Biomarkers in carcinoma of the gallbladder

Abstract

Background: Gallbladder carcinoma is an uncommon neoplasm that shows widespread geographic and gender variation. Complete surgical resection offers the only chance of cure, which is often not possible owing to the advanced stage of the disease at presentation. Early diagnosis is not yet possible despite advances in imaging modalities. A biomarker is a substance used as an indicator of a biological state. It is a characteristic that is measured objectively as an indicator of normal biological processes, pathological processes, or response to a therapeutic intervention. So far there is no known definite and specific marker of gallbladder cancer.

Objectives: To find out important biomarkers of carcinoma of the gallbladder that will help in early diagnosis of this disease.

Methods: A review of literature was carried out and important biomarkers were identified.

Results/conclusions: The list of the biomarkers that has been evaluated is exhaustive. Important ones are CA 242, CA 19-9, CA 15-3, CA 125, CA 50, CA 72-4, CEA, mucins, PCNA, RCAS1 and arginase. Important genetic and molecular ones are overexpression of p53, loss of heterozygosity (LOH) at chromosome 17p, LOH at chromosome 9p and 8q, mutations in the K-ras gene, LOH of chromosome 18, and FHIT gene mutation. Of these, CA 19-9 holds maximum promise. However, it has low specificity. Other more extensively studied markers are p53, bcl2 and C-erb-B2 (her2neu). There is an urgent need to look for a new and specific marker for gallbladder cancer that will help us to detect this cancer at an early stage so as to alter its poor prognosis.