Shoji Kubo1, Shigekazu Takemura2, Shogo Tanaka2, Takayoshi Nishioka2, Masahiko Kinoshita2, Genya Hamano2, Tokuji Ito2, Takatsugu Yamamoto3, Makoto Abue4, Masaru Aoki5, Kei Nakagawa6, Susumu Hijioka7, Atsushi Miyamoto8, Yukio Osaki9, Ginji Endo10, Shinji Kumagai11. 1. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. m7696493@msic.med.osaka-cu.ac.jp. 2. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. 3. Department of Surgery, Ishikiriseiki Hospital, Higashiosaka, Japan. 4. Department of Gastroenterology, Miyagi Cancer Center, Natori, Japan. 5. Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan. 6. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. 7. Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan. 8. Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan. 9. Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan. 10. Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan. 11. Department of Occupational and Environmental Management, University of Occupational and Environmental Health, Kitakyushu, Japan.
Abstract
PURPOSE: This study aimed to establish an efficient strategy for screening and surveillance for occupational cholangiocarcinoma. METHODS: We evaluated the consecutive changes in laboratory findings during regular health examinations and in abdominal ultrasonography findings before the diagnosis of occupational cholangiocarcinoma in nine patients. The results of laboratory tests and abdominal ultrasonography at the time of diagnosis were also examined. RESULTS: In all patients, the serum γ-glutamyl transpeptidase (γ-GTP) activity increased several years before the diagnosis of cholangiocarcinoma. The serum alanine aminotransferase (ALT) activity also increased several years before the diagnosis, following an increase in the serum aspartate aminotransferase (AST) activity in most patients. Abdominal ultrasonography before the diagnosis revealed regional dilatation of the bile ducts, which continued to enlarge. At the time of diagnosis, the γ-GTP, AST, and ALT activities were increased in nine, seven, and seven patients, respectively. The regional dilatation of bile ducts without tumor-induced stenosis, dilated bile ducts due to tumor-induced stenosis, space-occupying lesions, and/or lymph node swelling were observed. The serum concentrations of carbohydrate antigen 19-9 (CA 19-9) and/or carcinoembryonic antigen (CEA) were increased in all patients. CONCLUSIONS: Regular health examinations with a combination of ultrasonography and laboratory tests including the γ-GTP, AST, ALT, CA 19-9, and CEA levels are useful for screening and surveillance for occupational cholangiocarcinoma.
PURPOSE: This study aimed to establish an efficient strategy for screening and surveillance for occupational cholangiocarcinoma. METHODS: We evaluated the consecutive changes in laboratory findings during regular health examinations and in abdominal ultrasonography findings before the diagnosis of occupational cholangiocarcinoma in nine patients. The results of laboratory tests and abdominal ultrasonography at the time of diagnosis were also examined. RESULTS: In all patients, the serum γ-glutamyl transpeptidase (γ-GTP) activity increased several years before the diagnosis of cholangiocarcinoma. The serum alanine aminotransferase (ALT) activity also increased several years before the diagnosis, following an increase in the serum aspartate aminotransferase (AST) activity in most patients. Abdominal ultrasonography before the diagnosis revealed regional dilatation of the bile ducts, which continued to enlarge. At the time of diagnosis, the γ-GTP, AST, and ALT activities were increased in nine, seven, and seven patients, respectively. The regional dilatation of bile ducts without tumor-induced stenosis, dilated bile ducts due to tumor-induced stenosis, space-occupying lesions, and/or lymph node swelling were observed. The serum concentrations of carbohydrate antigen 19-9 (CA 19-9) and/or carcinoembryonic antigen (CEA) were increased in all patients. CONCLUSIONS: Regular health examinations with a combination of ultrasonography and laboratory tests including the γ-GTP, AST, ALT, CA 19-9, and CEA levels are useful for screening and surveillance for occupational cholangiocarcinoma.
Entities:
Keywords:
Health examination; Occupational cholangiocarcinoma; Organic solvent; Screening and surveillance
Authors: Annika Bergquist; Anders Ekbom; Rolf Olsson; Dan Kornfeldt; Lars Lööf; Ake Danielsson; Rolf Hultcrantz; Stefan Lindgren; Hanne Prytz; Hanna Sandberg-Gertzén; Sven Almer; Fredrik Granath; Ulrika Broomé Journal: J Hepatol Date: 2002-03 Impact factor: 25.083