Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma
Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma
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DOI：
10.1539/joh.14-0002-cs
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发表时间：
2014-07-01
影响因子：
3
通讯作者：
Endo, Ginji
中科院分区：
文献类型：
--
作者：
Kubo, Shoji;Takemura, Shigekazu;Endo, Ginji
目的：最近报道了一家印刷公司胶印彩色打样部门工人中胆管癌的爆发。了解职业性胆管癌发展的临床过程对研究癌变过程、监测和早期发现具有重要意义。我们评估了胆管癌检测前实验室检查结果和诊断影像表现的变化。方法：对2例有资料的胆管癌患者在发现胆管癌前的实验室检查结果和诊断影像学表现的变化进行分析。结果：2例患者的临床过程显示，在胆管癌检测前血清y -谷氨酰转肽酶水平持续升高，血清丙氨酸转氨酶和/或天冬氨酸转氨酶水平升高。在胆管癌发现前几年观察到胆管扩张，但没有肿瘤引起的狭窄，并且在两例患者中逐渐进展。两例患者在胆管癌检测前血清碳水化合物19-9浓度也升高。最后，观察到胆管狭窄和占位性病变强烈提示胆管癌。切除标本的病理检查显示胆管慢性损伤和肿瘤病变，如胆管各部位，特别是扩张胆管，可见“胆管上皮内瘤变”和“胆管内乳头状瘤变”。结论：实验室检查结果及诊断影像学改变可能与胆管癌的发展有关。监测长期接触有机溶剂的工人的诊断成像表现和实验室测试结果是很重要的。
Objectives: A cholangiocarcinoma outbreak among workers of an offset color proof-printing department in a printing company was recently reported. It is important to understand the clinical course leading to occupational cholangiocarcinoma development for investigation of the carcinogenesis process and for surveillance and early detection. We evaluated the changes in laboratory test results and diagnostic imaging presentation before the detection of cholangiocarcinoma. Methods: We investigated the changes in laboratory test results and diagnostic imaging presentation before the detection of cholangiocarcinoma in 2 patients because the data were available. Results: The clinical courses observed in the 2 participating patients showed persistent elevation of serum Y-glutamyl transpeptidase levels with or without elevated serum levels of alanine aminotransferase and/or aspartate aminotransferase before cholangiocarcinoma detection. Dilatation of the bile ducts without tumor-induced stenosis was observed several years before cholangiocarcinoma detection and progressed gradually in both patients. The serum concentration of carbohydrate 19-9 also increased prior to cholangiocarcinoma detection in both patients. Eventually, observation of stenosis of the bile duct and a space-occupying lesion strongly suggested cholangiocarcinoma. Pathological exannination of the resected specimens showed chronic bile duct injury and neoplastic lesions, such as "biliary intraepithelial neoplasia" and "intraductal papillary neoplasm of the bile duct" in various sites of the bile ducts, particularly in the dilated bile ducts. Conclusions: The changes in laboratory test results and diagnostic imaging might be related to the development of cholangiocarcinoma. It is important to monitor diagnostic imaging presentation and laboratory test results in workers with extended exposure to organic solvents.