• Cholecystectomy
• Gallbladder cancer
• IGBC
• Incidental gallbladder cancer
• Re-resection
• Residual disease

• Humans
• Gallbladder Neoplasms/diagnosis
• Gallbladder Neoplasms/therapy
• Gallbladder Neoplasms/pathology
• Incidental Findings
• Cholecystectomy
• Neoplasm Staging
• Prognosis
• Lymph Node Excision

• Humans
• Gallbladder Neoplasms/diagnostic imaging
• Gallbladder Neoplasms/surgery
• Diffusion Magnetic Resonance Imaging/methods
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/surgery
• Liver Neoplasms/pathology
• Magnetic Resonance Imaging/methods
• Carcinoma
• ROC Curve
• Retrospective Studies

• Gallbladder cancer
• National Surgery Quality Improvement Program
• Neoadjuvant chemotherapy
• Postoperative outcome
• Radical cholecystectomy

• elderly patients
• gallbladder cancer
• surgical resection

• Aged
• Humans
• Gallbladder Neoplasms/pathology
• Retrospective Studies
• Chemotherapy, Adjuvant
• Postoperative Complications/epidemiology
• Comorbidity

• cholecystectomy
• gallbladder cancer

• Female
• Humans
• Carcinoma in Situ
• Cholecystectomy
• Diabetes Mellitus/surgery
• Gallbladder Neoplasms/epidemiology
• Gallbladder Neoplasms/surgery
• Gallbladder Neoplasms/diagnosis
• Incidence
• Inflammatory Bowel Diseases/surgery
• Neoplasm Staging
• Retrospective Studies
• Male

• Gallbladder cancer
• Hepatectomy
• Segment 4b + 5 resection
• Wedge hepatic resection

• Humans
• Gallbladder Neoplasms/pathology
• Hepatectomy
• Cholecystectomy/methods
• Disease-Free Survival
• Postoperative Complications/etiology
• Postoperative Complications/surgery
• Retrospective Studies
• Treatment Outcome

• gallbladder cancer
• lymph node dissection
• prognosis

• Male
• Humans
• Female
• Adult
• Middle Aged
• Aged
• Aged, 80 and over
• Gallbladder Neoplasms/surgery
• Retrospective Studies
• Lymph Node Excision
• Lymph Nodes/surgery
• Prognosis
• Carcinoma in Situ

• mechanism
• pathway
• plants
• stigmasterol
• tumor

Incidental carcinoma gall bladder and benign disease in radical cholecystectomy specimen is the cause of concern. We attempted to find out the incidence and reasons thereof in the present study.

Present study is a retrospective analysis of a prospectively maintained database between July 2002 and July 2019. All patients with a diagnosis of carcinoma gall bladder admitted for surgery were included.

Out of 148 patients, 110 patients had carcinoma gall bladder (CAGB), while 38 patients (25.7%) had incidental carcinoma (under-diagnosis). Radical resection was done in 61/110 (55.4%) patients with clinical CAGB, where 15 (24.6%) patients had benign pathology (“over-diagnosis”). Overdiagnosis was due to xanthogranulomatous cholecystitis (n = 9), chronic cholecystitis (n = 2), tuberculosis (n = 2) and IgG4 related cholecystitis (n = 2). Among 61 patients, a history of weight loss and anorexia were significantly associated with malignancy. Asymmetrical wall thickness was significantly more common in benign mimickers.

Among patients with incidental carcinoma, preoperative ultrasonography reported normal wall thickness of gall bladder in 28 (73.7%), thickened gall bladder wall in 6, and polyp in 3 patients. The resectability rate among incidental carcinoma was 27/38 (71.05%).

Over-diagnosis of the carcinoma gall bladder was present in 24.6%. On the other hand, incidental carcinoma comprised 25.7% of all admissions for carcinoma gall bladder with resectability of 71%.

• anxiety
• depression
• gallbladder cancer
• routine nursing care
• target nursing care

• Anxiety/etiology
• Depression/etiology
• Gallbladder Neoplasms/surgery
• Humans
• Perioperative Period
• Quality of Life
• Retrospective Studies

• anomalous
• anomaly
• bile duct
• carcinogenesis
• carcinoma
• gallbladder
• hyperplasia
• junction
• maljunction
• reflux
• union

• gallbladder cancer
• incidental
• oncologic extended resection
• resectable
• treatment

• adjacent organ resection
• de novo
• gallbladder carcinoma
• radical cholecystectomy
• survival

• Adult
• Aged
• Aged, 80 and over
• Cholecystectomy/mortality
• Female
• Follow-Up Studies
• Gallbladder Neoplasms/mortality
• Gallbladder Neoplasms/pathology
• Gallbladder Neoplasms/surgery
• Humans
• Lymph Node Excision/mortality
• Male
• Middle Aged
• Prognosis
• Prospective Studies
• Retrospective Studies
• Survival Rate

Keratins are a group of proteins that can constitute intermediate fibers. It is a component of the cytoskeleton and plays an important role in cell protection and structural support. Keratin 17, a Type I keratin, is a multifunctional protein that regulates a variety of biological processes, including cell growth, proliferation, migration, apoptosis and signal transduction. Abnormal expression of KRT17 is associated with a variety of diseases, such as skin diseases. In recent years, studies have shown that KRT17 is abnormally expressed in a variety of malignant tumours, such as lung cancer, cervical cancer, oral squamous cell carcinoma and sarcoma. These abnormal expressions are related to the occurrence, development and prognosis of malignant tumors. In this review, we summarized the expression patterns of KRT17 in a variety of malignant tumours, the role of KRT17 in the development and prognosis of different malignant tumors and its molecular mechanisms. We also discuss the potential clinical application of KRT17 as a valuable therapeutic target.

• cancer
• gallbladder
• incidental
• surgery
• survival

• Gallbladder Neoplasms/pathology
• Gallbladder Neoplasms/surgery
• Humans
• Incidental Findings
• Lymph Nodes/pathology
• Lymph Nodes/surgery
• Lymphatic Metastasis
• Neoplasm, Residual
• Retrospective Studies

• Cholecystectomy
• Gallbladder cancer
• Prognosis
• Retrospective study
• Survival

Re-resection of incidental gallbladder carcinoma (IGBC) is possible in a select group of patients. However, the optimal timing for re-intervention lacks consensus.

A retrospective analysis was performed for a prospective database of 91 patients with IGBC managed from 2009 to 2018. Patients were divided into three groups based on the duration between the index cholecystectomy and re-operation or final staging: Early (E), < 4 weeks; Intermediate (I), > 4 weeks and < 12 weeks; and Late (L), > 12 weeks. Demographic data, tumor characteristics, and operative details of patients were analyzed to determine factors affecting the re-resectability of IGBC.

Twenty-two patients in &lsquo;E&rsquo;, 48 in &lsquo;I&rsquo;, and 21 in &lsquo;L&rsquo; groups were evenly matched. Nearly two thirds were asymptomatic. Curative resection was possible in 48 (52.7%) patients. Metastasis was detected during staging laparoscopy (SL)/laparotomy in 26 (28.6%) patients. The yield of SL was more in the &lsquo;L&rsquo; group (30.8%) than in the &lsquo;I&rsquo; (11.1%) or &lsquo;E&rsquo; (nil) group, avoiding unnecessary laparotomy in 13.6%. Only 28.5% of patients in the &lsquo;L&rsquo; group could undergo curative resection (R0/R1 resection), significantly less than that in the &lsquo;E&rsquo; (50.0%) or &lsquo;I&rsquo; group (64.6%) (both p < 0.001). On multivariate analysis, presentation in intermediate period and tumor differentiation increased the chance of curative resection (p < 0.05).

Asymptomatic patients in the &lsquo;I&rsquo; group with well differentiated IGBC have the best chance of obtaining a curative resection.

• Curative resection determinants
• Incidental gall bladder cancer
• Post-cholecystectomy interval

The primary laparoscopic approach (PLA) for T1b/T2 gallbladder cancer (GBC) remains contradicted. We aimed to compare the perioperative and long-term outcomes after PLA versus open approach (OA) for T1b/T2 GBC.

Patients with resected T1b/T2 GBC were selected from our hospital between January 2011 and August 2018. Overall survival (OS), disease-free survival (DFS), and several secondary outcomes were used to evaluate safety and effectiveness. Subgroup analyses were performed to identify significant risk factors for OS/DFS in GBC patients undergoing PLA/OA.

A total of 114 patients who underwent OA (n = 61) or PLA (n = 53) were included in the study. The percent of PLA cases was increased over time from 40.0% in 2011 to 70.0% in 2018 (p < 0.05). There was no significant difference in OS [hazard ratio (HR), 1.572; 95% confidence interval (CI), 0.866–2.855; p = 0.13] and DFS (HR, 1.225; 95% CI, 0.677–2.218; p = 0.49). No significance was found for intraoperative drainage placement (p = 0.253), intraoperative blood loss (p = 0.497), operation time (p = 0.105), postoperative hospitalization (p = 0.797), positive LNs (p = 0.494), total harvested LNs (p = 0.067), and recurrence rates (P = 0.334). Subgroup analyses demonstrated no significance of conversion rates after PLA (all p > 0.05). Patients undergoing PLA with good/poor OS would have similar recurrence rates (p = 0.402). Positive LNs (p = 0.032) and tumor differentiation (p = 0.048) were identified as risk factors for OS after PLA, while positive LNs (p = 0.005) was identified for OS after OA. Moreover, age (p = 0.013), gallbladder stone (p = 0.008), tumor size (p = 0.028), and positive LNs (p = 0.044) were potential risk factors for DFS after OA.

PLA for T1b/T2 GBC was comparable to OA in terms of perioperative and long-term outcomes. Less positive LNs and well-differentiated tumors were independent predictors for better OS after PLA, and less positive LNs were also identified for better OS after OA. Additionally, younger age, without gallbladder stone, smaller tumor size, and less positive LNs were potential risk factors for better DFS after OA.

• gallbladder cancer (GBC)
• long-term outcomes
• open approach
• perioperative outcomes
• primary laparoscopic approach

• Cholecystectomy
• Gallbladder Neoplasms/pathology
• Gallbladder Neoplasms/surgery
• Humans
• Incidental Findings
• Neoplasm Staging
• Reoperation
• Retrospective Studies

• case report
• fluorescence laparoscope
• gallbladder cancer
• indocyanine green
• near-infrared fluorescence

• Cancer
• Definitive
• Gallbladder
• Resection
• Survival

Gallbladder cancer (GBC) has a lower incidence rate among the population relative to other cancer types but is a major contributor to the total number of biliary tract system cancer cases. GBC is distinguished from other malignancies by its high mortality, marked geographical variation and poor prognosis. To date no systemic targeted therapy is available for GBC. The main objective of this study is to determine the molecular signatures correlated with GBC development using integrative systems level approaches. We performed analysis of publicly available transcriptomic data to identify differentially regulated genes and pathways. Differential co-expression network analysis and transcriptional regulatory network analysis was performed to identify hub genes and hub transcription factors (TFs) associated with GBC pathogenesis and progression. Subsequently, we assessed the epithelial-mesenchymal transition (EMT) status of the hub genes using a combination of three scoring methods. The identified hub genes including, CDC6, MAPK15, CCNB2, BIRC7, L3MBTL1 were found to be regulators of cell cycle components which suggested their potential role in GBC pathogenesis and progression.

• cell cycle machinery
• co-expression network
• differentially expressed genes
• epithelial-mesenchymal-transition
• gallbladder cancer
• transcription factors
• transcriptomics

Gallbladder cancer is the most common malignant tumor of the biliary system and is characterized by difficulty to diagnose in early stages, a high degree of malignancy, and poor prognosis. Finding new drugs may improve the prognosis for this dismal cancer. Herein, we investigated the potential application of pterostilbene (PTS) against gallbladder cancer in vivo and in vitro. PTS potently inhibited cell proliferation, migration and invasion of gallbladder cancer cells. Moreover, PTS also had a function of inducing apoptosis in vitro. Meanwhile, PTS reversed EMT with a correlated inhibition of PI3K/Akt activation. Tumor xenograft models showed that PTS inhibited tumor growth and had low toxicity in vivo, which were consistent with the in vitro data. These findings indicate that PTS arrests cell growth through inhibition of PI3K/AKT signaling and is a potential drug for the therapy of gallbladder cancer.

Laparoscopic cholecystectomy (LC) has been widely used in the treatment of gallbladder diseases. Since the indications for operation are constantly expanding, the intraoperative or postoperative incidence of unexpected gallbladder carcinoma (UGC) is gradually increasing. The incidence of UGC in LC and open cholecystectomy is 2.09% and 0.91%, respectively. Because gallbladder carcinoma is often accompanied by gallstones or inflammation and lacks specific clinical manifestations, imaging features, and specific serum tumor markers, the preoperative diagnostic rate of gallbladder carcinoma is only 30%, and 30% of cases of gallbladder carcinoma are diagnosed intraoperatively or postoperatively. Pathological T stage, lymph node metastasis, and gallbladder rupture are independent risk factors for the prognosis of patients with UGC. Preoperative imaging combined with serological tumor markers, intraoperative careful exploration, and rapid pathological examination are important measures to reduce the misdiagnosis and missed diagnosis of UGC. For patients with benign gallbladder diseases with a high potential of canceration, performing cholecystectomy in time and strictly grasping the indications for preserving gallbladder for benign gallbladder diseases are important preventive measures to reduce the incidence of UGC.

• Unexpected gallbladder carcinoma
• Misdiagnosis and missed diagnosis
• Causes
• Treatment
• Strategy
• Prevention

• diagnosis
• gallbladder cancer
• imaging
• mimics
• pitfalls

• Adult
• Aged
• Aged, 80 and over
• Diagnosis, Differential
• Female
• Gallbladder Neoplasms/diagnostic imaging
• Gallbladder Neoplasms/mortality
• Gallbladder Neoplasms/pathology
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Survival Rate
• Tomography, X-Ray Computed
• Ultrasonography

• oncogenes
• long non-coding rnas

• Cell Line, Tumor
• Cell Proliferation/genetics
• DNA Methylation/genetics
• Gallbladder Neoplasms/genetics
• Gene Expression Regulation, Neoplastic/genetics
• Humans
• MicroRNAs/genetics
• RNA, Long Noncoding/genetics

• National Natural Science Foundation of China (National Science Foundation of China)

The aim of the study is to evaluate the impact of application of surgical strategies at different cancer stages on the survival of gallbladder cancer (GBC) patients.

The patients with GBC were divided into 3 groups according to their received surgical strategies: simple resection (full-thickness cholecystectomy for removal of primary tumor site), radical resection (gallbladder bed removal combined with partial hepatectomy), and palliative surgery (treatment at advanced stages). The overall survival (OS) of GBC patients who were received different surgical strategies was compared.

Survival analysis showed that radical resection had a best OS at clinical stage II, and simple resection had a best OS at tumor clinical stage IV. Cox hazard proportional regression analysis showed that more advanced tumor stages, tumor location of gallbladder body or neck, and CA199 ≥ 27 U/mL were the major risk factors for the OS of GBC.

At tumor stage II, radical resection should be the most effective surgical therapy for GBC. However, the effect of radical resection at advanced stages could be restricted. The utilization of radical resection should be increased at tumor stage II for a better long-term survival outcome.

• Gallbladder cancer
• Palliative surgery
• Radical surgery
• Surgical strategy
• Survival analysis

Gallbladder cancer (GBC) is rare in Western populations and data about treatment and outcomes are scarce. This study aims to analyze survival and identify opportunities for improvement using population-based data from a low-incidence country. GBC patients diagnosed between 2005 and 2016 with GBC were identified from the Netherlands Cancer Registry. Patients were grouped according to time period (2005–2009/2010–2016) and disease stage. Trends in treatment and overall survival (OS) were analyzed. In total 1834 patients were included: 661 (36%) patients with resected, 278 (15%) with non-resected non-metastatic, and 895 (49%) with metastatic GBC. Use of radical versus simple cholecystectomy (12% vs. 26%, p < 0.001) in early (pT1b/T2) GBC increased. More patients with metastatic GBC received chemotherapy (11% vs. 29%, p < 0.001). OS improved from 4.8 months (2005–2009) to 6.1 months (2010–2016) (p = 0.012). Median OS increased over time (2005–2009 vs. 2010–2016) in resected (19.4 to 26.8 months, p = 0.038) and metastatic (2.3 vs. 3.4 months, p = 0.001) GBC but not in unresected, non-metastatic GBC. In early GBC, patients with radical cholecystectomy had a median OS of 76.7 compared to 18.4 months for simple cholecystectomy (p < 0.001). Palliative chemotherapy showed superior (p < 0.001) survival in metastatic (7.3 versus 2.1 months) and non-resected non-metastatic (7.7 versus 3.5 months) GBC. In conclusion, survival of GBC remains poor. Radical surgery and palliative chemotherapy appear to improve prognosis but remain under-utilized.

• chemotherapy
• cohort studies
• epidemiology
• gallbladder neoplasms
• surgery

There is a controversy as to whether laparoscopic surgery leads to a poor prognosis compared to the open approach for early gallbladder carcinoma (GBC). We hypothesized that the laparoscopic approach is an alternative for early GBC.

To identify and evaluate the safety and feasibility of laparoscopic surgery in the treatment of early GBC.

A comprehensive search of online databases, including MEDLINE (PubMed), Cochrane libraries, and Web of Science, was performed to identify non-comparative studies reporting the outcomes of laparoscopic surgery and comparative studies involving laparoscopic surgery and open surgery in early GBC from January 2009 to October 2019. A fixed-effects meta-analysis was performed for 1- and 5-year overall survival and postoperative complications, while 3-year overall survival, operation time, blood loss, the number of lymph node dissected, and postoperative hospital stay were analyzed by random-effects models.

The review identified 7 comparative studies and 8 non-comparative studies. 1068 patients (laparoscopic surgery: 613; open surgery: 455) were included in the meta-analysis of 1-, 3-, and 5-year overall survival with no significant differences observed [(HR = 0.54; 95%CI: 0.29-1.00; I² = 0.0%; P = 0.051), (HR = 0.75; 95%CI: 0.34-1.65; I² = 60.7%; P = 0.474), (HR = 0.71; 95%CI: 0.47-1.08; I² = 49.6%; P = 0.107), respectively]. There were no significant differences in operation time [weighted mean difference (WMD) = 18.69; 95%CI: −19.98-57.36; I² = 81.4%; P = 0.343], intraoperative blood loss (WMD = −169.14; 95%CI: −377.86-39.57; I² = 89.5%; P = 0.112), the number of lymph nodes resected (WMD = 0.12; 95%CI: −2.95-3.18; I² = 73.4%; P = 0.940), and the complication rate (OR = 0.69; 95%CI: 0.30-1.58; I² = 0.0%; P = 0.377 ) between the two groups, while patients who underwent laparoscopic surgery had a reduced length of hospital stay (WMD = −5.09; 95%CI: −8.74- −1.45; I² = 91.0%; P= 0.006).

This systematic review and meta-analysis confirms that laparoscopic surgery is a safe and feasible alternative to open surgery with comparable survival and operation-related outcomes for early GBC.

• Laparoscopic surgery
• Open surgery
• Early gallbladder carcinoma
• Survival
• Meta-analysis

Gallbladder carcinoma (GBC) is one of the most lethal malignancies which do not have a targeted drug in the clinic. Patient-derived primary cell lines (PDCs) are useful in assessment of cancer complexity and heterogeneity, drug-sensitivity tests, and personalized-drug-selection guidance. The aim of this study is to establish GBC PDCs and characterize their biological features.

The characterization of PDCs was defined by morphology, growth kinetics, chromosomal analysis, short tandem repeat (STR) analysis, RNA-seq and tumorigenicity. Glycosylation of PDCs derived from GBC was first studied, and the PDC model’s performance were also tested and evaluated using seven molecular target inhibitors.

Three novel GBC cell lines from three GBC patients were successfully established and denoted as JXQ-3D-902R4, JXQ-3D-4494R, and JXQ-3D-4786R. These cell lines demonstrated the heterogeneous characteristics of tumor morphology and phenotypes which are consistent with primary GBC, such as irregular cell shape, varied chromosomal numbers, and different STR patterns. Moreover, the growth activity and tumorigenicity ability varied among the cell lines, of which JXQ-3D-4494R exhibited the best growth rate. Furthermore, glycan profiling of whole proteins were detected and characterized. Unique N-glycans of each PDC were identified, JXQ-3D-902R4, JXQ-3D-4494R and JXQ-3D-4786R contained ten, four and seven unique glycans, respectively. The epithelial origins of three PDCs were confirmed using RNA-seq based on the highly expressed typical epithelial marker genes. Moreover, the drug-sensitivity results demonstrated that the three PDCs exhibited different responses to the seven-most commonly used targeted medicines belonging to three groups: cell-cycle inhibitors, PI3K/AKT/mTOR signaling-pathway inhibitors, and ErbB inhibitors. JXQ-3D-4494R was sensitive to most of the inhibitors, JXQ-3D-4786R was sensitive to ErbB inhibitors, and JXQ-3D-902R4 was sensitive to PI3K/AKT/mTOR inhibitors.

These results indicate that PDCs may be efficient preclinical models for further investigation of the biological behaviors and potential targeted therapies of human GBC.

• Gallbladder carcinoma (GBC)
• drug sensitivity
• glycosylation
• patient-derived primary cell line (PDC)
• preclinical model

• Gallbladder
• contrast enhanced ultrasound (CEUS)
• differential diagnosis
• focal wall thickening
• linear transducer

• Adult
• Aged
• Cell Differentiation
• Contrast Media/therapeutic use
• Female
• Gallbladder/diagnostic imaging
• Gallbladder/pathology
• Gallbladder Neoplasms/diagnostic imaging
• Gallbladder Neoplasms/pathology
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Transducers
• Ultrasonography/methods
• Young Adult

• Gallbladder neoplasms
• cholecystectomy
• lymph node dissection
• survival analysis

• Aged
• Disease-Free Survival
• Female
• Gallbladder Neoplasms/pathology
• Gallbladder Neoplasms/surgery
• Hepatectomy
• Humans
• Liver/pathology
• Liver/surgery
• Lymph Node Excision/adverse effects
• Lymph Nodes/pathology
• Male
• Neoplasm Recurrence, Local/pathology
• Neoplasm Staging
• Postoperative Complications/etiology
• Retrospective Studies
• Treatment Outcome

• Gallbladder cancer (GBC)
• LODDS
• nomogram
• prognostic model

The indications for extrahepatic bile duct (EHBD) resection remain a major controversy in the surgical management of patients with gallbladder cancer. On the other hand, perineural invasion (PNI) was reported as an important factor in patients with gallbladder cancer because gallbladder cancer cells frequently spread to the tissues surrounding the EHBD via perineural routes. We assessed the correlation of PNI with clinicopathological factors in patients with gallbladder cancer to elucidate EHBD resection indications specifically in patients with PNI.

This retrospective study assessed the PNI status of 50 patients with gallbladder cancer who underwent curative resection and examined the correlation between the presence of PNI and clinicopathological factors.

Thirteen patients (26%) were PNI positive. PNI was significantly correlated with male sex, proximal-type tumor, lymphatic and vascular invasion, and advanced T stage. Multivariate analysis found that PNI positivity (p < 0.001), lymphatic invasion (p = 0.007), and nodal stage (p < 0.001) were independent prognostic factors. PNI was never observed in patients with stage T1 cancer. Conversely, PNI was detected rarely in distal-type tumors, all of whom developed various types of recurrences.

These results clearly demonstrated the prognostic impact of PNI in patients with gallbladder cancer. We suggest that EHBD resection in combination with cholecystectomy may not be useful for distal-type tumors from a perspective of PNI.

• Extrahepatic bile duct resection
• Gallbladder cancer
• Perineural invasion

High rates of de novo lipid synthesis have been discovered in certain kinds of tumours, including gallbladder cancer (GBC). Unlike several other tumours, GBC is highly insensitive to standard adjuvant therapy, which makes its treatment even more challenging. Although several potential targets and signalling pathways underlying GBC chemoresistance have been revealed, the precise mechanisms are still elusive. In this study, we found that α‐Mangostin, as a dietary xanthone, repressed the proliferation and clone formation ability, induced cell cycle arrest and the apoptosis, and suppressed de novo lipogenesis of gallbladder cancer cells. The underlying mechanisms might involve the activation of AMPK and, therefore, the suppression of SREBP1 nuclear translocation to blunt de novo lipogenesis. Furthermore, SREBP1 silencing by siRNA or α‐mangostin enhanced the sensitivity of gemcitabine in gallbladder cancer cells. In vivo studies also displayed that MA or gemcitabine administration to nude mice harbouring NOZ tumours can reduce tumour growth, and moreover, MA administration can significantly potentiate gemcitabine‐induced inhibition of tumour growth. Corroborating in vitro findings, tumours from mice treated with MA or gemcitabine alone showed decreased levels of proliferation with reduced Ki‐67 expression and elevated apoptosis confirmed by TUNEL staining, furthermore, the proliferation inhibition and apoptosis up‐regulation were obviously observed in MA combined with gemcitabine treatment group. Therefore, inhibiting de novo lipogenesis via targeting the AMPK/SREBP1 signalling by MA might provide insights into a potential strategy for sensitizing GBC cells to chemotherapy.

• AMPK
• SREBP1
• gallbladder cancer
• gemcitabine
• lipogenesis
• α-mangostin