{"id":1227,"date":"2018-02-28T10:48:04","date_gmt":"2018-02-28T10:48:04","guid":{"rendered":"https:\/\/blogs.imperial.ac.uk\/ighi\/?p=1227"},"modified":"2019-03-28T16:27:18","modified_gmt":"2019-03-28T16:27:18","slug":"cholangiocarcinoma-rare-disease-thats-increase","status":"publish","type":"post","link":"https:\/\/blogs.imperial.ac.uk\/ighi\/2018\/02\/28\/cholangiocarcinoma-rare-disease-thats-increase\/","title":{"rendered":"Cholangiocarcinoma &#8211; the rare disease that&#8217;s on the increase"},"content":{"rendered":"<p><em>By <a href=\"http:\/\/www.imperial.ac.uk\/people\/s.taylor-robinson\" target=\"_blank\" rel=\"noopener noreferrer\">Professor Simon Taylor-Robinson<\/a>, Consultant Hepatologist and Professor of Translational Medicine at Imperial College London<\/em><\/p>\n<figure id=\"attachment_1228\" aria-describedby=\"caption-attachment-1228\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"200\" class=\"size-medium wp-image-1228\" src=\"https:\/\/blogs.imperial.ac.uk\/ighi\/files\/2018\/02\/P5142439-300x200.jpg\" alt=\"Professor Simon Taylor-Robinson with colleagues\" \/><figcaption id=\"caption-attachment-1228\" class=\"wp-caption-text\">Professor Simon Taylor-Robinson with colleagues<\/figcaption><\/figure>\n<p>Cholangiocarcinoma is a rare primary malignancy arising from cholangiocytes, the endothelial lining of the biliary ducts, with an incidence 2500 cases of per annum in the UK. The only option for cure is surgical resection, but cholangiocarcinoma usually presents late when it grows sufficiently to block the drainage of bile from the liver, presenting with jaundice. By this point it is often irresectable, and palliative management includes holding open the ducts with stents to prevent blockage, and chemotherapy. One-year survival is only 5%.<\/p>\n<p>The incidence of this insidious disease is increasing, and earlier diagnosis and better treatment are urgently required. Aetiological factors are thought to include exposure of the endothelium to carcinogenic compounds, and increased mutation induced by chronic inflammation, which may explain the association of chronic infection\/gallstones, anatomical abnormalities, intrabiliary parasites, chronic biliary inflammatory disease. However, many patients do not have any identifiable risk factors.<\/p>\n<p>The Lead Investigators\u00a0in our research, as well myself, include\u00a0<a href=\"http:\/\/www.imperial.ac.uk\/people\/shahid.khan\" target=\"_blank\" rel=\"noopener noreferrer\">Dr Shahid Khan<\/a>, <span id=\"titlepart6\">Honorary Clinical Senior Lecturer, Adjunct Reader from the <span id=\"titlepart4\">Faculty of Medicine<\/span>,\u00a0<span id=\"titlepart5\">Faculty of Medicine Centre and<\/span>\u00a0<\/span>Professor Richard Syms from the <span id=\"titlepart4\">Faculty of Engineering<\/span>,\u00a0<span id=\"titlepart5\">Department of Electrical and Electronic Engineering. Our work aims to tackle cholangiocarcinoma in five main areas:<br \/>\n<\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <span id=\"titlepart6\"><\/span><br \/>\n1) Novel biomarkers for cholangiocarcinoma. This takes advantage of the large numbers of patients with hepatobiliary malignancies including cholangiocarcinoma who are managed through the tertiary referral HPB services provided at Hammersmith Hospital, and utilises scientific expertise and infrastructure on both the Hammersmith and South Kensington sites. As part of a UKCRN-adopted programme we are establishing a biobank of body fluids from patients with various hepatobiliary malignancies in collaboration with other groups. We are applying metabonomic and proteomic analysis to blood, bile and urine samples to identify novel biomarkers for cholangiocarcinoma diagnosis and prognostication.<\/p>\n<p>2) Genetic risk factors for cholangiocarcinoma. We have established a bank of DNA samples from patients with cholangiocarcinoma and with related diseases. DNA SNP analysis has demonstrated association of mutations in bilary transporters with development of cancer. Further analysis continues.<\/p>\n<p>3) Epidemiology of Cholangiocarcinoma. It is known that the diagnosed incidence of cholangiocarcinoma is increasing. Work in our group in collaboration with <a href=\"http:\/\/www.imperial.ac.uk\/people\/m.toledano\" target=\"_blank\" rel=\"noopener noreferrer\">Mireille Toledano<\/a> (School of Public Health) has demonstrated the need for careful re-evaluation of these data as the real trend is obscured by changes in disease coding practice. Epidemiological work is continuing to identify associated factors which may give insight into cause, and assist in service planning.<\/p>\n<p>4) Improving imaging in Cholangiocarcinoma. Current imaging techniques include ultrasound, MRI and CT scanning. However, optimising patient staging to accurately identify those who may benefit from resection or other therapies demands greater imaging resolution than these techniques can provide. In a collaborative project with the Richard Syms in the Engineering Faculty, we are<br \/>\ndeveloping an MRI probe which could be placed inside the bile ducts to give fine detail on tumour anatomy and its breach of the ductal layers as it progresses. This has led to the development of novel coil technologies by our collaborating partners and offers exciting prospects for the future in this and other applications.<\/p>\n<p>5) International and Domestic\u00a0 Collaborations. In other countries infestation with biliary parasites is associated with a higher incidence of cholangiocarcinoma. We have previous, ongoing and evolving collaborations with Thailand, Egypt, and Bangladesh with the aim of comparing samples from fluke-related disease with our own cohort to identify differentiating factors. We also have collaboration with the Mayo Clinic and leading Norwegian researchers. Within the UK we have existing collaborations with Oxford and UCL, and are developing new relationships as part of the UKCRN scheme, with 6 new centres currently agreed<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Professor Simon Taylor-Robinson, Consultant Hepatologist and Professor of Translational Medicine at Imperial College London Cholangiocarcinoma is a rare primary malignancy arising from cholangiocytes, the endothelial lining of the biliary ducts, with an incidence 2500 cases of per annum in the UK. The only option for cure is surgical resection, but cholangiocarcinoma usually presents late [&hellip;]<\/p>\n","protected":false},"author":1013,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11192],"tags":[209939],"class_list":["post-1227","post","type-post","status-publish","format-standard","hentry","category-cancer","tag-cholangiocarcinoma"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cholangiocarcinoma - the rare disease that&#039;s on the increase - Institute of Global Health Innovation<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.imperial.ac.uk\/ighi\/2018\/02\/28\/cholangiocarcinoma-rare-disease-thats-increase\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cholangiocarcinoma - the rare disease that&#039;s on the increase - Institute of Global Health Innovation\" \/>\n<meta property=\"og:description\" content=\"By Professor Simon Taylor-Robinson, Consultant Hepatologist and Professor of Translational Medicine at Imperial College London Cholangiocarcinoma is a rare primary malignancy arising from cholangiocytes, the endothelial lining of the biliary ducts, with an incidence 2500 cases of per annum in the UK. 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