Diagnostic Strategies for Early Diagnosis

Strategies for early detection of gallbladder cancer are not always easy. Symptoms reported in gallbladder cancer patients include abdominal pain, jaundice, nausea, vomiting, and weight loss. However, these symptoms rarely occur in early gallbladder cancer, and many of the symptoms are found in advanced gallbladder cancer. Risk factors for the development of gallbladder cancer include pancreaticobiliary maljunction (PBM), gallbladder stone, porcelain gallbladder, infection, and adenomyomatosis. In particular, PBM without bile duct dilatation is considered a risk factor for the development of gallbladder cancer, and diagnosing PBM can be an important strategy for early detection of gallbladder cancer. Diagnosis of uniform gallbladder wall thickness by TUS (transabdominal ultrasonography) makes it possible to directly depict PBM in some es. Also, measurement of arterial blood flow velocity along the gallbladder wall by color Doppler flow imaging analysis can contribute to early diagnosis of gallbladder cancer and diagnosis of PBM. In Japan, in view of the risk of dissemination, biopsy using EUS-FNA is not recommended for patients with operable gallbladder cancer. Tumor markers capable of diagnosing early gallbladder cancer have not been developed at present and appearance of useful biomarkers for early detection of gallbladder cancer is eagerly awaited.