Objective To study the association and the effect of the expression of p16 and p53 protein on the occurence and development of gallbladder carcinoma. Methods The expression of p16 and p53 protein were detected in 40 cases of gallbladder carcinoma with immunohistochemical method. Results The expressions of p16 and p53 protein were closely correlated to the tumor pathological grade, lymph mode metastasis and prognosis. p16 protein was correlated to the Nevin classifications. Conclusion The results indicate that the low expression rate of p16 protein occurred in the advanced stage of gallbladder carcinoma. The expression of p16 and p53 protein are helpful in judging the malignant degree and prognosis of primary gallbladder cancer.
Objective To observe the expression of Ezrin protein in primary carcinoma of gallbladder tissue and the levels of CEA and CA19-9 in serum of patients with primary carcinoma of gallbladder, and to explore the relationship between the expressions of these measurements and clinicopathologic characteristics. Methods Immunohistochemistry was applied to analyze the expression of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue. The levels of CEA and CA19-9 in serum and clinicopathologic characteristics of all including patients were detected with clinical measurement. All data were analyzed statistically. Results ①The positive rates of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue were 66.7% （40/60） and 30.8%（4/13）, respectively (χ2=5.57, Plt;0.05). ②There was no difference between the expression of Ezrin protein in primary carcinoma of gallbladder tissue and age or gender (Pgt;0.05). However, difference was significant between the Ezrin expression and degree of difference, pNevin stages, pTNM stages, lymph node metastasis or distant metastasis (Plt;0.05). ③There were no differences between the positive rates of CEA and CA19-9 in primary carcinoma of gallbladder and age or gender (Pgt;0.05). However, differences were significant between the positive rates of CEA and CA19-9 and pNevin stages, pTNM stages, degree of difference, lymph node metastasis or distant metastasis (Plt;0.05). ④There was some relationship between the expression of Ezrin protein and the positive rate of CEA (rs=0.213, Plt;0.05), but not with the positive rate of CA19-9 (rs=0.081, Pgt;0.05). Conclusions The high expression of Ezrin protein may promote the invasion and metastasis in primary carcinoma of gallbladder. It could be possible to decide the outcome of primary carcinoma of gallbladder through the combined analysis on the expression of Ezrin protein and the serum levels of CEA and CA19-9.
ObjectiveTo investigate clinical value of magnetic resonance imaging (MRI) in differentiating xanthogranulomatous cholecystitis (XGC) with gallbladder cancer (GBC). MethodsMRI data of 7 patients with XGC and 13 patients with GBC proved by surgery and pathology were analyzed retrospectively. The main contents of the observation included:①Maximum thickness of gallbladder wall; ②Diffuse thickening or localized thickening of gallbladder wall; ③Enhancement pattern (uniform or nonuniform) of gallbladder wall; ④Gallbladder wall sandwiches enhancement; ⑤Gallbladder wall nodules; ⑥Completeness of gallbladder mucosa lines; ⑦Obstruction of biliary tract; ⑧Calculus in gallbladder or bile duct; ⑨Involvement of adjacent liver; ⑩Definition of surrounding fat layer; Lymphadenopathy. ResultsIn above 11 MRI comparing features, these features such as the gallbladder wall sandwiches enhancement, the gallbladder wall nodules, the completeness of gallbladder mucosa lines, the biliary obstruction, and the lymphadenopathy were statistically significant between the XGC and the GBC (P < 0.05), while the rest features such as the maximum thickness of gallbladder wall, the type of gallbladder wall thickening, the gallbladder wall enhancement pattern, the calculus in gallbladder or bile duct, the involvement of adjacent liver, and the definition of surrounding fat layer were not statistically significant between the XGC and the GBC (P > 0.05). ConclusionMRI has important values in differentiating XGC with GBC.
ObjectiveTo analyze the epidemiological characteristics and trends of gallbladder cancer incidence and mortality in Zhejiang cancer registration areas from 2000 to 2021, providing a basis for formulating prevention and control strategies for gallbladder cancer. MethodsData on incidence and mortality were collected from 22 cancer registry areas in Zhejiang Province from 2000 to 2021, calculating the crude incidence (mortality), age-standardized incidence / mortality rate by Chinese standard population(ASR China), age-standardized incidence /mortality rate by World standard population (ASR World) and cumulative rate (0–74 years old). The average annual percentage change (AAPC) was calculated by using Joinpoint software. ResultsIn 2021, the crude incidence of gallbladder cancer in Zhejiang cancer registration areas was 6.79 per 100 000. The ASR China and ASR World were 2.99 and 2.96 per 100 000, respectively, ranking 18th of all new cancer cases. The incidence ASR China in female (3.13 per 100 000) was higher than that in male (2.85 per 100 000). The incidence ASR China in rural areas (3.01 per 100 000) was slightly higher than that in urban areas (2.97 per 100 000). The crude mortality of gallbladder cancer was 5.14 per 100 000, with the mortality ASR China and ASR World of 2.09 and 2.10 per 100 000, respectively, ranking 10th of all new cancer deaths. The mortality ASR China in female (2.19 per 100 000) was higher than that in male (1.98 per 100 000). The mortality ASR China in urban areas (2.11 per 100 000) was slightly higher than that in rural areas (2.07 per 100 000). Both the crude incidence and mortality of gallbladder cancer increased with age. The crude incidence and mortality showed an upward trend over time, with AAPC of 2.59% and 3.75%, respectively (P<0.001). The incidence ASR China did not show significant changes over time (AAPC=0.05%, P=0.856). The incidence ASR China in male and rural areas showed increasing trends over time, with AAPCs of 0.89% (P=0.016) and 1.14% (P=0.001), respectively. The incidence ASR China in female and urban areas showed no significant trends over time, with AAPCs of –0.26% (P=0.503) and –0.02% (P=0.967), respectively. The mortality showed a slower upward trend after adjusting the age structure (AAPC=1.01%, P=0.020). ConclusionsThe elderly population in rural areas, especially elderly women, are the primary targets for the prevention and control of gallbladder cancer. Aging is the main factor contributing to the increase in the incidence and mortality of gallbladder cancer. After adjusting for demographic factors, the overall upward trend of the incidence in the male population and rural areas, as well as mortality, cannot be ignored.
ObjectiveTo investigate the effect of combined or non-combined liver resection for T2a gallbladder cancer. MethodsAccording to the established inclusion and exclusion criteria, the patients with T2a gallbladder cancer admitted to Peking Union Medical College Hospital from January 2016 to December 2021 were retrospectively collected, then were assigned into combined with liver resection group and non-combined with liver resection group. The general characteristics, perioperative information, and prognosis of the two groups were compared. ResultsA total of 58 patients were enrolled in this study, including 23 males and 35 females; aged (64.8±11.1) years. There were 43 cases in the combined with liver resection group and 15 cases in the non-combined with liver resection group. There were no statistic differences in the demographic data, lifestyle, onset symptoms, preoperative combined diseases, and preoperative tumor markers between the two groups (P>0.05). Compared with the combined with liver resection group, the proportion of patients received bile duct resection was higher (P=0.013) and the operation time was shorter (P=0.045) in the non-combined with liver resection group. There were no statistic differences in the other perioperative informations between the two groups (P>0.05). A total of 12 patients had postoperative complications, including 3 cases of grade Ⅰ, 8 cases of grade Ⅱ, and 1 case of grade Ⅲa by Clavien-Dindo classification. All patients improved after treatment and were discharged smoothly. No patient was readmitted within 30 d after discharge. All 58 patients were followed up with a median follow up time of 29 months. During the follow-up period, there were 47 cases (81.0%) of tumor-free survival, 2 cases (3.4%) of survival with tumor, and 9 cases (15.5%) of death. There were no statistic differences in the overall survival and disease-free survival between the two groups by log-rank test (χ2=3.418, P=0.064; χ2=1.543, P=0.214). ConclusionFromthe results of this study, for T2a gallbladder cancer, liver resection would not result in increased complications or longer hospital stay, but don’t obviously improve prognosis.
The expression of p21, p53, bcl-2 oncoprotein was evaluated using immunohistochemistry in 40 patients with gallbladder carcinoma and 8 patients with gallbladder adenomous polyp. In the study, the positive rate of expression of p21, p53 and bcl-2 oncoprotein was 52.5%, 52.5% and 70.0% respectively in gallbladder carcinoma, while, in gallbladder polyp, they were 0%, 0% and 100% respectively. The positive rate of expression of p53 oncoprotein was significantly higher in poor-differentiated adenocarcinomas than in well-differentiated ones (Ｐ＜0.05). The converse was true for bcl-2 oncoprotein. The positive rate of expression of p21 and p53 oncoprotein was significantly higher in metastatic group than in non-metastatic one. These results suggest that the patients with the expression of p21, p53 might be of poor-prognosis.
The morbidity and mortality of gallbladder cancer were rising. At present, there was no effective chemotherapy regimen, so it was of great practical significance to explore new therapy target. Ferroptosis is a non-apoptotic form of cell death characterized by iron-dependent lipid peroxidation and metabolic constraints. In recent years, it had become a research hotspot. Many studies had been carried out on the relevant biological mechanisms such as liver cancer, breast cancer, pancreatic cancer, and other cancer. At present, there are still few studies on ferroptosis in gallbladder cancer, and its relevant mechanisms need further in-depth analysis, which opens up a new research direction for exploring the treatment of gallbladder cancer.