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Gallbladder cancer Diagnosis

Gallbladder cancer (carcinoma of gallbladder) is diagnosed by some tests include as follow:

1. B-ultrasonography: B-ultrasonography is simple non-invasive, can be repeatedly used, and their diagnostic accuracy rate was 75% ~ 82.1%, should be the preferred method of diagnosis for Gallbladder cancer . However, B-(US) vulnerable wall hypertrophy, the effects of intestinal pneumatosis and are not easily determine the type filled with stones and gallbladder wall atrophy type situation. In recent years, the use of EUS (endoscopic ultrasonography) method, can solve the above-mentioned US issues. EUS with high-frequency probes are only 12 stomach or refers to the intestinal wall of the gall bladder scan, which greatly improved the detection rate of gallbladder cancer, and to further determine the structure of the gallbladder wall on each floor by the extent of tumor infiltration. so people will EUS as further US inspection methods to determine accurately. whether US or EUS, the early gallbladder ultrasound images mainly for elevated type lesions and the limitations of wall hypertrophy, there are two hybrid.

2.CT scan: CT scan of the gallbladder sensitivity of 50%, especially in the early diagnosis of gallbladder cancer is lower than US and EUS. CT image change can be divided into three types:

  • wall type: limited or diffuse gallbladder wall irregularity thickening.
  • nodular: papillary nodules protruding into the cavity from the gallbladder wall, gallbladder cavity exists.
  • real change: a result of gallbladder wall thickening by tumor infiltration combined with extensive cavity formation of substantial mass filling cancer. If the tumor violations of the liver or the hepatic portal, pancreatic lymph node metastasis, more than can be displayed in the CT images.

    3. Color Doppler flow imaging: in the gallbladder wall and the inner mass to the abnormal blood flow, high-speed signal is distinguished from primary malignant gallbladder gallbladder gallbladder metastatic carcinoma or a benign tumor of the important signs.

    4. ERCP: report ERCP was able to show that the diagnosis rate of gallbladder gallbladder up to 70% ~ 90%, but the check-ER-CP can not show more than half of the gallbladder. Its image can be divided into three situations:

  • gallbladder bile duct imaging is good: most of the early lesions, can be seen a typical case of gallbladder filling defect or associated with the wall, basement uplift wider lesions. gallbladder wall infiltration can be seen from the rigid wall or deformation.
  • do not develop gallbladder: an advanced cases.
  • do not develop gallbladder and liver or extrahepatic bile duct stenosis: filling defect, and the top of biliary obstruction is a late signs of expansion.

    5. Cytology: cytology test has a direct or biopsy samples of cancer cells to find two kinds of bile. Direct biopsy methods: B-ultrasound guided puncture of gallbladder disease, PTCCS (percutaneous endoscopic examination of gallbladder), such as laparoscopic method. take way more bile, such as ERCP extraction of bile, B ultrasound-guided puncture of the gallbladder, PTCD, biliary tract, such as cluster mirror. cytology literature reports of the positive rate is not high, but the combination of imaging methods, still more than half of patients with gallbladder cancer diagnosis.

    6. Tumor markers: CEA in the tumor specimens, immunohistochemical study, the gallbladder of the CEA-positive rate was 100%. Advanced gallbladder carcinoma patients with CEA values of up to 9.6ng/ml, but no value in early diagnosis . CA19-9, CA125, CA15-3 and so tumor carbohydrate antigen only is accessory examination for gallbladder.

    • Submitted by Health Studies on Fri, 04/17/2009 - 18:24
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