摘要
目的分析胆囊息肉>10mm发生肿瘤性病变的超声特征。方法根据术后病理确诊,胆囊息肉>10mm患者53例分为肿瘤性息肉组(12例)和非肿瘤性息肉组(41例),比较两组超声声像图特征。绘制ROC曲线确定肿瘤性与非肿瘤性息肉最佳截断点,采用单因素及多因素Logistic回归分析预测息肉肿瘤性病变的因素。结果 53例患者肿瘤性病变发生率为22.6%,恶性病变发生率为15.1%。息肉大小为15mm和年龄60岁是区分肿瘤性与非肿瘤性息肉的最佳截断点,AUC分别为0.880[95%CI(0.793~0.947),P<0.01]和0.757[95%CI(0.691~0.875),P<0.01],灵敏度分别为75.0%和83.3%,特异度分别为95.0%和72.2%。息肉偏大(≥15mm)、胆囊息肉内无高回声病灶、邻近胆囊壁增厚、表面不规则是肿瘤性息肉的预测因素(P<0.05)。结论胆囊息肉>10mm发生肿瘤性病变概率不高,息肉偏大(≥15mm)和胆囊息肉内无高回声病灶可作为新的预测因素。
Objective To analyze the ultrasonographic features of gallbladder polyps more than 10 mm in size with tumorous lesions. Methods Based on the postoperative pathological diagnosis, 53 patients with gallbladder polyps more than 10 mm in size were divided into two groups of A(with tumorous lesions, 12 cases) and B(without tumorous lesions, 41 cases). The ultrasonographic features of the polyps were compared and analyzed with univariate and multivariate Logistie regression analysis. The ROC curve was drawn to determine the cut-off points for differentiating the neoplastic polyps from the non-neoplastic polyps. Results The incidenee of polyps more than 10 mm in size with neoplasia was 22.6% and that with malignant lesions was 15.1%. Taking the size of 15 mm and patient age at 60 years old as the cut-off points of neoplastic polyps, the AUC values were 0. 880 [95%CI(0. 793-0. 947) ,P〈0. 01] and 0. 757[95%CI(0. 691-0. 875), P〈0.01] and the sensitivities predicting tumorous lesions were 75.0% and 83.3% and the speeificities were 95.0% and 72. 2%, respectively. The larger polyps with size ≥15 mm, non-hyperechoic lesions within polyp, and thick or/ and irregular adjacent gallbladder wall were the predictors of the neoplastic polyps (P〈0.05). Conclusion The incidence of neoplastic lesions is not high in gallbladder polyps with size 〉10 mm. Larger polyps (≥ 15 mm) and non-hyperchoic within polyps may be used as the predictors for tumorous lesions.
作者
董吉
丁炎
朱巧英
吴鹏西
DONG Ji;DING Yan;ZHU Qiaoying(Department of Medical Ultrasound, Affiliated Wuxi People ' s Hospital, Nanjing Medical University, Wuxi 214023, CHINA)
出处
《江苏医药》
CAS
2018年第5期546-548,共3页
Jiangsu Medical Journal
基金
无锡市卫计委科教强卫工程青年人才(QNRC069)
关键词
胆囊息肉
肿瘤性病变
超声
Gallbladder polyps
Neoplastic lesions
Ultrasonography