Molecular Pathology of Gallbladder Cancer
Gallbladder cancer is relatively rare worldwide, but constitutes an important health problem in certain parts of the globe. In Chile, it is the leading cause of cancer deaths among women. The reasons for this stark geographic variation in the incidence of GBC is not well understood, but attributed to both genetic as well as environmental factors. Perhaps more so than any other organ, the association of inflammation/injury with cancer of the gallbladder is very evident: Gallstones, infections, and inflammation secondary to anomalies of the distal biliary tract are well-established causes of cancerous transformation of GB epithelium. While most GBC arise in association with flat intraepithelial neoplasia, and their precursors of metaplasia, it is being recognized increasingly that an adenoma–carcinoma sequence (invasive cancers arising from mass-forming preinvasive neoplasia) also in play in a small percentage of cases. A variety of molecular and genetic alterations have been identified in GBC in the past decade, some associated with prognosis as well. In the ensuing chapter, a detailed analysis of the current literature on the molecular/genetic carcinogenesis in the gallbladder is provided. These alterations have the potential to serve not only as diagnostic and prognostic markers, but as potential targets for the management of these tumors which often show dismal prognosis otherwise.
KeywordsGallbladder Cancer Chronic Cholecystitis Biliary Tract Carcinoma Maspin Expression Gallbladder Epithelium
- Paigen BC, Carey MC. Gallstones. In: King RA, editor. Rotter JI. Motulsky AG (eds): Genetic basis of common diseases. Oxford University Press; 2002. p. 298–335.Google Scholar