Yokoyama N, Watanabe H, Ajioka Y, Nishikura K, Date K, Kijima H, Shirai Y, Hatakeyama K
Department of Pathology, Niigata University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1998 Oct;99(10):687-95.
Earlier evidence suggests that gallbladder carcinoma (GBC) has three carcinogenic pathways; de novo development; adenoma-carcinoma sequence; and hyperplasia-carcinoma sequence associated with an anomalous arrangement of the pancreaticobiliary duct (AAPBD). We review gene abnormalities in GBC reported to date. p53 mutation and its protein overexpression are frequently observed in de novo carcinoma and GBC with AAPBD, but never found in carcinoma with adenoma. The incidence of K-ras codon 12 mutation in GBCs with AAPBD is significantly higher than that in the other types. Mutation of K-ras is never detected in carcinoma with adenoma. These findings suggest that diverse genetic pathways may exist in gallbladder carcinogenesis and reflect morphologic variations.
早期证据表明，胆囊癌（GBC）有三种致癌途径：新发；腺瘤-癌序列；以及与胰胆管异常排列（AAPBD）相关的增生-癌序列。我们回顾了迄今为止报道的GBC中的基因异常情况。p53突变及其蛋白过表达在新发癌和伴有AAPBD的GBC中经常观察到，但在伴有腺瘤的癌中从未发现。伴有AAPBD的GBC中K-ras密码子12突变的发生率明显高于其他类型。在伴有腺瘤的癌中从未检测到K-ras突变。这些发现表明，胆囊癌发生过程中可能存在多种遗传途径，并反映了形态学变异。
