GALLBLADDER POLYPS: CORRELATION AND AGREEMENT BETWEEN ULTRASONOGRAPHIC AND HISTOPATHOLOGICAL FINDINGS IN A POPULATION WITH HIGH INCIDENCE OF GALLBLADDER CANCER.

GALLBLADDER POLYPS: CORRELATION AND AGREEMENT BETWEEN ULTRASONOGRAPHIC AND HISTOPATHOLOGICAL FINDINGS IN A POPULATION WITH HIGH INCIDENCE OF GALLBLADDER CANCER.
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DOI:
10.1590/0102-672020230002e1732
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发表时间:
2023
影响因子:
1.5
通讯作者:
Ibañez, Luis
Ibañez, Luis
中科院分区:
其他
文献类型:
--
作者:
Inzunza, Martin;Irarrazaval, Maria Jesus;Pozo, Paloma;Pimentel, Fernando;Crovari, Fernando;Ibañez, Luis

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胆囊息肉已成为超声检查的常见发现。治疗必须考虑潜在的恶性病变风险。本研究的目的是分析胆囊息肉患者行胆囊切除术的超声表现,并比较其组织病理学表现(HPs)。本研究纳入了2007年至2020年超声诊断为胆囊息肉并行胆囊切除术的患者。共纳入447例患者,其中58%为女性。平均年龄45±12岁。美国息肉的平均大小为7.9±3.6 mm。值得注意的是,9%的息肉大于10 mm,且单个息肉明显大于多个息肉(p=0.003)。组织病理学检查证实息肉的存在率为88.4%,平均大小为4.8±3.4 mm。肿瘤性息肉16例(4.1%),其中4例为恶性,均为单发,均大于10 mm。我们发现超声与组织病理学结果息肉大小测定之间有显著相关性(r=0.44; p<0.001)。Bland-Altman分析获得了3.26毫米的美国尺寸高估。两种测量方法的受试者工作特征(ROC)曲线分析得出受试者工作特征曲线下面积(AUC)为0.77 (95%CI 0.74-0.81)。超声息肉大于10 mm存在腺瘤和恶性肿瘤的比值比(OR)为8.147 (95%CI 2.56-23.40),似然比为2.78。胆囊息肉的超声大小与组织病理记录呈正相关,诊断准确性高,有高估约3mm的趋势。肿瘤性息肉并不常见,它与大小有关。大于10mm的息肉与腺瘤和恶性肿瘤有关。
Gallbladder polyps are becoming a common finding in ultrasound. The management has to consider the potential risk of malignant lesions. The aim of this study was to analyze the ultrasound findings in patients undergoing cholecystectomy due to gallbladder polyps and compare them for histopathological findings (HPs). Patients with an ultrasonographic diagnosis of gallbladder polyp and who underwent cholecystectomy from 2007 to 2020 were included in the study. A total of 447 patients were included, of whom 58% were women. The mean age was 45±12 years. The mean size of polyps in US was 7.9±3.6 mm. Notably, 9% of polyps were greater than 10 mm, and single polyps were significantly larger than the multiple ones (p=0.003). Histopathological findings confirmed the presence of polyps in 88.4%, with a mean size of 4.8±3.4 mm. In all, 16 cases were neoplastic polyps (4.1%), 4 of them being malignancies, and all were single and larger than 10 mm. We found a significant correlation between ultrasound and histopathological findings polyp size determination (r=0.44; p<0.001). The Bland-Altman analysis obtained an overestimation of the US size of 3.26 mm. The receiver operating characteristic (ROC) curve analysis between both measures obtained an area under the receiver operating characteristic curve (AUC) of 0.77 (95%CI 0.74–0.81). Ultrasound polyps size larger than 10 mm had an odds ratio (OR) of 8.147 (95%CI 2.56–23.40) for the presence of adenoma and malignancy, with a likelihood ratio of 2.78. There is a positive correlation and appropriate diagnostic accuracy between ultrasound size of gallbladder polyps compared to histopathological records, with a trend to overestimate the size by about 3 mm. Neoplastic polyps are uncommon, and it correlates with size. Polyps larger than 10 mm were associated with adenoma and malignancy.
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