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Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer.

Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW - J. Korean Med. Sci. (2009)

Bottom Line: Therefore clinicopathologic features of benign and malignant polyps are compared in an attempt to identify the risk factors of malignant polypoid lesions.Benign PLG was found in 256 patients (88.0%) and malignant PLG in 35 patients (12.0%).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

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.

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

Mentions: For continuous variables such as age and polyp size, the cut-off values were obtained by ROC curve in order to categorize the values into groups. The cut-off values were 57.5 yr of age and 12.5 mm for the size. The sensitivity and the specificity of the cut-off values were 0.77, 0.73 for age, and 0.83, 0.83 for size, respectively. The cut-off values were rounded off to 60 yr and 10 mm into denary scale to make the clinical application of the values more convenient. The sensitivity and the specificity of the rounded off selected cut-off value were 0.60, 0.81 for age, and 0.83, 0.78 for size, respectively (Fig. 1, 2).


Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer.

Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW - J. Korean Med. Sci. (2009)

ROC curve to determine the cut-off value of PLG size (P<0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698196&req=5

Figure 2: ROC curve to determine the cut-off value of PLG size (P<0.001).
Mentions: For continuous variables such as age and polyp size, the cut-off values were obtained by ROC curve in order to categorize the values into groups. The cut-off values were 57.5 yr of age and 12.5 mm for the size. The sensitivity and the specificity of the cut-off values were 0.77, 0.73 for age, and 0.83, 0.83 for size, respectively. The cut-off values were rounded off to 60 yr and 10 mm into denary scale to make the clinical application of the values more convenient. The sensitivity and the specificity of the rounded off selected cut-off value were 0.60, 0.81 for age, and 0.83, 0.78 for size, respectively (Fig. 1, 2).

Bottom Line: Therefore clinicopathologic features of benign and malignant polyps are compared in an attempt to identify the risk factors of malignant polypoid lesions.Benign PLG was found in 256 patients (88.0%) and malignant PLG in 35 patients (12.0%).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

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.

Show MeSH
Related in: MedlinePlus