Primary gallbladder cancer is a common malignant tumor of the biliary system, and its incidence has been increasing significantly in recent years. It accounts for about 5% of cancer tissue specimens at autopsy, and 91% of these patients are above the age of 50. The incidence rate of female patients is about three times higher than that of male patients. Gallbladder cancer has no specific clinical symptoms and signs in the early stage, and most patients are already in the middle and late stage when they are diagnosed, so the surgical resection rate is low and the 5-year survival rate after surgery is less than 5%, thus its early diagnosis and treatment have attracted more attention from scholars. Incidence and related diseases The incidence of primary gallbladder cancer is related to geography and ethnicity. The incidence rate is higher in South American countries, Mediterranean region and Japan. The incidence of gallbladder cancer is closely related to gallbladder stones. Statistics in China show that 49.7% of gallbladder cancers are associated with gallbladder stones. Overseas data are even higher, with about 70% of gallbladder cancer patients having gallbladder stones in combination. All of them are much higher than the general population of similar age. Symptoms and signs Gallbladder cancer lacks typical symptoms and signs. Among patients with gallbladder cancer, about 66% have abdominal pain, 59% show weight loss, 51% have xanthogranuloma, 40% have loss of appetite, and nearly 40% have epigastric mass. The clinical manifestations are different in different periods of disease onset. The symptoms and signs of gallbladder cancer patients depend on the location, degree and extent of development of the cancer. Generally speaking, patients with biliary tract symptoms of gallbladder cancer have more obvious clinical manifestations, which are easy to attract attention. The right upper abdominal mass, smooth and soft in texture, is mostly the enlarged gallbladder. Once xanthogranuloma appears, it indicates that the tumor has invaded the right hepatic duct, common hepatic duct or common bile duct, but it should also be considered that it may be due to the surrounding enlarged lymph nodes pressing on the bile duct. Tumor invasion of the liver can also cause xanthogranuloma. In a small number of patients with gallbladder cancer, gangrene may be caused by stones in the biliary system. Most of the patients have abdominal pain accompanied by gangrene, which can be distinguished from periampullary cancer. Tumor markers and gene research So far, no specific tumor markers for gallbladder cancer have been found, and related research work is still in progress. The positive rate of carcinoembryonic antigen (CEA) in the serum of gallbladder cancer patients is 70%, and the positive rate of glycocalyx antigen (CA19-9) is 81%. In addition, the detection of CA12-5, CA15-3 and CA50 in serum has also been reported in the diagnosis of gallbladder cancer, but they all lack specificity and can only be used as auxiliary tests for gallbladder cancer. In recent years, the combined test of CEA and CA199 has been proposed to be helpful for diagnosis, but it also has the problem of low specificity, and can be used as an auxiliary diagnosis and observation index for follow-up after surgical resection.