The Application Of Metatron 4025 Hunter And Gallbladder Cancer

Gallbladder cancer is a malignant tumor originating from the epithelial cells of the gallbladder mucosa. It is the most common malignant tumor of the biliary system, accounting for more than 70% of biliary malignant tumors. The location of the disease is located in the gallbladder. Depending on the anatomical location where the tumor originated from the gallbladder, it includes gallbladder cancer at the base of the gallbladder, body, neck and cystic duct. It is more common in the base of the gallbladder, neck and body.

Gallbladder cancer symptoms content:

The early stage of gallbladder cancer has no specific clinical manifestations or only symptoms of chronic cholecystitis. Early diagnosis is very difficult. Once persistent pain, masses, jaundice, etc. appear in the upper abdomen, the lesions have reached the advanced stage, and various examinations also appear abnormal. Therefore, for patients with discomfort or pain in the gallbladder area, especially middle-aged and elderly patients over the age of 50 with gallbladder stones, inflammation, and polyps, regular B-ultrasound examinations should be performed in order to confirm the diagnosis as soon as possible. At the same time, health testing can be performed through Metatron 4025 Hunter to detect gallbladder cancer in advance and prevent it in time.

Symptoms

1. Pain in the right upper abdomen: Most of the pain is persistent pain in the upper right abdomen, which may be exacerbated by paroxysmal, radiating to the right shoulder and lower back. This symptom accounts for 84%. Because gallbladder cancer mostly coexists with gallbladder stones and inflammation, so The nature of the pain is similar to that of calculous cholecystitis. It begins with discomfort in the right upper abdomen, followed by persistent dull or dull pain, sometimes with paroxysmal severe pain and radiation to the right shoulder.

2. Digestive symptoms:

The vast majority (90%) suffer from indigestion, greasiness, belching, and decreased appetite. This is due to the renewal function of the gallbladder and the inability to digest fatty substances. Nausea and vomiting are also quite common, and there is often loss of appetite.

3. Jaundice: Due to the spread of cancer, about 1/3 to 1/2 of patients have jaundice. A small number of patients have jaundice as the first symptom. Most of the jaundice appear after the pain. The jaundice is continuous and progressively worse. A few patients show It is intermittent jaundice, which often occurs in the late course of the disease, accounting for 36.5%. It is mostly caused by cancerous tissue invading the bile ducts and causing malignant obstruction, accompanied by weight loss, fatigue, and even cachexia, yellow staining of skin and mucous membranes, and difficult-to-treat skin. Itching.

4. Chills and fever: it mostly occurs in the late stage of cancer. 25.9% of patients have fever, and high fever may persist.

5. Right upper abdomen mass: The disease has advanced to the advanced stage, and there is a mass in the right upper abdomen or upper abdomen, accounting for 54.5%. One is the rapid growth of the tumor, which blocks the bile duct and causes the gallbladder to enlarge; the other is the obstruction caused by the invasion of the duodenum, and at the same time Symptoms of obstruction appear; in addition, the liver, stomach, pancreas, etc. may be invaded, and masses may also appear in the corresponding parts.

Signs

1. Jaundice: manifested in the mucous membranes, the skin is yellowish, yellowish stain is heavier, mostly obstructive, once jaundice appears, most of the lesions have reached the advanced stage.

2. Right upper abdomen mass: the right upper abdomen can touch the smooth and enlarged gallbladder. When there is no adhesion to the surrounding tissues, it has great mobility; when there is adhesion to the surrounding tissues, several masses can be touched, and sometimes the swollen liver can be touched. , Duodenal obstruction, masses in the abdomen, almost half of the cases can be palpable in the gallbladder area of ??the right upper abdomen at the first diagnosis, and some parts are hard in texture and may have a nodular sensation. This kind of mass is It is the gallbladder. Occasionally, due to the obstruction of the cystic duct, the gallbladder may have water or abscesses, tenderness in the gallbladder area, and rebound pain. Its signs are very similar to acute cholecystitis or obstructive cholangitis.

3. Weight loss: Most cases showed gradual weight loss, weight loss, fatigue, and cachexia.

4. Signs caused by metastasis: In some cases, there may be palpable lymph nodes on the clavicle and metastatic masses in the breast. In advanced cases, gastrointestinal bleeding, ascites, and liver failure may occur due to portal compression.

Gallbladder cancer has an insidious onset, no specific manifestations, but it is not irregular. According to the frequency of occurrence, the clinical manifestations are abdominal pain, nausea and vomiting, jaundice, and weight loss. The symptoms can be classified into five major clinical symptom groups. Comprehensive manifestations of these diseases: ①Acute cholecystitis: Some cases have a history of short right upper abdominal pain, nausea, vomiting, fever and palpitations, suggesting acute cholecystitis. About 1% of cases of acute cholecystitis surgery have gallbladder cancer. Chronic cholecystitis: The symptoms of many patients with primary gallbladder cancer are similar to those of chronic cholecystitis, and it is difficult to distinguish them. It is necessary to be highly vigilant against benign lesions combined with gallbladder cancer or benign lesions. Progression to gallbladder cancer, ③Biliary tract malignant tumor: Some patients may have jaundice, weight loss, poor general condition, right upper abdominal pain, etc., tumor lesions are often late, poor efficacy, ④Extrabiliary malignant tumor signs: a few cases may have nausea, weight Alleviate the symptoms of systemic weakness, internal fistula formation or invasion of neighboring organs. This type of tumor often cannot be removed. ⑤ The appearance of benign lesions outside the biliary tract: rare, such as gastrointestinal bleeding or upper gastrointestinal obstruction.

(1) Chronic cholecystitis symptoms: 30% to 50% of cases have chronic cholecystitis or gallstone symptoms such as long-term right upper abdominal pain, which is difficult to differential diagnosis. Patients with chronic cholecystitis or accompanied by stones are over 40 years old. The right upper abdomen pain has become persistent or progressively worse and has obvious symptoms of digestive disorders; those with asymptomatic gallbladder stones over 40 years old, especially those with larger single stones, have recently experienced persistent dull or dull pain in the right upper abdomen Patients with a short history of chronic cholecystitis, local pain and obvious changes in the general condition; patients with gallbladder stones or chronic cholecystitis who have recently experienced obstructive jaundice or palpable masses in the right upper abdomen should be highly suspected of the possibility of gallbladder cancer. Make further examinations to confirm the diagnosis.

(2) Symptoms of acute cholecystitis: account for 10% to 16% of gallbladder cancer. These patients are mostly caused by gallbladder neck tumors or stone incarceration that cause acute cholecystitis or gallbladder empyema. The resection rate and survival rate of such patients are both High, the resection rate is 70%, but it is almost impossible to diagnose before surgery. Some patients are misdiagnosed as acute cholecystitis by medication or simple cholecystostomy. Therefore, acute cholecystitis that occurs suddenly in the elderly, especially if there is no biliary tract in the past Patients with systemic diseases should pay special attention to the possibility of gallbladder cancer and strive for early surgical treatment. When cholecystostomy is necessary due to the condition, the gallbladder cavity should also be carefully checked to exclude gallbladder cancer.

(3) Obstructive jaundice symptoms: some patients are treated with jaundice as the main symptom. About 40% of gallbladder cancer patients have jaundice. The appearance of jaundice indicates that the tumor has invaded the bile duct or is accompanied by common bile duct stones. The situation can be encountered in the resection of gallbladder cancer.

(4) Right upper abdominal mass: tumor or stone blockage or gallbladder neck can cause gallbladder effusion, empyema, and swelling of the gallbladder. This smooth and elastic mass can be removed, and the prognosis is good, but hard A nodular and matte mass is an advanced cancer that cannot be cured.

(5) Others: hepatomegaly, weight loss, ascites, and anemia may all be advanced signs of gallbladder cancer, indicating that there has been liver metastasis or gastroduodenal invasion, which may not be surgically removed.

The clinical manifestations of gallbladder cancer lack specificity, and its early signs are often concealed by gallstone disease and its complications. Except for the first-onset acute cholecystitis to be diagnosed, it is generally difficult to make early clinical diagnosis based on clinical manifestations. According to statistics, the preoperative diagnosis rate is 29.6%, and most of them are in the late stage. Therefore, to achieve asymptomatic early diagnosis, close follow-up of high-risk populations, such as static gallbladder stones, gallbladder polyps, gallbladder adenomyosis, etc., is necessary. Active treatment is necessary to prevent gallbladder cancer. In recent years, with the development of imaging diagnostic technology, the early diagnosis of gallbladder cancer tends to increase. Those with one of the following manifestations should consider the possibility of gallbladder cancer:

1. Female patients over 40 years old, with a history of chronic cholecystitis or gallbladder stones, with repeated symptoms.

2. Jaundice, loss of appetite, general fatigue, weight loss, and a mass in the upper right abdomen.

3. Pain in the upper right abdomen or heart socket, and the treatment of general liver and stomach diseases is ineffective.

4. Digestive disorders, such as nausea, vomiting, anorexia, oiliness, loose stools, etc., generally ineffective in symptomatic treatment.

Early diagnosis of this disease is not easy, so the prognosis is poor. The 5-year survival rate after surgery is 0 to 7%. Occasionally, more than 10% are reported, and 80% of patients die within 1 year after diagnosis. In 1992, Heason collected data on 3,038 cases of gallbladder cancer and found that the age, gender, weight, race, geographic environment and diet of patients were all related to the onset of gallbladder cancer. The age of onset of gallbladder cancer was concentrated in 40-60 years. Women are relatively tall; obesity is an important risk factor for cholelithiasis; excessive intake of greasy foods, monosaccharides and disaccharides will increase the risk of gallbladder cancer. These findings have guiding significance for the prevention of gallbladder cancer.

For middle-aged and older patients, especially women with chronic atrophic cholecystitis, chronic calcifying cholecystitis, gallbladder stones that are not cured for a long time, gallbladder adenoma-like polyps, especially polyps> 10mm, wide base, polyps with stones, inflammation, should Perform cholecystectomy as soon as possible. In view of the relationship between benign gallbladder diseases and gallbladder cancer, it is generally believed that preventive measures should be taken for people at high risk of gallbladder cancer:

①Cholecystitis and gallbladder stones with obvious symptoms over the age of 40, especially those with stones larger than 3cm in diameter, with obvious thickening and shrinking of the gallbladder wall, or "porcelain", the gallbladder should be removed.

② For those who have undergone gallbladder fistula due to acute cholecystitis, gallbladder stones, and necrosis, if there are no contraindications, the gallbladder should be removed early.

③Benign tumors of the gallbladder, such as adenomas, adenomyomas should be checked regularly or the gallbladder should be removed in time.

④For those with malformation of the cystic duct, abnormal confluence of the pancreaticobiliary duct, congenital bile duct expansion, long-term ulcerative colitis, and long-term exposure to chemical carcinogens, the changes in the gallbladder should be observed regularly.

Treatment of gallbladder cancer:

For gallbladder cancer, a comprehensive treatment based on surgery should be adopted. General treatment includes systemic support, nutritional supplements, and increased diet. When the symptoms are related to diet, a low-fat diet can be used. Analgesia is the same as general treatment. If the pain is not easily relieved, procaine can be given intravenously or morphine drugs can be used. 　

Surgical treatment: The treatment of gallbladder cancer is mainly surgery, but due to the insidious onset, no specific symptoms, and difficulty in early diagnosis, there are not many patients who can be surgically removed, and the domestic literature reports 50%. Fewer patients can undergo radical surgery, only 20.2%. Even if the lesion has been removed, the average survival time after surgery is only 8.4 months. Nearly 90% of patients die within 1 year after surgery. The 5-year survival rate is less than 5% (0%-10%), and individual reports are 14.5%.

Other special treatments:

 (1) Radiotherapy: Gallbladder cancer has a certain sensitivity to radiotherapy. Early patients have a greater chance of local recurrence after surgery, and it is the main cause of death. Therefore, some authors advocate that radiotherapy should also be given after radical resection.　　

 (2) Chemotherapy: Gallbladder cancer is not sensitive to various chemotherapeutics, and it is mostly used for adjuvant treatment after surgery. There is no unified chemotherapy regimen, and the effects of chemotherapy regimens that have been used are not ideal. By measuring the P-glycoprotein content of normal gallbladder and gallbladder cancer specimens, it is found that the gallbladder itself is an organ rich in P-glycoprotein, so it is necessary to select chemotherapeutic drugs reasonably. Commonly used chemotherapeutic drugs include fluorouracil (5-FU), cyclo Hexanitrosourea (Me-CCNU), doxorubicin (doxorubicin), mitomycin, carmustine (carbazide) and so on. The combined application has a certain effect, and it can be tried when there is no other choice.

(3) Other treatments: Including interventional therapy, immunotherapy, etc., although it is difficult to achieve the purpose of treatment, it may improve the patient's condition, relieve pain, and prolong survival. If advanced gallbladder cancer invades the liver parenchyma extensively from the gallbladder bed, or invades one hepatic duct from the neck of the gallbladder, or even multiple metastases on one liver, interventional therapy can be used, and embolization and chemotherapy through hepatic artery intubation can be used. Better curative effect.

(4) Meta Therapy: Using meta therapy of Metatron 4025 Hunter for adjuvant therapy can significantly improve the effects of other therapies.

Recent studies have found that K-ras, c-erbB-2, c-myc, p53, p15, p16 and nm23 genes are closely related to the occurrence, development and outcome of gallbladder cancer, immunotherapy and application of various biological responses Regulators such as interferon and interleukin are often combined with radiotherapy and chemotherapy to improve their efficacy. In addition, hyperthermia is still in the exploratory stage, all in the exploratory stage, and further research is needed.

Under the current poor curative effect of gallbladder cancer, it is reasonable to actively explore various comprehensive treatment measures, which are expected to alleviate the patient's symptoms and improve the prognosis.

The prognosis of gallbladder cancer is very poor, with a total 5-year survival rate of less than 5%. It is mainly related to the high degree of malignancy of the tumor, early metastasis and spread, and the low rate of early diagnosis and surgical resection. As mentioned earlier, the effect of tumor treatment is closely related to the staging of gallbladder cancer. Patients with stage Ⅰ and stage Ⅱ gallbladder cancer accidentally discovered after cholecystectomy according to benign gallbladder disease can often survive for a long time. According to reports, the 5-year survival rate can reach 64% to 86%; on the contrary, the prognosis of cases above stage Ⅲ is very good. Difference. If the tumor has invaded the full thickness of the gallbladder, almost all of them will die within 2.5 years after surgery.

Since the prognosis of early gallbladder cancer is significantly better than that of patients with lymph node metastasis, efforts to improve the detection rate of asymptomatic early gallbladder cancer have become a research hotspot in recent years. Therefore, Metatron 4025 Hunter is popular with people.