J Korean Med Sci.  2009 Jun;24(3):481-487. 10.3346/jkms.2009.24.3.481.

Clinicopathologic Features of Polypoid Lesions of the Gallbladder and Risk Factors of Gallbladder Cancer

• Kwon W
• Jang JY
• Lee SE
• Hwang DW
• Kim SW

• KMID: 1779167
• DOI: http://doi.org/10.3346/jkms.2009.24.3.481

Abstract

It is difficult to differentiate benign and malignancy in polypoid lesions of the gallbladder (PLG) by solely depending on imaging studies. Therefore clinicopathologic features of benign and malignant polyps are compared in an attempt to identify the risk factors of malignant polypoid lesions. The medical records of 291 patients who were confirmed to have PLG through cholecystectomy were reviewed and analyzed for age, sex, symptom, associated gallstone, morphology of PLG, size of PLG, number of PLG, and preoperative tumor markers. Benign PLG was found in 256 patients (88.0%) and malignant PLG in 35 patients (12.0%). Compared with benign group, the malignant group were older (61.1 yr vs. 47.1 yr, P<0.001), more often accompanied with symptoms (62.9% vs. 28.9%, P<0.001). Malignant PLG tended to be sessile (60.0% vs. 10.5%, P<0.001), larger (28.0 mm vs. 8.6 mm, P<0.001) and single lesion (65.7% vs. 44.1%, P<0.016). Age over 60 yr (P=0.021, odds ratio [OR], 8.16), sessile morphology (P<0.001, OR, 7.70), and size over 10 mm (P=0.009, OR, 8.87) were identified as risk factors for malignant PLG. Careful decision making on therapeutic plans should be made with consideration of malignancy for patients over 60 yr, with sessile morphology of PLG, and with PLG size of over 10 mm.

Keyword

Gallbladder; Polyps; Gallbladder Neoplasms; Risk Factors

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
Female
Gallbladder Neoplasms/*diagnosis/pathology
Humans
Male
Middle Aged
Polyps/*pathology
ROC Curve
Risk Factors

Figure

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  Fig. 1 ROC curve to determine the cut-off value of age (P<0.001).

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  Fig. 2 ROC curve to determine the cut-off value of PLG size (P<0.001).

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