancy.  Int J Oncol. 1999;  14 727-732
  PubMedGoogle Scholar
• 9 Almoguera C, Shibata D, Forrester K. et al . Most human carcinomas of the exocrine pancreas contain mutant c-K-ras genes.  Cell. 1988;  53 549-559
  PubMedGoogle Scholar
• 10 Berthelemy P, Bouisson M, Escourrou J. et al . Identification of K-ras mutations in pancreatic juice in the early diagnosis of pancreatic cancer.  Ann Intern Med. 1995;  123 188-191
  PubMedGoogle Scholar
• 11 Tada M, Omata M, Kawai S. et al . Detection of ras gene mutations in pancreatic juice and peripheral blood of patients with pancreatic adenocarcinoma.  Cancer Res. 1993;  53 2472-2474
  PubMedGoogle Scholar
• 12 Watanabe H, Yamaguchi Y, Ha A. et al . Quantitative determination of K-ras mutations in pancreatic juice for diagnosis of pancreatic cancer using hybridization protection assay.  Pancreas. 1998;  17 341-347
  PubMedGoogle Scholar
• 13 Itoi T, Shinohara Y, Takeda K. et al . Detection of telomerase activity in biopsy specimens for diagnosis of biliary tract cancers.  Gastrointest Endosc. 2000;  52 380-386
  CrossrefPubMedGoogle Scholar
• 14 Niiyama H, Mizumoto K, Kusumoto M. et al . Activation of telomerase and its diagnostic application in biopsy specimens from biliary tract neoplasms.  Cancer. 2000;  85 2138-2143
  PubMedGoogle Scholar
• 15 Feng J, Funk W D, Wng S S. et al . The RNA component of human telomerase.  Science. 1995;  269 1236-1241
  PubMedGoogle Scholar
• 16 Harrington L, McPhail T, Mar V. et al . A mammalian telomerase-associated protein.  Science. 1997;  275 973-977
  CrossrefPubMedGoogle Scholar
• 17 Nakamura T N, Morin G B, Champman K B. et al . Telomerase catalytic subunit homologues from fission yeast and human.  Science. 1997;  277 955-959
  CrossrefPubMedGoogle Scholar
• 18 Itoi T, Shinohara Y, Takeda K. et al . Detection of telomerase reverse transcriptase mRNA in biopsy specimens and bile for diagnosis of biliary tract cancers.  Int J Mol Med. 2001;  7 281-287
  PubMedGoogle Scholar
• 19 Takakura M, Kyo S, Kanaya T. et al . Expression of human telomerase subunits and correlation with telomerase activity in cervical cancer.  Cancer Res. 1998;  58 1558-1561
  PubMedGoogle Scholar
• 20 Glabrenner B, Ardan M, Boeck W. et al . Prospective evaluation of brush cytology of biliary strictures during endoscopic retrograde cholangiopancreatography.  Endoscopy. 1999;  31 712-717
  Article in Thieme ConnectPubMedGoogle Scholar

N. Uchida, M.D.

Third Department of Internal Medicine, Kagawa Medical University

1750-1 Ikenobe · Miki-cho · Kita-gun · Kagawa 761-0793 · Japan

Fax: + 81-87-8912158

Email: naohito@kms.ac.jp