Noninvasive early markers in gallbladder cancer

Abstract

Gallbladder cancer (GBC) is the most common biliary tree cancer in the world, but it is only 0.5% of all gastrointestinal cancers with lethal malignancy and marked ethnic and geographical variations. The presenting symptoms are typically vague so patient presents in advanced stage. The overall mean survival rate for patients with advanced GBC is 6 months, with a 5-year survival rate of 5% (Levy et al. 2001). Early GBC (confined to the mucosa), though infrequent, offers the potential for a cure by cholecystectomy. Most (>80%) GBCs are adenocarcinomas that originate from the fundus (60%), body (30%), or neck (10%). The basis likely is genetic susceptibility, perhaps elicited by chronic gallbladder inflammation, often a product of cholelithiasis (Pandey 2003). One reasonable hypothesis focuses on chronic irritation of the mucosa (e.g., from the physical presence of the stones and/or superimposed chronic infection such as from Salmonella typhi) leading to dysplasia (perhaps abetted by mutagenic secondary bile acids) and terminating in malignant change. © 2014 by Taylor & Francis Group, LLC.