[Histogenesis of gallbladder cancer with special reference to metaplastic changes and distribution of various mucins...

In order to study the histogenesis of gallbladder cancer, metaplastic changes and dysplasia in the mucosal epithelium were investigated in 30 cases of gallbladder cancer and 300 cases of chronic cholecystitis. Intestinal metaplasia was observed more frequently in the cases of cancer, both in cancerous and non-cancerous tissues, than those of chronic cholecystitis. In addition, CPS III type of mucin, which is preferably demonstrated in the pyloric glands, was observed in the tumor cells of 50% of cancers. Thus, gastric metaplasia as well as intestinal metaplasia seems to be important as a predisposing lesion to gallbladder cancer. By means of reconstruction method carried out on the specimens of cancer, multifocal gradual transition among metaplasia, dysplasia and cancer was observed and dysplasia is an important step in cancer development. As for mucin secretion, the rate of sialomucin-containing cells was notably high in the lesions of dysplasia and cancer, increasing in intensity in this order, accompanied with positive CEA. The results of the present study support the hypothesis that cancer arises from such pre-existing mucosal lesions as metaplasia and dysplasia.