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[Research progress on perineural invasion and the immune microenvironment in biliary tract cancers].

Biliary tract cancer (BTC) is a group of highly malignant gastrointestinal tumors with poor prognosis, whose aggressiveness and therapeutic resistance are partly attributable to the complex interplay between perineural invasion (PNI) and the tumor microenvironment (TME). In recent years, accumulating evidence has shown that PNI not only promotes local tumor invasion and distant metastasis, but may also contribute to tumor immune evasion through modulation of the TME. This review summarizes the pathological features and molecular mechanisms of PNI in biliary tract tumors, including signal trans…

The Evolving Landscape of Immune Regulation and Immunotherapy in Cholangiocarcinoma and Biliary Tract Cancer.

Cholangiocarcinoma (CCA) is an aggressive and molecularly heterogeneous malignancy characterized by a profoundly immunosuppressive tumor microenvironment (TME) and historically limited therapeutic options. Recent advances have redefined the treatment paradigm, with phase III trials establishing chemoimmunotherapy as a standard of care and multi-omic profiling elucidating the interplay between tumor genomics, stromal architecture, and immune regulation. Despite these gains, durable clinical benefit remains confined to a minority of patients, reflecting convergent mechanisms of primary and acqui

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… Table 1 Key clinical trials of immune checkpoint inhibitor-based regimens in cholangiocarcinoma and biliary tract cancer from approved standards of care to early-phase studies. … CD73 inhibitors are being evaluated in combination with checkpoint inhibitors in multiple solid tumor types including biliary tract cancers. …

Enhanced Potential of Durvalumab in the Initial Treatment of Advanced Biliary Tract Cancer.

BACKGROUND/AIM: The prognosis of biliary tract cancer is extremely poor, with a 5-year survival rate of 20%. Surgery is the only treatment that can be expected to cure biliary tract cancer, but because many cases are unresectable or recurrent, chemotherapy has become the standard treatment. The effects of first-line administration of durvalumab have not been explored. This study examined whether durvalumab has an additive effect in the first line. PATIENTS AND METHODS: Twenty-three patients who were diagnosed with recurrent or non-resected biliary tract cancer requiring anticancer chemotherap…

The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer.

Biliary tract cancers (BTC) are a highly heterogeneous group of cancers at the genomic, epigenetic and molecular levels. The vast majority of patients initially present at an advanced (unresectable) disease stage due to a lack of symptoms and an aggressive tumour biology. Chemotherapy has been the mainstay of treatment in patients with advanced BTC but the survival outcomes and prognosis remain poor. The addition of immune checkpoint inhibitors (ICI) to chemotherapy have shown only a marginal benefit over chemotherapy alone due to the complex tumour immune microenvironment of these cancers. Th…

The Status and Development of Oral Choledochoscopy Diagnosis and Treatment of Biliary Tract Diseases.

Choledochoscopy technology has realized the direct observation of bile duct lesions, and can be loaded with a variety of special accessories … and reviewed the latest clinical advances of oral choledochoscopy in the diagnosis and treatment of biliary tract diseases.

[Clinical characteristics and prognosis of intraductal papillary mucinous neoplasm of the biliary tract].

Objective: To study the clinical features, diagnosis, surgery treatment and prognosis of intraductal papillary mucinous neoplasm of the biliary tract (IPMN-B). Methods: The data of 16 patients with IPMN-B admitted to The First Hospital of Jilin University and Xi'an Third Hospital from January 2014 to January 2018 were retrospectively analyzed. Kaplan-Meier method was used to conduct the survival analysis. These patients included 10 males and 6 females, the median age was 57 years. Results: Clinical manifestations were mainly jaundice (11 cases), upper abdominal pain (12 cases) and hyperpyretic…

Uncommon Intraluminal Tumors of the Gallbladder and Biliary Tract: Spectrum of Imaging Appearances.

Intraluminal pathologic conditions of the bile ducts and gallbladder are common, most frequently consisting of calculi and adenocarcinoma. In recent years, intraductal papillary neoplasm of the bile ducts (IPN-B), which is analogous to intraductal papillary mucinous neoplasm of the pancreas, has been recognized as a distinct pathologic entity and a precursor lesion to adenocarcinoma of the bile ducts. Intraductal tubulopapillary neoplasm (ITPN) of the bile duct was subsequently described as a distinct pathologic entity. With increased awareness and advances in imaging techniques, these lesions

Development of the Intrahepatic and Extrahepatic Biliary Tract: A Framework for Understanding Congenital Diseases.

The involvement of the biliary tract in the pathophysiology of liver diseases and the increased attention paid to bile ducts in the bioconstruction of liver tissue for regenerative therapy have fueled intense research into the fundamental mechanisms of biliary development. Here, I review the molecular, cellular and tissular mechanisms driving differentiation and morphogenesis of the intrahepatic and extrahepatic bile ducts. This review focuses on the dynamics of the transcriptional and signaling modules that promote biliary development in human and mouse liver and discusses studies in which th…

Neuroendocrine carcinoma in the extrahepatic biliary tract: A case report and literature review.

RATIONALE: Neuroendocrine carcinoma (NEC) arising from the extrahepatic biliary tracts (EHBTs) is rare, and thus its management and prognosis remain poorly clarified. We herein describe a case of NEC in the perihilar EHBTs, and review the literature, together with a comparison between NECs in the perihilar and distal EHBTs, to elucidate the management strategy and oncological outcome of this rare entity. PATIENT CONCERNS: A 62-year-old Chinese male was admitted with complaints of painless jaundice. Imaging studies revealed a 2-cm mass in the hepatic hilum, regional lymph node involvement, and…

Preliminary Report of Percutaneous Cholecystostomy as Diagnosis and Treatment of Biliary Tract Trauma.

BACKGROUND: Biliary leak following severe blunt liver injuries is a complex problem becoming more frequent with improvements in non-operativ … , simple and safe first-line procedure in the diagnostic and therapeutic approach of post-traumatic biliary tract injuries.

Treatment of biliary tract stones after gastrectomy in the era of laparoscopic cholecystectomy.

BACKGROUND: The incidence of biliary tract stones has widely been reported to be high after gastrectomy. Treatment of biliary tract stones in post-gastrectomy patients was examined retrospectively, particularly minimally invasive therapy with laparoscopic cholecystectomy for gallbladder stones and endoscopic bile duct lithotomy for common bile duct stones. METHODS: Treatment of 122 post-gastrectomy patients with biliary tract stones was examined retrospectively from 1995 to April 2015. RESULTS: Symptomatic biliary tract stones were found in 3.7% of post-gastrectomy patients. The frequency of…

Predictive Factors of Biliary Tract Cancer in Anomalous Union of the Pancreaticobiliary Duct.

The assessment of malignancies associated with anomalous union of the pancreaticobiliary duct (AUPBD) is essential for the design of appropr … D, and the level of pancreatic enzymes refluxed in the bile duct were associated with occurrence of biliary tract cancers. In multivariate analysis, age ≥45 years (odds ratio [OR] 1.042, 95% confidence interval [CI] 1.011-1.073, P < 0.05), P-C type (OR 3.327, 95% CI 1.031-10.740, P < 0.05), and a high level of biliary lipase (OR 4.132, 95% CI 1.420-12.021, P < …

Medical conditions, family history of cancer, and the risk of biliary tract cancers.

BACKGROUND: Scanty data exist on the role of personal medical conditions, except for gallstones, and family history of cancer on the risk of biliary tract cancers (BTC). METHODS: We analyzed this issue using data from two Italian case-control studies, including 159 cases of BTC and 795 matched hospital controls. Odds ratios (ORs) of BTC and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression models. RESULTS: Gallstones were associated with a 2-fold excess risk of BTC (95% CI 1.24-3.45). No significant associations were observed with other conditions…

Biliary tract schwannoma: a rare cause of obstructive jaundice in a young patient.

Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastrointestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered …

[Pathology of biliary tract IN elderly patients with the system approach. Principles of therapy].

The biliary tract pathology gains the increasing distribution.So cholelitiasis in different camps is registered from 7.8 to 38%. In Russia the given indicator from 3 to 12%. Special importance cholelitiasis and chronic cholecystitis without cholelitiasis get at persons of the advanced age, connected as with morfofunkcional'nymi changes in an organism of senior citizens, and with a wrong way of life. All it demands the differentiated approach to treatment of this group of patients and includes change of a way of life, a dietotherapy, farmako- and physiotherapeutic treatment.