What causes gallbladder cancer

In recent years, gallbladder cancer has become one of the major diseases that endangers society and human health, and it has brought great pain and distress to humans. In order to reduce the incidence of gallbladder cancer, we humans should understand the causes of gallbladder cancer:

1. The relationship between cholelithiasis and gallbladder cancer Patients with gallbladder cancer often have gallstones, with a combined rate of 70% to 80% in Europe and the United States, 58.8% in Japan, and 80% in my country. Gallbladder cancer often occurs in the neck of the gallbladder, which is easily hit by gallstones, and often occurs when the patient has suffered from gallstones for more than 10 years, so it is believed that gallstones are closely related to gallbladder cancer. For patients with gallstones larger than 3cm in diameter, the risk of gallbladder cancer is 10 times greater than that of patients with gallstones smaller than 1cm in diameter. Some people believe that gallstones contain carcinogenic factors, but there is a lack of definite evidence, and the incidence of gallbladder cancer in patients with cholelithiasis is only 1% to 2%. Therefore, it is not clear whether there is a clear causal relationship between gallstones and gallbladder cancer.

40% to 50% of patients with gallbladder cancer have chronic gallbladder inflammation. Some people studied the gallbladder resection specimens and found that the rate of atypical cell proliferation and malignant transformation was higher in the group with severe chronic gallbladder inflammation than in the group with mild chronic gallbladder inflammation; there was a high rate of intestinal metaplasia in non-cancerous areas; there was a tumor structure similar to intestinal epithelium in the cancerous lesion, so intestinal metaplasia was considered to be an important lesion for canceration. The occurrence of gallbladder cancer may be: normal gallbladder mucosa → chronic cholecystitis (including stones) → intestinal metaplasia → differentiated gallbladder cancer (intestinal type cancer) occurrence and development process.

2. The relationship between benign gallbladder polyps, adenomas and gallbladder cancer Sawyer reported 29 cases of benign gallbladder tumors, of which 4 were malignant. He reviewed the literature of the past 20 years and believed that gallbladder adenomas are precancerous lesions. Gallbladder adenomas are mostly solitary, pedunculated, and the canceration rate is about 10%. If combined with gallstones, the risk of canceration increases. Studies have found that those with a diameter of less than 12mm are mostly benign adenomas, while those with a diameter of more than 12mm are mostly malignant lesions. All carcinomas in situ and 19% of invasive carcinomas have adenomatous components, so it is believed that adenomas have the possibility of canceration.

3. The relationship between abnormal bile-pancreatic duct confluence and the incidence of gallbladder cancer Kinoshita and Nagata studied that when the common channel of the bile-pancreatic duct confluence exceeds 15mm, pancreaticobiliary reflux occurs, which is called abnormal bile-pancreatic confluence. Many authors have pointed out that abnormal bile-pancreatic duct confluence increases the incidence of gallbladder cancer. When the pancreaticobiliary duct confluence is malformed, the long-term reflux of pancreatic juice causes the gallbladder mucosa to be continuously destroyed and regenerated repeatedly, and cancer may occur in this process. It has been reported that ERCP examination found that 16% of patients with gallbladder cancer had combined pancreaticobiliary duct confluence malformation. Kimura et al. reported 96 cases of gallbladder cancer, which were confirmed by angiography in 65 cases of abnormal bile-pancreatic duct confluence. At the same time, 65 cases of abnormal bile-pancreatic confluence were observed, and 16.7% of them had combined gallbladder cancer. In the control group, 641 cases of normal bile-pancreatic duct confluence had a gallbladder cancer incidence of 8%. Another group reported that the incidence of gallbladder cancer was 25% in patients with abnormal bile-pancreatic duct confluence, and the incidence of gallbladder cancer was 1.9% in 635 cases in the normal confluence group.

4. Other factors In addition, Ritchie et al. reported that chronic ulcerative colitis is often associated with gallbladder cancer. The incidence of gallbladder cancer in patients with Mirizzi syndrome is increased, which may also be one of the causes. There are reports that the onset of gallbladder cancer is related to abnormalities of the cystic duct or congenital bile duct dilatation.

The above are the causes of gallbladder cancer. Expert Tips: If you have symptoms of disease, do not delay diagnosis and go to a regular hospital for treatment in time to avoid delaying the disease and causing serious consequences. If you have other questions, please consult our online experts or call for consultation.

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