Abstract
BackgroundAdenomatous gallbladder polyps, premalignant lesions of the gallbladder, have fatal outcomes, whereas cholesterol polyps have benign features. Herein, we proposed a novel, predictive scoring model of adenomatous polyps to distinguish them from cholesterol polyps, by analyzing bile components and bile viscosity.MethodsPatients with gallbladder polyp pathologically confirmed after cholecystectomies were analyzed. After dividing patients into two groups (adenomatous or cholesterol polyps), the clinicopathologic profiles and bile nature, including components and viscosity were compared and a predictive scoring model for adenomatous polyps was assessed.ResultsEleven adenomatous polyps and 96 cholesterol polyps were analyzed. The variables significantly associated with adenomatous polyps were age > 55 years (OR = 23.550, p = 0.020), bile viscosity< 7.5 s− 1 (OR = 22.539, p = 0.012), and bile cholesterol< 414.5 mg/dl (OR = 10.004, p = 0.023) and the points for each variable in the predictive scoring model were allocated as 3, 3, and 2, respectively. Final scores ranged from 0 to 8 points and the best performance of model at a cutoff of ≥6 points had 90.9% of sensitivity and 80.2% of specificity.ConclusionsBile viscosity and bile cholesterol accompanied by age were revealed as significant predictors of adenomatous polyps, distinguishing them from cholesterol polyps of gallbladder. It can be the cornerstone for creating accurate guidelines for preoperatively determining treatment strategies of gallbladder polyps.
Highlights
Adenomatous gallbladder polyps, premalignant lesions of the gallbladder, have fatal outcomes, whereas cholesterol polyps have benign features
Among the patients diagnosed with polypoid lesions of the gallbladder larger than 1 cm, patients with cholesterol polyps or adenomas identified on the permanent pathology test were enrolled for analysis and retrospectively reviewed
Relevant predictive models for premalignant Gallbladder polypoid lesion (GBP) Using the significant variables from multivariate logistic regression analysis, we developed a predictive scoring model for adenomatous polyps that would distinguish them from cholesterol polyps
Summary
Adenomatous gallbladder polyps, premalignant lesions of the gallbladder, have fatal outcomes, whereas cholesterol polyps have benign features. We proposed a novel, predictive scoring model of adenomatous polyps to distinguish them from cholesterol polyps, by analyzing bile components and bile viscosity. Polypoid lesions of the gallbladder (GBP) are defined as any raised lesion of the mucosal surface of the gallbladder. The majority of GBPs are asymptomatic benign polyps which are classified as pseudopolyps, and most of them are cholesterol polyps. About 2% of the GBPs have malignant potential and most of which are adenomas. These premalignant lesions could proceed to gallbladder cancer, usually with a dismal prognosis as the stage advances.
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