摘要
Background:Preoperative differentiation of malignant and premalignant gallbladder polyps(GBPs)from benign lesions is a key imperative to guide treatment decision-making.We aimed to characterize the various types of GBPs and sought to identify the risk factors for neoplastic polyps.Our findings may help optimize treatment strategy.Methods:Retrospective analysis of 686 patients with post-cholecystectomy pathologically-proven GBPs between January 2003 and December 2016.The patients were classified into non-neoplastic polyp group,benign neoplastic polyp group,and adenoma canceration group.Clinical features,ultrasound findings,and results of laboratory investigations and histopathological examination were reviewed and compared between the groups.Results:Out of 686 patients,542(79.0%)had non-neoplastic polyps,134(19.5%)had neoplastic polyps,and 10(1.5%)had adenoma canceration.The mean age was 46.06±12.12 years;383(55.8%)patients were female.The median(25th percentile,75th percentile)time between diagnosis and surgery in the cholesterol polyp group[24(3.5,60)months]was significantly longer than that in adenoma[12(2,60)months]and adenoma canceration[5(0.475,12)months]groups.The mean diameter was 1.14±0.61 cm(range,0.5–8.4 cm).Three hundred twelve(45.5%)patients had solitary polyps and intralesional blood flow was observed in 41(6.0%)patients.On univariate analysis,age>49.5 years,polyp size>1.15 cm,solitary polyp,intralesional blood flow,absence of symptoms,and lack of cholecystitis showed a significant association with adenoma.On multivariate analysis,polyp size(>1.15 cm),intralesional blood flow,and lack of cholecystitis were independent predictors of adenoma.Conclusions:Polyp size>1.15 cm,intralesional blood flow,and lack of cholecystitis were predictors of neoplastic polyps.Malignant transformation of adenoma may occur over a relatively short time.
