Bojan Andrei, Foia Liliana Georgeta, Vladeanu Maria Cristina, Bararu Bojan Iris, Plesoianu Carmen, Plesoianu Alexandru, Pricop Catalin
Department of Surgical Sciences, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.
Department of Pathophysiology and Morpho-Functional Sciences, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.
Exp Ther Med. 2022 Jul 29;24(3):604. doi: 10.3892/etm.2022.11541. eCollection 2022 Sep.
The gallbladder undergoes different types of pathologies, ranging from inflammatory to preneoplasia and finally to malignant lesions. Gallbladder carcinoma can be highly invasive, and it is known that chronic inflammation of the gallbladder can lead to preneoplastic abnormalities and subsequently malignant phenotypes. Gallbladder neoplasia has a low incidence but is associated with a very poor prognosis. An early diagnosis is therefore extremely important in order to improve the prognosis of patients. Immunohistochemical markers of the mucin family can distinguish between different types of gallbladder lesions. Mucins are glycoproteins that can be attached to threonine residues that are -glycosylated (due to the hydroxyl group of this amino acid). Mucins are divided into two types: those that bind to the membrane, such as MUC1, and those that form gels or are secreted, such as MUC5AC. Various alterations in mucin expression have been revealed to be associated with the development of neoplasia, as they modulate cell growth, karyokinetic transformation, dedifferentiation, adhesion, invasion and immune surveillance. p53 is a tumor suppressor gene and is linked to the development of different types of neoplasia. The incidence of the p53 gene is variable in the pathophysiology of gallbladder cancer. Several studies have revealed an incidence of ~50% of the p53 gene in gallbladder tumors. Studying the immunohistochemical profile of mucins and the presence of different gene mutations in neoplastic lesions of the gallbladder and surrounding mucosa may contribute to the understanding of the pathophysiology of the disease and the mechanisms involved in tumor development, allowing the identification of patients at increased risk of developing neoplasia, thus leading to improved management.
胆囊会发生不同类型的病变，从炎症到癌前病变，最终发展为恶性病变。胆囊癌具有高度侵袭性，已知胆囊慢性炎症可导致癌前异常，进而发展为恶性表型。胆囊肿瘤发病率较低，但预后很差。因此，早期诊断对于改善患者预后极为重要。黏蛋白家族的免疫组化标志物可区分不同类型的胆囊病变。黏蛋白是一种糖蛋白，可附着于经O-糖基化修饰的苏氨酸残基上（由于该氨基酸的羟基）。黏蛋白分为两种类型：一种是与膜结合的，如MUC1；另一种是形成凝胶或分泌型的，如MUC5AC。已发现黏蛋白表达的各种改变与肿瘤形成有关，因为它们可调节细胞生长、有丝分裂转化、去分化、黏附、侵袭和免疫监视。p53是一种肿瘤抑制基因，与不同类型肿瘤的发生有关。p53基因在胆囊癌病理生理学中的发生率各不相同。多项研究表明，胆囊肿瘤中p53基因的发生率约为50%。研究黏蛋白的免疫组化特征以及胆囊及周围黏膜肿瘤性病变中不同基因突变的存在情况，可能有助于理解该疾病的病理生理学以及肿瘤发生所涉及的机制，从而识别出发生肿瘤风险增加的患者，进而改善治疗效果。
