[Natural history of gallbladder cancer. Analysis of biopsy specimens].
BACKGROUND
There is scarcity of knowledge about the development of gallbladder cancer.


OBJECTIVE
To study the features of development and progression of gallbladder cancer.


METHODS
Review of histopathological studies of gallbladder obtained in 25,971 cholecytectomies performed in patients aged 45+/- 16 years, 79% females, between 1993 and 2004. Among these, 210 had a dysplasia not associated to cancer and 1,039 had a gallbladder cancer Clinical and morphological parameters of preneoplastic and neoplastic lesions were analyzed. Ninety five percent of patients were followed.


RESULTS
All cases of dysplasia were incidental findings. Metaplasia, dysplasia and carcinoma in situ were present in the adjacent mucosa in 66%, 81% y 69% of gallbladder carcinomas, respectively. Twenty five percent of gallbladders studied were carcinomas (mucous carcinoma in 18% and muscular carcinoma in 7%). Ninety two percent of cases had chronic inflammation in the gallbladder wall. Seventy two percent of mucous carcinomas were not detected macroscopically Five years survival of mucous carcinoma was 92%. There was an association between the intensity of the lesion and the age of the patients. The age difference between chronic cholecystitis and gallbladder cancer was 11 years for women and nine for men.


CONCLUSIONS
From a morphological standpoint, the period in which a dysplasia becomes a carcinoma is approximately 10 years.
Servicio de Anatomía Patológica, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago de Chile, Chile. iroa@alemana.cl
Iván
I
Roa E
Sergio
S
Muñoz N
Gilda
G
Ibacache S
Xabier de
Xd
Aretxabala U
D001706:Biopsy; D002277:Carcinoma / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005704:Gallbladder / Q000473:pathology*; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011230:Precancerous Conditions / Q000473:pathology*; D013997:Time Factors