What to pay attention to when diagnosing gallbladder cancer

Primary gallbladder cancer is the most common type of malignant tumor of the biliary tract, and its incidence has been increasing in recent years. Due to the lack of specific clinical manifestations, once discovered, it is usually in the middle or late stages, with extremely poor efficacy and prognosis, and the 5-year survival rate is only less than 5%. Therefore, early diagnosis is very important.

(1) There are no specific symptoms in the early stage. There may be symptoms of gallstones such as pain and discomfort in the right upper abdomen, anorexia, and indigestion. More than half of the patients have a history of biliary colic or acute cholecystitis; physical examination may show signs of cholecystitis and biliary colic;

(2) Laboratory examination: The detection of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in serum and bile both have a certain positive rate, which is helpful for early diagnosis. In particular, the positive rate of CA19-9 can reach 81.3%, but the specificity of the two is poor.

(3) Imaging examination: B-ultrasound examination is the first choice. If the patient is found to have blurred gallbladder outline, gallbladder atrophy, local thickening or irregularity of the gallbladder wall, porcelain gallbladder, or protruding lesions of the gallbladder (diameter > 1 cm), an upper abdominal CT scan combined with tumor marker examination should be performed in a timely manner for careful screening and follow-up.