title: Diagnostic imaging of early gallbladder cancer: retrospective study of 53 cases.
abstract: To diagnose early gallbladder carcinoma is difficult but essential to improve the survival of the patients with this cancer. Fifty-three early gallbladder cancers were macroscopically divided into protruding and flat types. The diagnostic devises [ultrasonography (US), computed tomography (CT), and drip infusion cholangiography (DIC)] were compared for their ability of early 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. Carcinoma tended to be missed when gallstones were present. Preoperative diagnosis of the flat type was difficult. Tumor location did not always correlate with the preoperative diagnosis. Of the misdiagnosed cases of the protruding type, half were missed with US and CT and were not visualized clearly by DIC. Among the flat type cancers, only three had no abnormal findings by diagnostic 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 suspicious of gallbladder cancer. Cytology and p53 expression may be useful for the intraoperative diagnosis, and a combination of diagnostic methods is important.
authors.affiliation: First Department of Surgery, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Onoyama
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Takada
authors.forename: T
authors.initials: T
authors.lastname: Urakawa
authors.forename: T
authors.initials: T
authors.lastname: Ajiki
authors.forename: I
authors.initials: I
authors.lastname: Yamada
authors.forename: T
authors.initials: T
authors.lastname: Fujita
authors.forename: Y
authors.initials: Y
authors.lastname: Saitoh
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D016009:Chi-Square Distribution; D002758:Cholangiography; D002764:Cholecystitis / Q000175:diagnosis; D002769:Cholelithiasis / Q000175:diagnosis; D003581:Cytodiagnosis; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D014463:Ultrasonography
chemical_list: D016159:Tumor Suppressor Protein p53