title: Xanthogranulomatous cholecystitis: a clinicopathological study of its association with gallbladder carcinoma.
abstract: OBJECTIVE
  To determine the distribution of macrophages (MΦ) in both xanthogranulomatous cholecystitis (XGC) and gallbladder carcinoma (GBC) and to analyze the association between XGC and GBC.
  
  
  METHODS
  From January 2009 to June 2011, 110 patients with gallbladder diseases, including 35 with GBC, 45 with XGC and 30 with chronic cholecystitis (CC), were enrolled. Immunohistochemistry stain and real-time polymerase chain reaction using oncogenes (BCL-2, c-Myc) and anti-oncogene genes (p53, p21) were performed, serum expressions of tumor marker (CA19-9, CA724 and CA242) were also conducted. MΦ were used to determine their potential role in the carcinogenesis of GBC.
  
  
  RESULTS
  BCL-2 and c-Myc expressions gradually increased among CC, XGC and GBC (P = 0.032 and P = 0.020, respectively); while p53 and p21 were similar in the three groups (P = 0.167 and P = 0.122, respectively). Serum BCL-2 and c-Myc were significantly correlated with their tissue levels; in terms of serum tumor markers, which gradually increased among CC, XGC and GBC, however, CA242 and CA724 were both negative in XGC but positive in GBC. Furthermore, gradually increasing MΦ counts were observed among CC, XGC and GBC groups; c-Myc and CA724 were independent predictors for the differentiation of XGC and GBC.
  
  
  CONCLUSIONS
  XGC is an uncommon inflammatory condition distinct from CC and may be associated with the precancerous nature of GBC for its upregulated oncogenes and MΦ biology. c-Myc and CA724 were independent predictors for the differentiation of XGC and GBC.
authors.affiliation: Department of General Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Peng Yuan
authors.initials: PY
authors.lastname: Zhuang
authors.forename: Ming Jie
authors.initials: MJ
authors.lastname: Zhu
authors.forename: Jian Dong
authors.initials: JD
authors.lastname: Wang
authors.forename: Xue Ping
authors.initials: XP
authors.lastname: Zhou
authors.forename: Zhi Wei
authors.initials: ZW
authors.lastname: Quan
authors.forename: Jun
authors.initials: J
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D018395:CA-19-9 Antigen / Q000097:blood; D002277:Carcinoma / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology; D002452:Cell Count; D002764:Cholecystitis / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology; D002908:Chronic Disease; D016001:Confidence Intervals; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000235:genetics / Q000378:metabolism; D005260:Female; D005706:Gallbladder Neoplasms / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology; D015870:Gene Expression; D006099:Granuloma / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D008264:Macrophages; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics / Q000378:metabolism; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics / Q000378:metabolism; D012372:ROC Curve; D016159:Tumor Suppressor Protein p53 / Q000235:genetics / Q000378:metabolism; D014973:Xanthomatosis / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; D019253:Proto-Oncogene Proteins c-bcl-2; D016271:Proto-Oncogene Proteins c-myc; D016159:Tumor Suppressor Protein p53