[Histogenesis of metaplastic and cancerous changes in the gallbladder]

Six hundred cases of resected gallbladder were histologically investigated by serial sections for intestinal (goblet cell) metaplasia and pseudopyloric gland metaplasia. Intestinal metaplasia was found at the rates of 4.8% and 30.0% in the stone-free cases and those with bile duct stone, respectively. It was found at rates of 52.0% in cases of gallbladder carcinoma. On the other hand, goblet cell-like cells were found at the rates of 35.0% and 26.0% in the tissues of carcinoma and dysplasia, respectively. Although the normal epithelium of the gallbladder has sulfomucin, goblet cells contain sialomucin. The ratio of sialomucin-containing cells increased in dysplasia and carcinoma. Pseudopyloric gland metaplasia was found at the rates of 46.0 and 70.0% in the stone-free cases and those with bile duct stone, respectively. However, it should be considered that this change has less of a relationship with the bases of carcinogenesis than with those of intestinal metaplasia.