Cholangiocarcinoma pathophysiology: Difference between revisions

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==Genetics==
==Genetics==
<div style="text-align: center>'''Algorithm showing molecular mechanism of cholangiocarcinoma'''<ref name="pmid21691113">{{cite journal |vauthors=Wadsworth CA, Dixon PH, Wong JH, Chapman MH, McKay SC, Sharif A, Spalding DR, Pereira SP, Thomas HC, Taylor-Robinson SD, Whittaker J, Williamson C, Khan SA |title=Genetic factors in the pathogenesis of cholangiocarcinoma |journal=Dig Dis |volume=29 |issue=1 |pages=93–7 |year=2011 |pmid=21691113 |pmc=3696362 |doi=10.1159/000324688 |url=}}</ref><ref name="pmid25332972">{{cite journal |vauthors=Maroni L, Pierantonelli I, Banales JM, Benedetti A, Marzioni M |title=The significance of genetics for cholangiocarcinoma development |journal=Ann Transl Med |volume=1 |issue=3 |pages=28 |year=2013 |pmid=25332972 |pmc=4200671 |doi=10.3978/j.issn.2305-5839.2012.10.04 |url=}}</ref>
<div style="text-align: center>'''Algorithm showing molecular mechanism of cholangiocarcinoma'''<ref name="pmid21691113">{{cite journal |vauthors=Wadsworth CA, Dixon PH, Wong JH, Chapman MH, McKay SC, Sharif A, Spalding DR, Pereira SP, Thomas HC, Taylor-Robinson SD, Whittaker J, Williamson C, Khan SA |title=Genetic factors in the pathogenesis of cholangiocarcinoma |journal=Dig Dis |volume=29 |issue=1 |pages=93–7 |year=2011 |pmid=21691113 |pmc=3696362 |doi=10.1159/000324688 |url=}}</ref><ref name="pmid25332972">{{cite journal |vauthors=Maroni L, Pierantonelli I, Banales JM, Benedetti A, Marzioni M |title=The significance of genetics for cholangiocarcinoma development |journal=Ann Transl Med |volume=1 |issue=3 |pages=28 |year=2013 |pmid=25332972 |pmc=4200671 |doi=10.3978/j.issn.2305-5839.2012.10.04 |url=}}</ref><ref name="pmid25966424">{{cite journal |vauthors=Kongpetch S, Jusakul A, Ong CK, Lim WK, Rozen SG, Tan P, Teh BT |title=Pathogenesis of cholangiocarcinoma: From genetics to signalling pathways |journal=Best Pract Res Clin Gastroenterol |volume=29 |issue=2 |pages=233–44 |year=2015 |pmid=25966424 |doi=10.1016/j.bpg.2015.02.002 |url=}}</ref></div>
<br><ref name="pmid25966424">{{cite journal |vauthors=Kongpetch S, Jusakul A, Ong CK, Lim WK, Rozen SG, Tan P, Teh BT |title=Pathogenesis of cholangiocarcinoma: From genetics to signalling pathways |journal=Best Pract Res Clin Gastroenterol |volume=29 |issue=2 |pages=233–44 |year=2015 |pmid=25966424 |doi=10.1016/j.bpg.2015.02.002 |url=}}</ref></div>
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{{Family tree| | | | | | | | A01 | | | | | | A01=Cholangiocytes}}
{{Family tree| | | | | | | | A01 | | | | | | A01=Cholangiocytes}}

Revision as of 20:15, 2 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR


[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

  • The epithelial cell lining the bile ducts are called cholangiocytes. The malignant transformsation of cholangiocytes leads to cholangiocarcinoma.[1]
  • Malignant transformation of cholangiocytes into cholangiocarcinoma include following stages:[2]
    1. Hyperplasia
    2. Metaplasia
    3. Dysplasia
    4. Frank carcinoma
  • Progression of malignancy is believed to be due to:[2][3][4]
    • Inflammation
    • Obstruction of bile ducts
    • Biliary intraepithelia neoplasia
  • Biliary intraepithelial neoplasia is believed to be the initial lesion of cholangiocarcinoma, particularly in patients with hepatolithiasis in bile ducts.

Genetics

Algorithm showing molecular mechanism of cholangiocarcinoma[5][6][7]


 
 
 
 
 
 
 
Cholangiocytes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Proinflammatory cytokines (TNF-α and IL-6)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Several cytokines )
 
Stimulates the expression of inducible nitric oxide synthase (iNOS) and enhancing NO production
 
Reactive oxygen species
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EGFR (epidermal growth factor receptor) family, specifically the tyrosine kinase ErbB-2 (HER2/neu
 
 
 
 
 
 
Inhibit DNA repair mechanism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Stimulation of cyclooxygenase 2 (COX-2)
 
Nitrosylation of caspase
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Increased invasiveness, proliferation, and mobility of cholangiocytes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Prostaglandin E2 production(Rate limitimg step)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Activate cell cycle of cholangiocytes
 
Inhibit apoptosis of cholangiocytes
 
Promotes mutagenesis
 
 
 

Associated Conditions

Gross Pathology

  • On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

  • On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

References

  1. Fava, G.; Lorenzini, I. (2012). "Molecular Pathogenesis of Cholangiocarcinoma". International Journal of Hepatology. 2012: 1–7. doi:10.1155/2012/630543. ISSN 2090-3448.
  2. 2.0 2.1 Sirica A (2005). "Cholangiocarcinoma: molecular targeting strategies for chemoprevention and therapy". Hepatology. 41 (1): 5–15. PMID 15690474.
  3. Holzinger F, Z'graggen K, Büchler M. "Mechanisms of biliary carcinogenesis: a pathogenetic multi-stage cascade towards cholangiocarcinoma". Ann Oncol. 10 Suppl 4: 122–6. PMID 10436802.
  4. Gores G (2003). "Cholangiocarcinoma: current concepts and insights". Hepatology. 37 (5): 961–9. PMID 12717374.
  5. Wadsworth CA, Dixon PH, Wong JH, Chapman MH, McKay SC, Sharif A, Spalding DR, Pereira SP, Thomas HC, Taylor-Robinson SD, Whittaker J, Williamson C, Khan SA (2011). "Genetic factors in the pathogenesis of cholangiocarcinoma". Dig Dis. 29 (1): 93–7. doi:10.1159/000324688. PMC 3696362. PMID 21691113.
  6. Maroni L, Pierantonelli I, Banales JM, Benedetti A, Marzioni M (2013). "The significance of genetics for cholangiocarcinoma development". Ann Transl Med. 1 (3): 28. doi:10.3978/j.issn.2305-5839.2012.10.04. PMC 4200671. PMID 25332972.
  7. Kongpetch S, Jusakul A, Ong CK, Lim WK, Rozen SG, Tan P, Teh BT (2015). "Pathogenesis of cholangiocarcinoma: From genetics to signalling pathways". Best Pract Res Clin Gastroenterol. 29 (2): 233–44. doi:10.1016/j.bpg.2015.02.002. PMID 25966424.

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