Gallbladder cancer blood test items

Patients with bile duct cancer lack specific clinical manifestations, and most are misdiagnosed as having gallstones, cholecystitis, etc. Some patients are already in the advanced stage when they experience symptoms such as right upper abdominal pain, right upper abdominal mass, or anemia. Understanding the examination methods for gallbladder cancer can help patients with bile duct cancer detect the disease early.

The main examination methods for bile duct cancer include:

1. Ultrasound examination: B-ultrasound examination is simple, non-destructive and can be used repeatedly. Its diagnostic accuracy rate is 75% to 82.1%. It should be the preferred examination method. However, B-ultrasound (US) is easily affected by abdominal wall hypertrophy and intestinal gas accumulation, and it is not easy to judge the gallbladder wall conditions of stone-filled and atrophic types. In recent years, people have adopted EUS (endoscopic ultrasound) to better solve the above problems of US. EUS uses a high-frequency probe to scan the gallbladder only through the stomach or duodenal wall, which greatly improves the detection rate of gallbladder cancer and can further judge the degree of tumor infiltration of each layer of the gallbladder wall. Therefore, people use EUS as a further accurate judgment method after US examination. Regardless of US or EUS, the ultrasound images of early gallbladder cancer are mainly manifested as protruding lesions and localized cysts. There are also mixed types of wall thickening. 2. CT scan: The sensitivity of CT scan for gallbladder cancer is 50%, especially for the diagnosis of early gallbladder cancer, which is not as good as US and EUS. CT image changes can be divided into three types: ① Wall thickening type: localized or diffuse irregular thickening of the gallbladder wall ② Nodular type: papillary nodules protrude from the gallbladder wall into the gallbladder cavity ③ Solid type: due to the extensive infiltration and thickening of the gallbladder wall by the tumor and the filling of the intracavitary mass to form a substantial mass. If the tumor invades the liver or the hepatic hilum and pancreatic head lymph nodes, metastasis can often be displayed under CT images. 3. Color Doppler blood flow imaging: Domestic literature reports that the abnormal high-speed arterial blood flow signal detected in the gallbladder mass and wall is an important feature that distinguishes primary malignant tumors of the gallbladder from metastatic cancer or benign gallbladder masses.

4. ERCP: Some people say that the diagnosis rate of ERCP for gallbladder cancer can reach 70% to 90%. However, more than half of ER-CP examinations cannot show the gallbladder. The imaging manifestations can be divided into three situations: (1) The gallbladder and bile duct are well visualized: mostly early lesions. Typical cases can show gallbladder filling defects or lesions with a wide base connected to the cyst wall. Infiltration of the gallbladder wall can show cyst wall stiffness or deformation. (2) The gallbladder is not visualized: mostly middle and late stage cases. (3) The gallbladder is not visualized and there is hepatic or extrahepatic bile duct stenosis: filling defects and dilatation of the hepatic bile duct above the obstruction are already late stage signs. 5. Cytology: Cytology examination includes direct biopsy or extraction of bile to find cancer cells. There are two direct biopsy methods: : Ultrasound-guided gallbladder puncture PTCCS (percutaneous cholecystoscopy) There are more methods to collect bile through laparoscopy, such as extracting bile under ERCP, ultrasound-guided gallbladder puncture PTCD, choledochoscopy, etc. Although the positive rate of cytological examination reported in the literature is not high, it can still be used to diagnose more than half of gallbladder cancer patients in combination with imaging examination methods. 6. Tumor markers: In the report of CEA immunohistochemistry research on tumor specimens, the CEA positivity rate of gallbladder cancer is 100%. The serum CEA value of patients with advanced gallbladder cancer can reach 9.6ng/ml, but it is of no value in early diagnosis. Tumor sugar chain antigens such as CA19-9CA125CA15-3 can only be used as auxiliary examinations for gallbladder cancer.

Extrahepatic bile duct cancer rarely metastasizes in the early stages, and the disease mainly spreads directly by infiltrating upward and downward along the bile duct wall. For example, upper hepatic duct cancer can directly invade the liver, which is more common than middle and lower cancer. The most common metastasis is lymph node metastasis in the liver hilar region, but it can also spread to lymph nodes in other parts of the abdominal cavity. Blood-borne metastasis is generally rare unless it is in the late stage of cancer. Among bile duct cancers in various parts of the body, liver metastasis is the most common, especially high-positioned bile duct cancer. Cancerous tissue can easily invade the portal vein and form cancerous blood clots, which can lead to liver metastasis and metastasis to nearby organs such as the pancreas and gallbladder.