Early detection of gallbladder cancer: Current status and future perspectives

Abstract

Gall bladder cancer (GBC) remains a highly aggressive disease, with an overall 5-year dismal survival rate of 15%-20%. Its asymptomatic nature in very early stages and non-specific clinical presentations pose significant challenges to timely detection. Consequently, GBC often presents late, making it one of the most challenging cancers to manage. Surgery offers the best chance for long-term survival; however, only 10% of GBC patients are candidates for upfront resection, with the majority presenting in locally advanced or metastatic stages. Furthermore, GBC is generally resistant to chemotherapy and radiotherapy, limiting the effectiveness of systemic therapy. Therefore, early diagnosis is crucial to offer the best treatment through surgical resection and to improve the outcome. Recent advancements in imaging technologies, biomarker discovery, and molecular diagnostics offer promising avenues for enhancing detection rates. Though non-invasive, most of them lack specificity, and the majority fail as an early diagnostic tool. This review examines the current status of early detection strategies for GBC, addresses the limitations of existing approaches, and explores the newer emerging diagnostic tools and techniques and how they can be exploited in future for its early detection.

Keywords: Artificial intelligence; Biomarkers; Early diagnosis; Gall bladder cancer; High risk factors; Liquid biopsy; Radiology.

Figure 1

Pathogenesis of gall bladder cancer-biomarkers working at different stages. GB: Gall bladder.

Figure 2

Various liquid biopsy tools. NGS: Next-generation sequencing; PCR: polymerase chain reaction; FISH: Fluorescence in situ hybridization; CAGE: Cap analysis of gene expression; PRO-cap: Precision RNA on-cap; PAR-CLIP: Photoactivatable ribonucleoside-enhanced crosslinking and immunoprecipitation; SMART: Simple Modular architecture research tool; cfDNA: Cell-free DNA; ctDNA: Circulating tumor DNA.