Review Article

Gallbladder Cancer in the 21st Century

Table 1

Summary of the major genes implicated in gallbladder carcinogenesis as available in the published literature (2000–present).

GeneExpression in GBCTissues of comparisonAdditional informationReference(s)

OncogeneKRASHigher (10–67%)Adenoma (0%)Marker of GBC in PBM
No correlation with stage, histology, and survival
[23, 26, 29]
EGFRHigher (63.4%)Dysplasia (71.4%)
Hyperplasia (15.4%)
Normal (0%)
[23]
HER-2/neu (ERBB2)Higher (16–64%)Carcinoma in situ (0%)
Gallstones (0%)
Marker of metastatic disease (70%)
Marker of poor prognosis (10x mortality)
[23, 30, 31]

Tumor suppressorTP53Higher (58.3–100%)Adenoma (10–20%)
Normal (0%)
Unknown relation to prognosis
More prominent with poor differentiation
[23, 32]
P16Lower (48.8%)Adenoma (100%)
Chronic cholecystitis (100%)
Related to poorer prognosis
Negative correlation with cyclin D1
[33]
Fragile histidine triad (FHIT)Lower NormalEarly change in carcinogenesis[26]
RetinoblastomaLower (58.5%)Adenoma (100%)
Cholecystitis (100%)
Causes cell proliferation, apoptosis, and developmental defects[33]
VHLLower (48.1%)Peritumoral tissue (80.4%)
Polyps (80%)
Chronic cholecystitis (88.6%)
Marker progression, biological behavior, and prognosis[34]

Adhesion molecules and mucinsCadherinsHigher (N-cadherin 55%; P-cadherin 53%)NoneAssociated with large tumor size, invasion, and node metastases[35]
MUC1Higher (78%)Normal tissue (absent)Higher expression in more advanced tumours; poor survival[36]
Erythrocyte complement receptor 1 (CR1)LowerChronic cholecystitis
Cholelithiasis
Normal
Role under investigation[23]

AngiogenesisThrombospondin-1Higher (74.5%)Normal (0%)
T1 cancer (0%)
Associated with venous involvement
Predictor of vascular involvement and nodal metastases
[23]
Cyclooxygenase-2 Higher (59.2–71.9%)Normal (0–25%)
Dysplasia (70.3%)
Associated with poor prognosis, mean survival, and tumor progression[23, 26]
VEGF-AHigher (81%)Chronic cholecystitis (5.1%)Expression related to histologic grade, TNM stage, and prognosis[37]

Cell cycle regulatorsCyclin EHigher (33%)Adenoma (12.5%)[23]
Cyclin D1 Higher (41–68.3%)Adenoma (57.1–67%)
Chronic cholecystitis (7.1%)
Normal (0%)
Marker of lymphatic/venous involvement and lymph node metastases[23, 33]
P27Kip1Lower (43–65%)None[23]

ApoptosisCaspasesHigher (95%; caspase 3; 77%; caspases 6 and 8)NoneHigher extent apoptosis in grade II/III GBC compared with grade I/dysplasia [23]
Bcl-2Higher (34.7%)