The Epidemiological Investigation And Immunohistochemistry Study On The Relationship Between Gallbladder Carcinoma And Gallbladder Stones

BackgroundCarcinoma of Gallbladder(GBC) is a kind of malignant tumor with a rapid progress and poor prognosis.There still been an uncertain etiology study about GBC.We consider large ranges of risk factors for GBC such as gallbladder stones(GS).There were many same features epidemiology between GBC and GS in epidemiology such as sex distribution, age distribution, the correlation with the diabetes.The discussion on the relations between size,number,symptomatic of gallbladder stone and GBC have not come to a closure.This case-control study was designed to present the risk factors for GBC and the relation between GS and GBC.And as a new step to explore the contribution of P53,c-erbB-2and Bcl-2on the pathway from GS to GBC,the study proposed an immunohistochemistry study.MethodsThe study consisted of two parts.The first part was a case-control study.The case group included all the GBC cases (n=114) in the PUMCH from1990to2010.The control group contained135healthy physical examination reports from the physical examination centre of PUMCH in2010.The comparison between GBC and GS was used for the examination of relationship between GS and GBC.Further, the other case-control comparison was chosen as a group of all cases of GBC companied by GS in the PUMCH from1990-2010(n=69) vs. a group of54GS cases in the recent2years from PUMCH. This pair of comparison was used to explore the relationship between characteristics of GS and GBC.The second part of the present study was the immunohistochemistry study. Five pathological paraffin blocks were selected from the group of GBC companied by long-term GS (more than5years) and5samples of GS (more than5years) were chosen as a control group, the examination of expression of P53, Bcl-2and c-erbB-2was conducted. The differences of their expression between the two groups was used to reveal the effects of the genes in the pathway from GS to GBC.Resultsthe case-control study suggested that1)there was strong relationship between GS and GBC, OR=10.86, p<0.05;2) Gender was another risk factor, females were more likely to develop GBC than males, OR=2.06, p<0.05;3) obesity was related to GS as well;4) the number of stones was a marginally significant risk factor of GBC, p=0.069.The risk of GBC increased as the increase of number of stones;5) GS companied by cholecystitis was another risk factor, OR=2.25,p=0.04.6)Gender was still a risk factor of GBC in the GS patients, OR=2.38, p=0.04.the immunohistochemistry study revealed that there were extra high expression of P53and Her-2in the group of GBC companied by GS, whereas no significant difference was found for Bcl-2in the two groups.Conclusion:GS was a significant risk factor of GBC. Female, senior age, suffering from multiple gallbladder stones and accompanied by chronic cholecystitis were at special risk to develop GBC. In addition, the expression of P53and Her-2were excessively high in the samples of GBC accompanied by GS. This was a preliminary attempt to explore the molecular pathway from GS to GBC. Further research is needed.