Management Strategies for Gallbladder Polyps: Is It Possible to Predict Malignant Gallbladder Polyps?
Management Strategies for Gallbladder Polyps: Is It Possible to Predict Malignant Gallbladder Polyps?
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DOI：
10.5009/gnl.2008.2.2.88
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发表时间：
2008-09-01
期刊：
影响因子：
3.4
通讯作者：
Park, Min Jung
中科院分区：
文献类型：
--
作者：
Park, Joo Kyung;Yoon, Yong Bum;Park, Min Jung
背景/目标：胆囊（GB）息肉在临床实践中经常遇到，并且随着医学筛查检查次数的增加而更频繁地被发现。本研究的目的是确定GB息肉手术治疗和随访的最佳实践指南。研究方法：来自江南中心首尔国立大学医院（SNUH）保健系统的健康受试者的数据被用来调查GB息肉的真实患病率。我们还纳入了1988年5月1日至2006年4月30日在SNUH诊断为GB息肉的689例患者。结果：胆囊息肉的患病率为6.1%（男性7.1%，女性4.8%）。689例患者的中位随访时间为60个月，其中139例（20%）息肉大小>= 10 mm。180例接受胆囊切除术的患者中有25例患有腺癌。卡方检验用于确定以下哪些是恶性肿瘤的危险因素：年龄、性别、症状、大小、生长速度、多样性、伴随结石和形状。单变量分析发现，年龄（≥ 57岁）、有症状、大小（≥ 10 mm）和形状（无柄）是统计学上显著的危险因素。然而，多变量分析仅将年龄（>= 57岁）和大小（>= 10 mm）确定为恶性肿瘤的独立预测因子。结论：本研究表明年龄≥ 57岁的患者中胆囊息肉≥ 10 mm是预测胆囊恶性的独立因素。(Gut和肝脏2008;2：88-94）
Background/Aims: Gallbladder (GB) polyps are commonly encountered in clinical practice, and are found more frequently as the number of medical screening examinations increases. The aim of this study was to determine optimal practice guideline for surgical treatment and follow-up of GB polyps. Methods: Data from healthy subjects of Seoul National University Hospital (SNUH) Health Care System of Gangnam Center were used to investigate the true prevalence of GB polyps. We also enrolled 689 patients with GB polyps diagnosed at SNUH from May 1(st), 1988 to April 30(th), 2006. Results: The GB polyp prevalence was 6.1% (7.1% in males and 4.8% in females). The median follow-up duration in the 689 study patients was 60 months, and 139 (20%) of them had polyps >= 10 mm in size. Twenty-five of the 180 patients who underwent cholecystectomy had adenocarcinomas. The chi(2) test was used to identify which of the following were risk factors of malignancy: age, sex, symptoms, size, rate of growth, multiplicity, accompanying stones, and shape. Age (>= 57 years), presence of symptoms, size (>= 10 mm), and shape (sessile) were found to be statistically significant risk factors by univariate analysis. However, multivariate analysis identified only age (>= 57 years) and size (>= 10 mm) as independent predictors of malignancy. Conclusions: The present study shows that GB polyps >= 10 mm in size in patients aged >= 57 years are the independent factors predicting malignancy of the GB. (Gut and Liver 2008;2:88-94)