目的：探讨胆囊癌肝侵犯的CT诊断及临床价值。方法：回顾性分析经手术、病理证实的17例胆囊癌肝侵犯CT资料。结果：肿块型11例，腔内型2例，厚壁型4例。侵犯肝左内叶5例，肝右叶前段3例，同时侵犯肝左内叶及右叶前段9例。5例侵犯深度＜2 cm，12例侵犯深度＞2 cm。CT表现为胆囊窝脂肪间隙消失，邻近胆囊窝的肝脏组织内出现不规则形低密度影，边界模糊，胆囊癌肿与肝脏组织分界不清，增强后肝内病灶不规则强化。结论：CT对胆囊癌肝侵犯的诊断及临床分期、治疗方案的选择具有重要价值。
ObjectiveTo summarize the research progress of long non-coding RNA (lncRNA) in the regulation of malignant biological behavior of gallbladder cancer so as to provide references for its related research.MethodThe relevant literatures about studies of lncRNA in gallbladder cancer in recent years were reviewed.ResultsThe recent studies had shown that 19 lncRNAs associated with gallbladder cancer had played the important roles in regulating tumor cell proliferation, migration, invasion, apoptosis, “sponge” miRNAs, chemoresistance, and tumor metastasis. Among them, most lncRNAs tended to have carcinogenic properties, only a few had anticarcinogenic effect. Although the research suggested the mechanism and role of lncRNA to promote or inhibit the occurrence and development of gallbladder cancer, the current research on its mechanism was still limited. In addition, some lncRNAs were found to be specifically expressed in the serum of patients with gallbladder cancer, so which were expected to become biomarkers for tumor diagnosis and prognosis.ConclusionslncRNAs associated with gallbladder cancer have carcinogenic or anticarcinogenic effect, or chemoresistance. They play potential roles in diagnosis, prognosis, and (or) treatment of tumors, but molecular mechanisms of their effects are still limited.
We reviewed the clinical studies on drug therapy for gallbladder cancer and expounded on the current situation of conversion therapy for gallbladder cancer. Gallbladder cancer was usually diagnosed late, with high malignancy, low surgical resection rate, and poor prognosis. With the development of conversion therapy, systemic therapy combined with radical resection had effectively improved the surgical resection rate and prognosis of gallbladder cancer patients. At present, most of the published conversion therapies for gallbladder cancer were mainly retrospective researches, lacking large multicenter prospective research, and the treatment plan was still based on chemotherapy, lacking the research of targeted therapy in combination with immunotherapy. It is expected that more high-quality clinical trials can be made first-line recommendations for the conversion therapy of gallbladder cancer.
Objective To study the relation between expressions of transforming growth factor β1 （TGF-β1）, transforming growth factor receptor type Ⅰ (TβRⅠ) and cell proliferation, cell cycle in gallbladder carcinomas, to disclose the mechanism of TGF-β1 and TβRⅠin the gallbladder carcinogenesis，and to evaluate their values in the prognosis of gallbladder carcinomas. Methods Thirty five gallbladder carcinomas 〔age （57.94± 4.61） years, 14 male cases and 21 female cases〕 comprised 32 adenocarcinomas, 2 adenosquamous carcinoma and 1 squamous cell carcinomas. Formalin fixed, paraffin embedded sections from gallbladder carcinomas were immunostained with TGF-β1, TβRⅠ, PCNA, cyclin E antibodies by immunochemical assays. Gallbladder adenoma and chronic cholecystitis were collected as non-malignant controls. Patients of gallbladder carcinomas were followed up. Results Positive immunostaining rate of TGF-β1 was 57.14% in gallbladder carcinomas, which was significantly higher than that in gallbladder adenomas and chronic cholecystitis (P＜0.01, respectively). Expression of TGF-β1 was associated with Nevin stage, lymph nodes and distant metastasis (P＜0.05, P＜0.01, respectively). Expression of TGF-β1 was positively correlated with expression of PCNA LI and cyclin E (r=0.523 2, P=0.001 3; r=0.406 5, P=0.015 4), and 34.29% of gallbladder carcinomas were immunostained positively for TβRⅠ. Expression of TβRⅠwas significantly lower in gallbladder carcinomas than that in gallbladder adenomas and cholecystitis (P＜0.05, respectively). It was significantly lower in gallbladder carcinomas patients with lymph nodes and distant metastases than in those without (P＜0.05). Expression of TβRⅠwas negatively correlated with PCNA LI (r=-0.402 4, P=0.016 6). Patients with negative expression of TGF-β1 and/or positive expression of TβRⅠ had significant longer survival rates than those with positive expression of TGF-β1 and/or negative expression of TβRⅠ(P＜0.01, P＜0.05, respectively). Expressions of TGF-β1 and TβRⅠ correlated with prognosis of gallbladder carcinomas closely. Conclusion TGF-β1 and TβRⅠ have close correlation with cell proliferation, cell cycle of gallbladder carcinomas and are important biological markers of carcinogenesis and progress of gallbladder carcinomas. The escape of growth inhibition of TGF-β1 due to low expression of TβRⅠand carcinogenesis of TGF-β1 may play an important role in gallbladder carcinogenesis. TGF-β1 and TβRⅠare valuable indices for judging the prognosis of gallbladder carcinoma.
目的 综合评价胰胆管合流异常（PBM）与胆囊癌发生的关系，为胆囊癌的预防提供更多、更准确的信息。 方法 计算机检索中国生物医学文献数据库（CBM）、中国期刊网（CNKI）、PubMed、EMBASE、万方等数据库，检索时间从1977年4月－2011年5月，并结合文献追溯的方法，收集国内外公开发表的关于PBM与胆囊癌关系的病例对照研究或队列研究，采用RevMan 5.0.25软件进行Meta分析。 结果 总计纳入文献8篇，其中3篇仅对比分析了PBM在胆囊癌患者与正常对照组中发生率的差异，2篇仅对比分析了胆囊癌在PBM患者与正常对照组中发生率的差异，而另外3篇文献则对这两种发生率的差异都进行了对比。Meta分析结果显示：胆囊癌患者中PBM的发生率明显高于正常对照组，差异有统计学意义[OR=7.41，95%CI（5.03，10.87），P＜0.000 01]；且PBM患者中胆囊癌的发生率明显高于正常对照组，差异有统计学意义[OR=17.67，95%CI（10.43，29.94），P＜0.000 01]。 结论 PBM是胆囊癌发生的高危因素，与胆囊癌的发生密切相关。
ObjectiveTo review the latest advances in diagnosis and treatment of gallbladder carcinoma.MethodsThe recent literatures on diagnosis and treatment of gallbladder carcinoma at home and abroad were reviewed, and the diagnosis, staging and treatment progress of gallbladder carcinoma were systematically reviewed.ResultsThere are many methods to diagnose gallbladder carcinoma, among which imaging methods are commonly used, as well as various tumor markers and gallbladder carcinoma-related genes. Surgical resection is still the only possible cure for gallbladder carcinoma, but the scope and timing of surgical resection are still controversial. Radiotherapy, chemotherapy and gene therapy also play an important role in the treatment of gallbladder carcinoma.ConclusionsImaging examination is still the first choice for the diagnosis of gallbladder carcinoma. The tumor markers and gene diagnosis has broad prospects. Gallbladder carcinoma is mainly treated by surgery. Gene intervention and precise targeted therapy are the future development direction.
ObjectiveTo evaluate the diagnostic value of ultrasound for gallbladder carcinoma (GA), in order to improve the ability of early ultrasonic and clinical diagnosis of GA. MethodsWe analyzed and compared the clinical data and ultrasonic results of 42 GA cases confirmed by surgery and pathology between January 2008 and December 2013, and summarized the classification, ultrasonographic features, and diagnosis of GA. ResultsAmong the 42 cases, 25 were correctly diagnosed by ultrasound (59.5%), among which 9 were thick-wall type, 11 were protrusion type and 5 were solid type. Seventeen cases were misdiagnosed (40.5%). Pathological results showed 14 cases of highly-differentiated adenocarcinoma, 16 of moderately differentiaed adenocarcinoma, 9 of poorly-differentiated adenocarcinoma, 2 of squamous adenocarcinoma and 1 of neuroendocrine carcinoma. ConclusionUltrasound is the preferred method for the diagnosis of GA because of its convenience, although the diagnostic accuracy is still not good and more efforts should be done.
ObjectiveTo summarize the progress and challenges in the research of gallbladder cancer organoid, and explore the possible solution strategies. MethodThe literature relevant to the researches of gallbladder cancer organoid at home and abroad in recent years was reviewed. ResultsThe research of gallbladder cancer organoid was in its infancy. The gallbladder cancer organoid was mainly constructed from surgically resected gallbladder cancer tissues. Now the research of gallbladder cancer organoid had made some progress, such as on the pathogenesis and drug screening of gallbladder cancer. ConclusionsThe study on gallbladder cancer organoid can further understand the gallbladder cancer and help to speed up the update of diagnosis and treatment plan. However, the model of gallbladder cancer organoid is facing the challenges such as low construction success rate. The experience gained from organoids research in other diseases is worthy of reference.