| Because of lacking of specific symptom, it is hard to diagnosis the primary gallbladder carcinoma, many sufferer had been misdiagnosed and lost the opportunity to receive surgery and had a poor prognosis, overall , the 5-year survival is below 5%. Operation is only method in the cure of he primary gallbladder carcinoma. Thus, Preventive cholecystectomy turns to be a good resolvent for those premalignant lesions such as dysplasia. Rothenberg reported because of selective cholecystectomy in chronic cholecystitis, the risk of he primary gallbladder carcinoma declined 21. 5%. However, there is always a certain extent of risk associating with the operation which calls for a precise and reliable indication.Contracted cholecystitis, which refers to a macroscopically contracted gallbladder lesion with thickening of its wall and often full of gallstones, is very common in clinic. Its normal tissue is replaced by connective tissue in almost all wall layers. Pathological studies of contracted cholecystectomy showed that it might be a precursor lesion of gallbladder carcinoma.Telomerase has been found to play an important role in carcinogenesis.It is composed by HRT, HEEP1 and hTERT. The expression of telomerase is found in lots of malignant tumor such as liver carcinoma, gastric carcinoma and so on. Telomerase activity is dependent on hTERTupregulaion. hTERT is reliable and effective label for detecting malignant tumor including gallbladder carcinoma.We evaluated the expression of hTERT in 50 contracted cholecystitis in this study, and then discussed the relationships between hTERT expression and several clinicopathological agents such as patient' s gender and age, course of disease, thickness of gallbladder wall and diameter of gallstone. We hope to predict the malignancy potential of contracted cholecystitis, and find out an operational indication of preventive cholecystectomy.Material and methodsParaffin embedded tissues from 50 patients who had undergone cholecystectomy at our department for contracted cholecystitis were studied. We also observed 10 cases of chronic cholecystits (non-contracted cholecystitis) and 16 cases of primary gallbladder carcinoma(Nevin IK III). Expression of hTERT was detected by immunohistochemical S-P method with 1:100 dilution of hTERT. Positive and negative controls were designed.For each antibody, nuclei or cytoplasm stained brown were regarded as positive. At least 1000 epithelial cell were evaluated for hTERT staining. Statistical analysis: Spss 11.5 chi-square test.Results1. hTERT positivity in contracted cholecystitis 48.0% (24/50) was significantly higher than in chronic cholecystitisO%, lower than primary gallbladder carcinoma 87.5% (14/16) .2. The contracted cholecystitis patients who were older than 50 years had a significantly higher hTERT positivity 62. 1%( 18/29) than those under 50 years 28.6% (6/21) . Patients with a history of over 5 years had a significantly higher hTERT positivity 63. 2% (12/19) than those under 5 years 38. 7% (12/31) .Patients had his gallstone diameter over 1. 0cmhad a significantly higher hTERT positivity 64. 5% (20/31) than those diameter less than 1.0cm 21.5% (4/19) .No statistically significant association was found between hTERT expression data and gallbladder wall thickness and gender of patients.Conclusions1. The expression of hTERT in contracted cholecystitis significantly increased comparing with chronic cholecystitis(non-contracted).2. In contracted cholecystitis patients, we found the hTERT expression data correlated positively with those clinicopathological agents including patient' s age, course of disease, diameter of gallstone. No correlations were found between the hTERT expression and gallbladder wall thickness and gender of patients.
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