Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (1): 59-63.doi: 10.6040/j.issn.1671-7554.0.2020.0742

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Analysis of clinical characteristics of 48 cases of gallbladder adenoma based on different pathological grades

LIANG Li, SUN Bin, ZHANG Hongzhan, YE Fangzhi, FENG Xianguang, ZHANG Kai   

  1. Department of Hepatobiliary Surgery, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250031, Shandong, China
  • Published:2021-01-09

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Abstract: Objective To investigate the clinical characteristics and canceration risks of gallbladder adenoma with different pathological grades. Methods The clinical data of 48 cases of gallbladder adenoma were retrospectively analyzed. The patients were divided into different groups according to the pathological grades and canceration risks. Gender, age, associated clinical symptoms, complicated gallstones, single polyp, polyp size, CEA and CA199 were analyzed. Results According to the pathological grades, the patients were divided into 3 groups: simple gallbladder adenoma group(n=24, 50%), gallbladder adenoma with low-grade intraepithelial neoplasia group(n=17, 35.4%), and gallbladder adenoma with high-grade intraepithelial neoplasia group(n=7, 14.6%), which included 2 cases of intramucosal focal carcinoma. The incidence of gallbladder adenoma with intraepithelial neoplasia was 50%, and the overall cancerization rate was 4.2%(2/48). Among the clinical characteristics, age, associated clinical symptoms and polyp size showed significant statistical differences among gallbladder adenoma with different pathological grades(P<0.05). There were significant statistical differences in age, associated clinical symptoms and polyp size between the simple gallbladder adenoma group and intraepithelial neoplasia groups(P<0.05). According to binary Logistic regression analysis, age(OR=5.716, 95%CI: 1.387-23.564)and polyp size(OR=4.442, 95%CI: 1.057-18.675)were the risk factors of canceration. Conclusion Half of gallbladder adenomas are complicated with different grades of intraepithelial neoplasia, with a certain malignant potential.

Key words: Gallbladder adenoma, Intraepithelial neoplasia, Gallbladder cancer, Clinical analysis

CLC Number: 

  • R657.4
[1] 卢昊, 刘全达. 2017年欧洲多学会联合指南:胆囊息肉管理和随访[J]. 临床肝胆病杂志, 2017, 33(6): 1051-1055.
[2] Choi YS, Do JH, Seo SW, et al. Prevalence and risk factors of gallbladder polypoid lesions in a healthy population [J]. Yonsei Med J, 2016, 57(6): 1370-1375.
[3] Sung JE, Nam CW, Nah YW, et al. Analysis of gallbladder polypoid lesion size as an indication of the risk of gallbladder cancer [J]. Korean J Hepatobiliary Pancreat Surg, 2014, 18(1): 9-13.
[4] Albores-Saavedra J, Chable-Montero F, Gonzalez-Romo MA, et al. Adenomas of the gallbladder. Morphologic features, expression of gastric and intestinal mucins, and incidence of high-grade dysplasia/carcinoma in situ and invasive carcinoma [J]. Hum Pathol, 2012, 43(9): 1506-1513.
[5] Katharine VP, Dhanpat J. Benign tumors and tumor-like lesions of the gallbladder and extrahepatic biliary tract [J]. Diagnostic Histopathology, 2010, 16(8): 371-379.
[6] 邹声泉, 张林. 全国胆囊癌临床流行病学调查报告[J]. 中国实用外科杂志, 2000, 20(1): 43-46. ZOU Shengquan, ZHANG Lin. Clinical epidemiologic characteristics of carcinoma of gallbladder in China [J]. Chinese Journal of Practical Surgery, 2000, 20(1): 43-46.
[7] 屠金夫, 蒋飞照, 黄秀芳, 等. 胆囊腺瘤及癌变的诊断与治疗[J]. 肝胆胰外科杂志, 2007, 4(19): 255-256. TU Jinfu, JIANG Feizhao, HUANG Xiufang, et al. Diagnosis and treatment of cystic adenoma and canceration [J]. Journal of Hepatopancreatobiliary Surgery, 2007, 4(19): 255-256.
[8] Lee SH, Lee DS, You IY, et al. Histopathologic analysis of adenoma and adenoma-related lesions of the gallbladder [J]. Korean J Gastroenterol, 2010, 55(2): 119-126.
[9] Roa I, De Aretxabala X, Araya JC. Preneoplastic lesions in gallbladder cancer [J]. J Surg Oncol, 2006, 93(8): 615-623.
[10] Kwon W, Jang JY, Lee SE, et al. Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer[J]. J Korean Med Sci, 2009, 24(3): 481-487.
[11] Kozuka S, Tsubone M, Yasui A, et al. Relation of adenoma to carcinoma in the gallbladder [J]. Cancer, 1982, 50: 2226-2234.
[12] 张林, 邹声泉. 胆囊腺瘤-腺癌中的DNA含量和基因表达[J]. 中华肝胆外科杂志, 2004, 10(7): 460-462. ZHANG Lin, ZOU Shengquan. DNA content and gene expression in adenoma-carcinoma sequence of gallbladder carcinogenesis [J]. Chinese Journal of Hepatobiliary Surgery, 2004, 10(7): 460-462.
[13] 步宏, 李一雷. 病理学[M]. 9版. 北京: 人民卫生出版社, 2018: 118-119.
[14] 陆良勇, 陈成伟, 刘燕, 等. 胆囊腺瘤伴不典型增生及原位癌的组织形态和免疫组化研究[J]. 中华消化杂志, 2000, 20(2): 130-131. LU Liangyong, CHEN Chengwei, LIU Yan, et al. Histological and immunohistochemical studies of cystic adenoma with atypical hyperplasia and carcinoma in situ[J]. Chinese Journal of Digestion, 2000, 20(2): 130-131.
[15] Lee KF, Wong J, Li JC, et al. Polypoid lesions of he gallbladder [J]. Am J Surg, 2004, 188(2): 186-190.
[16] 吕文才, 贾莉, 温爽, 等. 从胆囊癌的高危因素看胆囊息肉的外科处理策略:是否大于1 cm的胆囊息肉都需要手术[J]. 中华肝胆外科杂志, 2017, 12(23): 861-864. LYU Wencai, JIA Li, WEN Shuang, et al. Surgical treatment strategy of gallbladder polyps based on high risk factors of gallbladder cancer [J]. Chinese Journal of Hepatobiliary Surgery, 2017, 12(23): 861-864.
[17] Kasle D, Rahnemai-Azar AA, Bibi S, et al. Carcinoma in situ in a 7 mm gallbladder polyp: Time to change current practice? [J]. World J Gastrointest Endosc, 2015, 7(9): 912-915.
[18] Terzi C, Sokmen S, Seçkin S, et al. Polypoid lesions of the gallbladder: report of 100 cases with special reference to operative indications [J]. Surgery, 2000, 127(6): 622-627.
[19] 钱能,陈文超,陈海华,等. 胆囊息肉样病变748例分析[J]. 中华肝胆外科杂志, 2014, 20(9): 655-658. QIAN Neng, CHEN Wenchao, CHEN Haihua, et al. Management of polypoid lesions of the gallbladder: an analysis of 748 patients [J]. Chinese Journal of Hepatobiliary Surgery, 2014, 20(9): 655-658.
[20] 冯贤松, 李时望, 方开锋, 等. 胆囊息肉样病变281例临床分析[J]. 腹部外科, 2004, 17(6): 332-333. FENG Xiansong, LI Shiwang, FANG Kaifeng, et al. Clinical analysis on 281 cases of polypoid lesions of gallbladder [J]. Journal of Abdominal Surgery, 2004, 17(6): 332-333.
[21] 慎浩鑫, 宋虎伟, 王林, 等. 西北五省17家医院2 379例胆囊癌临床分析[J]. 中华外科杂志, 2015, 53(10): 747-751. SHEN Haoxin, SONG Huwei, WANG Lin, et al. Clinical feature of gallbladder cancer in Northwestern China: a report of 2 379 cases from 17 institutions [J]. Chinese Journal of Surgery, 2015, 53(10): 747-751.
[22] Elmasry M, Lindop D, Dunne DF, et al. The risk of malignancy in ultrasound detected gallbladder polyps: A systematic review [J]. Int J Surg, 2016, 33(PtA): 28-35.
[23] Guo J, Wu G, Zhou Z. Polypoid lesions of the gallbladder: report of 160 cases with special reference to diagnosis and treatment in China [J]. Int J Clin Exp Pathol, 2015, 8(9): 11569-11578.
[24] 张禀业, 葛春林. 胆囊腺瘤癌变的相关因素分析[J]. 现代肿瘤医学, 2019, 27(22): 4026-4028. ZHANG Bingye, GE Chunlin. Analysis of related factors of carcinogenesis of gallbladder adenoma[J]. Journal of Modern Oncology, 2019, 27(22): 4026-4028.
[25] Jones-Monahan KS, Gruenberg JC, Finger JE, et al. Isolated small gallbladder polyps: an indication for cholecystectomy in symptomatic patients[J]. Am Surg, 2000, 66(8): 716-719.
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