Assuntos
Neoplasias da Vesícula Biliar , Humanos , Chile/epidemiologia , Neoplasias da Vesícula Biliar/mortalidade , Neoplasias da Vesícula Biliar/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Cálculos Biliares/mortalidade , Cálculos Biliares/epidemiologia , Adulto , Programas Governamentais , IdosoRESUMO
OBJECTIVE: to determine the prevalence of incidental gallbladder cancer (IGBC) in cholecystectomies performed in a tertiary public hospital and to describe technical and epidemiological aspects of performing cholecystectomies for presumably benign disease. METHOD: descriptive, retrospective observational study, based on analysis of medical records of patients undergoing cholecystectomy with preoperative hypothesis of benign disease between January 2018 and January 2022. RESULTS: prevalence of gallbladder adenocarcinoma in our sample was 0.16%, similar to data in the literature. Technical aspects during cholecystectomy were also described with a frequency similar to that found in the literature. CONCLUSION: despite a rare disease, IGBC is relevant in the routine of the General Surgeon. Its diagnosis, staging and treatment directly affect the prognosis. Technical aspects during cholecystectomy are not always remembered by surgeons and can interfere with the prognosis and subsequent treatment of the patient.
Assuntos
Neoplasias da Vesícula Biliar , Humanos , Neoplasias da Vesícula Biliar/diagnóstico , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/cirurgia , Prevalência , Achados Incidentais , Colecistectomia , Estudos RetrospectivosRESUMO
BACKGROUND: Gallbladder Cancer (GBC) prevalence varies among countries, associated with different geographical and genetic factors. The Mapuche ethnicity (Ethnia mostly located between the VIII and X Chilean regions) stands out in Chile due to its high GBC prevalence. Aim: To estimate the GBC prevalence in patients undergoing cholecystectomy at a public hospital in the Northern region of Chile (Tarapaca), where other ethnical groups are common. MATERIAL AND METHODS: Pathological reports of 3270 patients (72% women) who underwent cholecystectomy between January 2016 and December 2019 were revised. Subsequently, the accreditation of ethnic belonging for each patient to one of the ten native communities in Chile was requested to the National Corporation for Native Communities Development (CONADI). RESULTS: According to the analysis of pathological reports, the global GBC prevalence was 0.3 %. The prevalence in Aymaras was 0.4% and 0% in Mapuches. The distribution of ethnic origins among analyzed patients was Aymara in 14.3, Mapuche in 2.7%, Diaguita in 1.7%, Quechua in 1.3%, Atacameña in 0.2%, and Colla in 0.2%. No specific ethnic origin was found in 79% of patients. Conclusions: There was a low GBC prevalence rate in Northern Chile and among the Aymara population.
Assuntos
Humanos , Masculino , Feminino , Neoplasias da Vesícula Biliar/epidemiologia , Colecistectomia , Etnicidade , Chile/epidemiologia , PrevalênciaRESUMO
BACKGROUND: Gallbladder Cancer (GBC) prevalence varies among countries, associated with different geographical and genetic factors. The Mapuche ethnicity (Ethnia mostly located between the VIII and X Chilean regions) stands out in Chile due to its high GBC prevalence. AIM: To estimate the GBC prevalence in patients undergoing cholecystectomy at a public hospital in the Northern region of Chile (Tarapaca), where other ethnical groups are common. MATERIAL AND METHODS: Pathological reports of 3270 patients (72% women) who underwent cholecystectomy between January 2016 and December 2019 were revised. Subsequently, the accreditation of ethnic belonging for each patient to one of the ten native communities in Chile was requested to the National Corporation for Native Communities Development (CONADI). RESULTS: According to the analysis of pathological reports, the global GBC prevalence was 0.3 %. The prevalence in Aymaras was 0.4% and 0% in Mapuches. The distribution of ethnic origins among analyzed patients was Aymara in 14.3, Mapuche in 2.7%, Diaguita in 1.7%, Quechua in 1.3%, Atacameña in 0.2%, and Colla in 0.2%. No specific ethnic origin was found in 79% of patients. CONCLUSIONS: There was a low GBC prevalence rate in Northern Chile and among the Aymara population.
Assuntos
Neoplasias da Vesícula Biliar , Humanos , Feminino , Masculino , Neoplasias da Vesícula Biliar/epidemiologia , Chile/epidemiologia , Prevalência , Colecistectomia , EtnicidadeRESUMO
Gallbladder cancer (GBC) is a highly fatal cancer that can be cured through cholecystectomy if identified early. The presence of gallstones is the primary risk factor for GBC, but few people with gallstones develop GBC. A key question is what drives the development of GBC among persons with gallstones. We initiated the Chile Biliary Longitudinal Study (Chile BiLS) to address this question. From 2016 to 2019, Chile BiLS enrolled 4,726 women aged 50-74 years with ultrasound-detected gallstones from southern-central Chile, accounting for an estimated 36% of eligible women with gallstones in the study area. The median age was 59 years; 25% of the women were Amerindian (Mapuche), 60% were obese, 25% had diabetes, and 6% had cardiovascular disease. Participants will be followed for gallbladder dysplasia or cancer for 6 years. As of April 30, 2020, over 91% of those eligible completed the year 2 follow-up visit. Data being collected include epidemiologic and sociodemographic information, anthropometric measurements, blood pressure, and tooth counts. Biosamples being taken include baseline plasma, buffy coat, red blood cells, serum, blood clot from serum, and PAXgene whole blood (PreAnalytiX GmbH, Hombrechtikon, Switzerland). Complete gallbladder sampling is conducted for most participants undergoing cholecystectomy. The Chile BiLS cohort study will increase our understanding of GBC etiology and could identify potential risk stratification and early detection strategies in high-risk areas.
Assuntos
Neoplasias da Vesícula Biliar/epidemiologia , Cálculos Biliares/epidemiologia , Idoso , Pressão Sanguínea , Pesos e Medidas Corporais , Doenças Cardiovasculares/epidemiologia , Chile , Diabetes Mellitus/epidemiologia , Feminino , Neoplasias da Vesícula Biliar/diagnóstico por imagem , Neoplasias da Vesícula Biliar/etnologia , Cálculos Biliares/diagnóstico por imagem , Cálculos Biliares/etnologia , Humanos , Mediadores da Inflamação/sangue , Estudos Longitudinais , Pessoa de Meia-Idade , Obesidade/epidemiologia , Projetos de Pesquisa , Fatores de Risco , Fatores Socioeconômicos , Perda de Dente/epidemiologiaRESUMO
BACKGROUND AND AIMS: Gallbladder cancer (GBC) is a neglected disease with substantial geographical variability: Chile shows the highest incidence worldwide, while GBC is relatively rare in Europe. Here, we investigate the causal effects of risk factors considered in current GBC prevention programs as well as C-reactive protein (CRP) level as a marker of chronic inflammation. APPROACH AND RESULTS: We applied two-sample Mendelian randomization (MR) using publicly available data and our own data from a retrospective Chilean and a prospective European study. Causality was assessed by inverse variance weighted (IVW), MR-Egger regression, and weighted median estimates complemented with sensitivity analyses on potential heterogeneity and pleiotropy, two-step MR, and mediation analysis. We found evidence for a causal effect of gallstone disease on GBC risk in Chileans (P = 9 × 10-5 ) and Europeans (P = 9 × 10-5 ). A genetically elevated body mass index (BMI) increased GBC risk in Chileans (P = 0.03), while higher CRP concentrations increased GBC risk in Europeans (P = 4.1 × 10-6 ). European results suggest causal effects of BMI on gallstone disease (P = 0.008); public Chilean data were not, however, available to enable assessment of the mediation effects among causal GBC risk factors. CONCLUSIONS: Two risk factors considered in the current Chilean program for GBC prevention are causally linked to GBC risk: gallstones and BMI. For Europeans, BMI showed a causal effect on gallstone risk, which was itself causally linked to GBC risk.
Assuntos
Índice de Massa Corporal , Proteína C-Reativa/análise , Neoplasias da Vesícula Biliar/etiologia , Cálculos Biliares/complicações , Adulto , Fatores Etários , Chile/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/genética , Cálculos Biliares/epidemiologia , Predisposição Genética para Doença/genética , Variação Genética , Humanos , Masculino , Análise da Randomização Mendeliana , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Fatores de RiscoRESUMO
Background: The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups. Aim: To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals. Material and Methods: An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed. Results: Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported. Conclusions: There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Colelitíase , Colecistite , Neoplasias da Vesícula Biliar , Colecistectomia , Colelitíase/cirurgia , Colelitíase/epidemiologia , Colelitíase/diagnóstico por imagem , Colecistite/cirurgia , Prevalência , Neoplasias da Vesícula Biliar/cirurgia , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/diagnóstico por imagemRESUMO
BACKGROUND: The first large-scale genome-wide association study of gallbladder cancer (GBC) recently identified and validated three susceptibility variants in the ABCB1 and ABCB4 genes for individuals of Indian descent. We investigated whether these variants were also associated with GBC risk in Chileans, who show the highest incidence of GBC worldwide, and in Europeans with a low GBC incidence. METHODS: This population-based study analysed genotype data from retrospective Chilean case-control (255 cases, 2042 controls) and prospective European cohort (108 cases, 181 controls) samples consistently with the original publication. RESULTS: Our results confirmed the reported associations for Chileans with similar risk effects. Particularly strong associations (per-allele odds ratios close to 2) were observed for Chileans with high Native American (=Mapuche) ancestry. No associations were noticed for Europeans, but the statistical power was low. CONCLUSION: Taking full advantage of genetic and ethnic differences in GBC risk may improve the efficiency of current prevention programs.
Assuntos
Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Neoplasias da Vesícula Biliar/genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Chile/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Neoplasias da Vesícula Biliar/epidemiologia , Estudos de Associação Genética , Humanos , Indígenas Sul-Americanos/genética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , População Branca/genéticaRESUMO
Trends in gallbladder cancer incidence and mortality in populations across the Americas can provide insight into shifting epidemiologic patterns and the current and potential impact of preventative and curative programs. Estimates of gallbladder and extrahepatic bile duct cancer incidence and mortality for the year 2018 were extracted from International Agency for Research on Cancer (IARC) GLOBOCAN database for 185 countries. Recorded registry-based incidence from 13 countries was extracted from IARCs Cancer Incidence in Five Continents series and corresponding national deaths from the WHO mortality database. Among females, the highest estimated incidence for gallbladder and extrahepatic bile duct cancer in the Americas were found in Bolivia (21.0 per 100,000), Chile (11.7) and Peru (6.0). In the US, the highest incidence rates were observed among Hispanics (1.8). In the Chilean population, gallbladder cancer rates declined in both females and males between 1998 and 2012. Rates dropped slightly in Canada, Costa Rica, US Whites and Hispanics in Los Angeles. Gallbladder cancer mortality rates also decreased across the studied countries, although rising trends were observed in Colombia and Canada after 2010. Countries within Southern and Central America tended to have a higher proportion of unspecified biliary tract cancers. In public health terms, the decline in gallbladder cancer incidence and mortality rates is encouraging. However, the slight increase in mortality rates during recent years in Colombia and Canada warrant further attention. Higher proportions of unspecified biliary tract cancers (with correspondingly higher mortality rates) suggest more rigorous pathology procedures may be needed after surgery.
Assuntos
Neoplasias dos Ductos Biliares/epidemiologia , Ductos Biliares Extra-Hepáticos/patologia , Neoplasias do Sistema Biliar/epidemiologia , Neoplasias da Vesícula Biliar/epidemiologia , Sistema de Registros/estatística & dados numéricos , América/epidemiologia , Canadá/epidemiologia , Geografia , Humanos , Incidência , América do Sul/epidemiologiaRESUMO
BACKGROUND: The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups. AIM: To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals. MATERIAL AND METHODS: An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed. RESULTS: Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported. CONCLUSIONS: There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.