Diagnostic imaging of early gallbladder cancer: Retrospective study of 53 cases

Citation
H. Onoyama et al., Diagnostic imaging of early gallbladder cancer: Retrospective study of 53 cases, WORLD J SUR, 23(7), 1999, pp. 708-712
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
WORLD JOURNAL OF SURGERY
ISSN journal
0364-2313 → ACNP
Volume
23
Issue
7
Year of publication
1999
Pages
708 - 712
Database
ISI
SICI code
0364-2313(199907)23:7<708:DIOEGC>2.0.ZU;2-I
Abstract
To diagnose early gallbladder carcinoma is difficult but essential to impro ve the survival of the patients with this cancer. Fifty-three early gallbla dder cancers were macroscopically divided into protruding and bat types. Th e diagnostic devises [ultrasonography (US), computed tomography (CT), and d rip infusion cholangiography (DIC)] were compared for their ability of earl y detection. The specimens were examined cytologically for diagnosis during operation and the p53 protein was investigated. Thirty-three cases were of the protruding type, eighteen of the flat type, and two unclassified. Carc inoma tended to be missed when gallstones were present. Preoperative diagno sis of the bat type was difficult. Tumor location did not always correlate with the preoperative diagnosis. Of the misdiagnosed eases of the protrudin g type, half were missed with US and CT and were not visualized clearly by DIG. Among the hat type cancers, only three had no abnormal findings by dia gnostic imaging. Cytologic examination was effective, and p53 was expressed only in early carcinoma, not in adenoma or dysplasia. Even in the presence of gallstones or cholecystitis, any abnormal findings should make one susp icious of gallbladder cancer. Cytology and p53 expression may be useful for the intraoperative diagnosis, and a combination of diagnostic methods is i mportant.