胆囊息肉样病变的临床预测分析

Clinical analysis of prediction to polypoid lesions of gallbladder

目的探讨影响术前预测肿瘤性息肉的临床病理指标，明确指标间的交互效应。方法对347例手术治疗的胆囊息肉样病变患者的临床资料进行回顾性研究。结果Logistic多因素回归分析显示仅5个指标对预测肿瘤性息肉有统计学意义，即年龄（P=0．015）、息肉数量（P=0．018）、息肉直径（P=0．000）、超声回声性质（P=0．000）以及息肉部位（P=0．030）。ROC曲线分析显示直径0．925cm是预测息肉为肿瘤与否的最佳临界点。结论年龄、息肉数量、息肉直径、息肉部位、超声回声性质均对预测胆囊息肉样病变性质有显著价值，其中息肉直径价值最高。直径0．925cm为预测胆囊息肉样病变假瘤性与肿瘤性的最佳临界点。

Objective To investigate the factor that related to neoplasm from the clinicopathologic character of gallbladder polyps, and identify the reciprocal effectiveness of these factors. Method Three hundred and forty-seven patients who were underwent operation with gallbladder polypoid lesions were reviewed, Results Logistic regression analysis showed, only 5 parameters were signifieant for the prediction of neoplastic lesions, including age of the patient （P = 0.015 ）, the number of polyps （P = 0.018 ）, the maximal diameter （P = 0.000）, echo property （P = 0.000）, as well as the position of polyps （P = 0.030）, of which the maximal diameter was the best one to predict the neoplasm polyps. Further analysis with ROC curve showed that 0.925 cm, the diameter of polyps, was the critical point to calculate the polyp was neoplasm or not. Conclusions Age of the patient, the number of polyps, the maximal diameter, the position of polyps, and echo property are independent factors in predicting gallbladder neoplastic lesions. The size of the polyps is the most significant one among the factors to predict gallbladder neoplasm with its critical point of 0.925 cm.