Pathogenesis and therapeutic options of gallbladder carcinoma

Gallbladder cancer is a rare disease that may be diagnosed incidentally cholecystectomy, often with more advanced disease. Jaundice is considered an ominous sign in the presentation of gallbladder cancer. The K-ras proto-oncogene is thought to exert control over some of the mechanisms of cell growth and differentiation. This gene is converted to an active oncogene by point mutations significantly concentrated in codons 12, 13, or 61. The Ras family consists of three genes located in different chromosomes, encoding the homologous 21 kDa proteins H-Ras, N-Ras and K-Ras. p53 acts as the single most important gene in cancer as a single mutation can lead to tumor genesis. p53 functions have been further diversified by the discovery of various isoforms of p53. These isoforms derived either by alternative splicing or by differential translational sites are expressed in a tissue specific manner. The influence of p53¿ isoform on p53 activity either by its transcriptional repression or by forming a complex with p53 thereby modulating its activity at p53 dependent promoters. The roles of adjuvant and neoadjuvant therapies in the treatment of gallbladder cancer remain poorly elucidated.