What are the examination methods for 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. Gallbladder cancer is relatively rare clinically. According to domestic textbooks, it only accounts for about 1% of all cancers. For a long time, it has not attracted people's attention. In order to reduce the incidence of gallbladder cancer, we humans should master the examination methods of gallbladder cancer:

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, and it is not easy to determine the condition of gallbladder wall filled with stones and atrophic gallbladder wall. 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 determine 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 cyst wall hypertrophy. There are also mixed types of the two.

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: limited 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 node metastasis, it can often be shown 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 that can show the gallbladder can reach 73% 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 bulges 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. Cytological examination:

1. Cytological examination includes direct biopsy or bile extraction to find cancer cells. There are two direct biopsy methods: B-ultrasound-guided gallbladder puncture PTCCS (percutaneous cholecystoscopy) and laparoscopic bile extraction. There are more methods such as ERCP-guided gallbladder puncture PTCD choledochoscopy. Although the positive rate of cytological examination reported in the literature is not high, it can still be combined with imaging examination methods to diagnose more than half of gallbladder cancer patients.

2. 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 worthless in early diagnosis. Tumor sugar chain antigens such as CA19-9CA125CA15-3 can only be used as auxiliary examinations for gallbladder cancer.

3. Extrahepatic bile duct cancer rarely metastasizes in the early stage, and 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 is metastasis to the lymph nodes in the liver hilar region, and it can also spread to lymph nodes in other parts of the abdominal cavity. Blood metastasis is generally rare unless it is a late-stage 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 is prone to invade the portal vein, forming cancerous blood clots, which can lead to liver metastasis. It can also metastasize to adjacent organs such as the pancreas and gallbladder.

The above is the examination method for gallbladder cancer. Expert Tips: If your health shows symptoms of disease, you can choose the appropriate treatment according to your symptoms, but do not delay diagnosis, and do not let your life be ruined in hesitation. You should go to a regular hospital for medical 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. Believe in miracles, and wish you health, happiness, and joy!

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