Gall stones size, number, biochemical analysis and lipidogram- an association with gall bladder cancer: a study of 200 cases

Shveta Narang, Parul Goyal, Manjit Singh Bal, Usha Bandlish, Sunder Goyal


Purpose: Objective of the study was to find out if there is any relation of number, size and type of gall stones and patient’s lipid profile with the occurrence of gall bladder carcinoma (GBC) as presence of gall stones is considered to be the most important risk factor for gall bladder cancer.

Methods: 200 specimens of post-cholecystectomy gallbladder were studied. The number, size and type of stones and lipid profile were compared in all these cases. Gross as well as histopathological examination of gall bladders specimens was done.

Results: 185 (92.5%) gall bladders were associated with gall stones. On histopathological examination, malignancy was found in 6 cases (3%) only and rest 194 cases (97%) revealed inflammatory/ non-neoplastic pathology. A statistically significant difference was observed in the number of stones in gall bladders with malignancy than those with benign lesions (P < 0.001). Similarly, a statistically significant difference was seen in terms of stone size between gallbladder cancer (GBC) cases and those with benign pathology (P < 0.005). Benign lesions of gall bladders were mostly associated with mixed type of stones whereas malignant cases were associated with pure cholesterol type of stones. No significant relation was found between the patient’s lipid profile and occurrence of gallbladder carcinoma (GBC) (p > 0.005).

Conclusion: Thus we concluded that as the number, size and cholesterol gall stone increase the risk of gall bladder cancer also increases without any relation with lipid profile.


Cite this article as:
Narang S, Goyal P, Bal MS, Bandlish U, Goyal S. Gall stones size, number, biochemical analysis and lipidogram- an association with gall bladder cancer: a study of 200 cases. Int J Cancer Ther Oncol 2014; 2(3):020310. DOI: 10.14319/ijcto.0203.10


Gall Stones; Cancer; Gall Bladder; Lipid Profile

Full Text:



Lazcano-Ponce EC, Miquel JF, Muñoz N, et al. Epidemiology and molecular pathology of gall bladder cancer.CA Cancer J Clin 2001; 51:349-64.

Randi G, Franceschi S, La Vecchia C. Gall bladder cancer worldwide: Geographical distribution and risk factors. Int J Cancer 2006; 118:1592-602.

Curado MP, Edwards B, Shin HR, et al. Cancer Incidence in Five ContinentsVol IX. (IARC)Scientific Publications, No.160.International Agency for Research Cancer, Lyon, France, 2007.

Strom BL. Epidemiological and biochemical aspects of an important sequel to cholelithiasis: Gallbladder cancer. In: Capocaccia G, Ricci F, Angelico F, (eds) Epidemiology and Prevention of Gallstone Disease. MTP Press, Lancaster 1984; 64-76.

Diehl AK. Epidemiology of gallbladder cancer: a synthesis of recent data. J Natl Cancer Inst 1980; 65:1209-14.

Diehl AK. Gallstone size and the risk of gallbladder cancer. JAMA 1983; 250:2323-6.

Black WC, Key CR, Carvant JB, et al. Carcinoma of the gall bladder in a population of South-Western American Indians. Cancer 1977; 39:1267-79.

Lowewfels AB, Lindstrom CG, Conway MJ, et al. Gallstone and risk of gall bladder cancer. J Natl Cancer Inst 1985; 75:77-80.

Hart J, Modan B, and Shanti M. Cholelithiasis in the etiology of gall bladder neoplasm. Lancet 1971; 1:1151-3.

Kato K, Akai S, Toninga S, Kato I.A case-control study of biliary tract cancer in Niigata Prefecture, Japan. Jpn J Cancer Res 1989; 80:932-8.

Zantonski WA, La Veccia C, Przewozniak K, et al. Risk factors for gallbladder cancer: a Polish case-control study. Int J Cancer 1992; 51:707-11.

Malik IA, Aziz Z, Zaidi SH, Sethuraman G. Gemcitabine and Cisplatinis a highly effective combination chemotherapy in patients with advanced cancer of the gallbladder. Am J Clin Oncol 2003; 26: 174-7.

Kapoor VK, Mcmichael AG. Gallbladder Cancer: An ‘Indian’ disease. Natl Med J India 2003; 16:209-13.

Maram ES, Ludwig J, Kurland LT, Brian DD. Carcinoma of the gallbladder and extrahepatic biliary ducts in Rochester, Minnesota, 1935-71. Am J Epidemiol 1979; 109:152-7.

Nervi F, Duarte I, Gomez G, et al. Frequency of gallbladder cancer in Chile, a high-risk area. Int J Cancer 1988; 41:657-60.

Gupta SC, Mishra V, Singh PA, et al. Gall stone and carcinoma gall bladder. Indian J Pathol Microbiol 2000; 43:147-54.

Hsing AW, Rashid A, Devesa SS, et al. Biliary tract cancer. In: Schottenfeld D, Fraumeni JF, Jr, eds. Cancer epidemiology and prevention. 3rd edn. Oxford: Oxford University Press, 2006; 787-800.

deGroen PC, Gores GJ, LaRusso NF, et al. Biliary tract cancers. N Engl J Med 1999; 341:1368-78.

Tandon RK. Current developments in the pathogenesis of gall stones in India. Tropical Gastroenterol 1990:11:130-9.

OserLB. Analysis of biliary calculi. Hawk’s physiological chemistry. 14th edn McGraw Hill; 1971: 497.

Allan CC, Porn LS, Chan CS, et al. Enzymatic determination of total serum cholesterol. Clin Chem 1974; 20:470-5.

McGowan MW, Artiss JD, Strandbergh DR, Zak B. A peroxidase coupled method for the calorimetric determination of triglycerides. Clin Chem 1983; 29:538-42.

Burstein M, Schalnick HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. J Lipid Res 1970; 11:583-95.

Friedewald WT, Levy RS, Friedricksen DS. Estimation of concentration of low density lipoprotein cholesterol in plasma without rise of preparative ultracentrifuge. Clin Chem 1972; 18:499-502.

Adam R,Stranahan A. Cholecystitis and cholelithiasis; an analytical report of 1,104 operative cases. Surg Gynecol Obstet 1947; 85:776-84.

Glenn F, Frey C. Re-evaluation of the treatment of pancreatitis associated with biliary tract diseases. Ann Surg 1964; 160: 723-36.

Khanna R, Chansuria R, Kumar M, Shukla HS. Histological changes in gallbladder due to stone disease. Indian J Surg 2006; 68:201-4.

Aulakh R, Mohan H, Attri AK, et al. Comparative study of serum lipid profile and gallstone disease. Indian J Pathol Microbiol 2007; 50:308-12.

Meirelles-Costa AL, Bresciani CJ, Perez RO, et al. Are histological alterations observed in the gallbladder precancerous lesions? Clinics (Sao Paulo) 2010; 65: 143-50.

Kapoor VK. Cholecystectomy in patients with asymptomatic gallstones to prevent gall bladder cancer--the case against. Indian J Gastroenterol 2006; 25:152-4.

Lowenfels AB, Walker AM, Althaus DP, et al. Gallstone growth, size, and risk of gallbladder cancer: An interracial study. Int J Epidemiol 1989; 18:50-4.

Cooke L, Jones FA, Keech MK. Carcinoma of the gall-bladder; a statistical study. Lancet 1953; 1:585-7.

Vitetta L, Salia A, Little P, Mrazek L. Gall stones and gall bladder carcinoma. Aust N ZJ Surg 2000; 70: 667-73.

Roa I, Ibacache G, Roa J, et al. Gall stones and gall bladder cancer-volume and weight of gall stones are associated with gall bladder cancer: A case control study. J Surg Oncol 2006; 93:624-8.

Moerman CJ, Lagerwaard FJ, Bueno de Mesquita HB, et al. Gallstone size and the risk of gallbladder cancer. Scand J Gastroenterol 1993; 28: 482-6.

Venniyoor A. Cholesterol gallstones and cancer of gallbladder (CAGB): molecular links. Med Hypotheses 2008; 70:646-53.

MisraVatsala, Misra SP, Singh PA, et al. Significance of cytomorphological and microbiological examination of bile collected by endoscopic cannulation of the papilla of vater. Indian J PatholMicrobiol 2009; 52: 328-31.

Kimura W, Shimada H, Kuroda A, Morioka Y. Carcinoma of the gall bladder and extrahepatic bile duct in autopsy cases of the aged, with special reference to its relationship to gall stones. Am J Gastroenterol1989; 84:386-90.

Rizvi TJ, Zuberi SJ. Risk factors for gall bladder cancer in Karachi. J Ayub Med Coll Abbottabad 2003; 15: 16-8.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.


International Journal of Cancer Therapy and Oncology (ISSN 2330-4049)

© International Journal of Cancer Therapy and Oncology (IJCTO)

To make sure that you can receive messages from us, please add the '' domain to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', check your 'bulk mail' or 'junk mail' folders.


Number of visits since October, 2013