Induction In Italy According to the most recent available epidemiological data, incidence rates for acute gallbladder cancer are 6.7 and 7.6 cases / 100,000 resident / year respectively in male and female populations; the mortality rate is 4,8 and 6,1 cases per 100,000 residents per year; 5-year survival is 21% in male and 18% in females, and then there is a series of crucial epigenetic alterations in biliary carcinogenesis. Due to the silent genes involved in a variety of functions, including apoptosis or growth arrest (p73, DAPK), DNA repair, and finding alterations in the DNA methylation pattern in the early stages of cancer carcinogenesis and even in chronic cholecystitis findings led to the hypothesis that modification of DNA The epigenetic structure is an early occurrence (18) This study shows the results of a research conducted on ca patients with the gallbladder using advanced diagnostics and gene expression precursors for the purpose of defining pre-clinical disease. Materials and Methods: From January 2015 to December 2017 at the AOU company in Catania, G Rodolico Presidium, the database was hospitalized in n 13 cases with gallbladder neoplasia, of which n 9 was female and 4 male with average age of 64 years Staging criteria are TNM AJCC in addition to headquarters and TN, the latter being the most important prognostic factor through determination of lymph node metastases, as well as invasion of the hepatoma ligament. Results Surgical resection is the only treatment that can offer a chance of treating cancer of the gallbladder. Surgical treatment depends on the stage of the neoplasm. Absolute resectivity criteria included the presence of liver, peritoneal and lymphoid metastases (in defined N2 stage - celiac lymph nodes, upper mesenteric artery, para-aortic and paracavals), neoplastic ascites, and widespread involvement of the peduncle liver The findings also confirmed the presence of gene mutations that may be one of the factors useful to assess the presence of neoplasia even at an early stage. Discussion Staging In patients with pT1b, pT2 and pT3 incident neoplasms, reintervention with hepatic resection, lymphadenectomy, resection of the cystic stump and in some cases VBP resection is now required. 2-3 cm of the liver bed and in patients with neoplasia In the case of cholecystitis neoplasia after cholecystectomy, cholecystectomy was sufficient in T1a and did not require reintervention as survival after simple cholecystectomy is close to 100 %. Thermoablation Used in localized localized control of small size (<3-4 cm in diameter), localized, non-resectable Conclusions in our brief experience determining genetic mutations helps to define the risk of neoplasia in the context of factors that determine the diagnosis . In the traditional model of cholangiocarcinogenesis, tumor promotion results in a background of cholestasis and / or chronic biliary flogosis: high cell turnover and abundant release of cytokines that facilitate the accumulation of mutations and the proliferation of genes with genetic alterations. the consequence of all this and that codetermination helps to define the clinical risk of neoplasia especially in the preclinical phase.
