Preneoplastic lesions in gallbladder cancer
Gallbladder cancer mostly grows from flat dysplasia rather than from polyps: dysplasia and carcinoma in situ sit next to four in five cancers, adenomas are rare, and the age gap between dysplasia and invasive cancer suggests about ten years of progression.
Overview
A review of the epithelial lesions involved in gallbladder carcinogenesis, dysplasia and adenomas, which represent two biologically distinct models. Dysplasia progresses to carcinoma in situ and then invasion; over 80% of invasive gallbladder cancers have areas adjacent to carcinoma in situ and epithelial dysplasia. Adenomas are uncommon (0.14% of cholecystectomies) and adenomatous remnants are found next to fewer than 3% of early carcinomas, suggesting the limited importance of that pathway.
Epithelial dysplasia unassociated with cancer is seen in about 1% of cholecystectomies for symptomatic stones. Metaplasia, dysplasia and carcinoma in situ are present in the mucosa adjacent to cancer in 66%, 81.3% and 69% of cases. The average ages of patients with isolated dysplasia (51.9 years), early carcinoma (56.8) and advanced carcinoma (62.9) form a gradient that suggests progression over roughly 10 years.
- Metaplasia, dysplasia and carcinoma in situ adjacent to cancer in 66%, 81.3% and 69% of cases.
- Adenomas in 0.14% of cholecystectomies; adenomatous remnants next to fewer than 3% of early carcinomas.
- Mean ages 51.9 (dysplasia), 56.8 (early carcinoma), 62.9 (advanced carcinoma): about a 10-year sequence.
The morphological argument that gallbladder cancer is a flat-dysplasia disease, which is why it is invisible on imaging until late and why prevention rests on removing the diseased gallbladder rather than on polyp surveillance alone.
- Chilean cholecystectomy series; the adenoma fraction may differ elsewhere.
- Age gradients estimate, rather than observe, progression time.
Similar pages
not linked directly; found by shared links- Key paperIntracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are at least 1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases
Shares Intracholecystic papillary-tubular neoplasm (ICPN), Dysplasia (pre-cancerous change), Gallbladder cancer.
- Key paperPreneoplastic lesions and gallbladder cancer: an estimate of the period required for progression
Shares Metaplasia, dysplasia, carcinoma in situ: the flat route to gallbladder cancer, Dysplasia (pre-cancerous change), Gallbladder cancer.
- Key paperGenomic characterization of co-existing neoplasia and carcinoma lesions reveals distinct evolutionary paths of gallbladder cancer
Shares Metaplasia, dysplasia, carcinoma in situ: the flat route to gallbladder cancer, Dysplasia (pre-cancerous change), Gallbladder cancer.
- TargetCTNNB1
Shares Intracholecystic papillary-tubular neoplasm (ICPN), Metaplasia, dysplasia, carcinoma in situ: the flat route to gallbladder cancer, Gallbladder cancer.
- TermCarcinoma in situ (CIS)
Shares Dysplasia (pre-cancerous change), Gallbladder cancer.
- CancerCarcinoma in situ and dysplasia of the gallbladder
Shares Dysplasia (pre-cancerous change), Gallbladder cancer.