How is gallbladder cancer diagnosed?

With the progress of the times, people's living standards are getting higher and higher. While you are enjoying life with your family, have you ever thought about paying attention to some cancers? Although modern technology is advanced, due to the hidden nature of gallbladder cancer, the symptoms of early cancer patients are extremely subtle. Clinically, most gallbladder cancer patients have obvious symptoms in the middle and late stages. Here, we remind our friends that even if you are not sick, you should pay attention to it. Even if you don't consider yourself, you should consider your family. The health of your family is your own health.

1. Ultrasound examination:

Ultrasound is a non-invasive examination method. It is simple, non-destructive and can be used repeatedly. Its diagnostic accuracy rate is 75% to 82.1%. It should be the first choice. Its basic characteristics are irregular thickening of the gallbladder wall and echogenic masses with fixed positions in the cavity without acoustic shadows. It should be the first choice. Percutaneous transhepatic cholangiography (PTC) and retrograde pancreaticocholangiography (ERCP) may show irregular filling defects at the bottom of the gallbladder; or the gallbladder is not visualized; or the common bile duct or right hepatic duct is narrowed or displaced due to external compression. The CT diagnosis rate is about 60%. When performing ERCP and PTC, bile can be collected for cytological examination at the same time. Direct cholecystography under the guidance of X-ray or B-ultrasound can be performed through the skin, with success rates of 85% and more than 95% respectively; in addition, the gallbladder wall can be punctured to obtain biopsy tissue for cytological examination, with a diagnostic accuracy rate of about 85%. Laparoscopic examination can detect tumor nodules, and biopsy can be performed to make a cytological or histological diagnosis. The diagnostic accuracy of abdominal artery angiography is about 70% to 80%, and it is possible to find early-stage cancer. Its manifestation is the widening, uneven thickness or interruption of the gallbladder artery.

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 thickness 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 hilar pancreatic head lymph node metastasis, it can often be displayed under CT images.

3. Color Doppler blood flow imaging:

Domestic literature reports that abnormal high-speed arterial blood flow signals detected in gallbladder masses and walls are important features that distinguish primary malignant gallbladder tumors from gallbladder metastatic cancer or benign gallbladder masses.

4. ERCP:

Some people report 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) Good visualization of the gallbladder and bile duct: Most of these are early-stage lesions. Typical cases show gallbladder filling defects or bulges connected to the cyst wall with a wide base. Infiltration of the gallbladder wall may show stiffness or deformation of the cyst wall.

(2) Gallbladder not visualized: mostly in 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 signs

5. Cytological examination:

Cytological examination includes direct biopsy or bile extraction to search for cancer cells. There are two direct biopsy methods: B-ultrasound-guided gallbladder puncture PTCCS (percutaneous cholecystoscopy) and laparoscopic methods for taking bile. There are more methods such as bile extraction under ERCP, B-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 diagnosed in more than half of gallbladder cancer patients when combined with imaging examination methods.

6. Tumor markers:

In the report of CEA immunohistochemistry study of tumor specimens, the CEA positivity rate of gallbladder cancer was 100%. The serum CEA value of patients with advanced gallbladder cancer can reach 9.6ng/ml, but it is worthless in early diagnosis. Tumor sugar chain antigens such as CA19-9CA125CA15-3 can only be used as auxiliary examinations for gallbladder cancer.

The above is a brief introduction to "How is gallbladder cancer diagnosed?" For people who are related to the pathogenic factors of gallbladder cancer, it is recommended to take preventive measures for gallbladder cancer and receive specific treatment according to the doctor's instructions. I hope that patients can recover soon! If you have other questions about gallbladder cancer, please consult our experts online or call for consultation.

Gallbladder cancer http://www..com.cn/zhongliu/dna/