胆囊息肉的长期随访

Long-term follow up of gallbladder polyps.

作者信息

Park Jeong Youp, Hong Sung Pil, Kim Yoon Jae, Kim Hong Jeoung, Kim Hee Man, Cho Jae Hee, Park Seung Woo, Song Si Young, Chung Jae Bock, Bang Seungmin

机构信息

Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.

出版信息

J Gastroenterol Hepatol. 2009 Feb;24(2):219-22. doi: 10.1111/j.1440-1746.2008.05689.x. Epub 2008 Nov 26.

DOI:10.1111/j.1440-1746.2008.05689.x

PMID:19054258

Abstract

BACKGROUND AND AIM

The management of gallbladder polyps (GBP) is directly linked to the early diagnosis of gallbladder cancer (GBC). This study aimed to evaluate the malignant risk of GBP.

METHODS

In total, 1558 patients diagnosed with GBP were followed. Neoplastic polyps were defined as GBC and its premalignant lesions. The risk for malignancy was estimated with the cumulative detection rate of neoplastic polyps.

RESULTS

Thirty-three cases (2.1%) were diagnosed with neoplastic polyps. The cumulative detection rates of neoplastic polyps were 1.7% at 1 year, 2.8% at 5 years, and 4% at 8 years after diagnosis. The size of GBP and the presence of gallstones were risk factors for neoplastic polyps. Polyps > or = 10 mm had a 24.2 times greater risk of malignancy than polyps < 10 mm. However, 15 of 33 neoplastic polyps (45.5%) were < 10 mm at the time of diagnosis of GBP. During follow up in 36 (3.5%) of 1027 cases, an increase in size was detected; of these, nine (25%) had neoplastic polyps.

CONCLUSION

Even small polyps have a risk of malignancy, and careful long-term follow up of GBP will help detect and treat early GBC.

摘要

背景与目的

胆囊息肉（GBP）的管理与胆囊癌（GBC）的早期诊断直接相关。本研究旨在评估GBP的恶性风险。

方法

总共对1558例诊断为GBP的患者进行随访。肿瘤性息肉定义为GBC及其癌前病变。通过肿瘤性息肉的累积检出率评估恶性风险。

结果

33例（2.1%）诊断为肿瘤性息肉。诊断后1年、5年和8年肿瘤性息肉的累积检出率分别为1.7%、2.8%和4%。GBP的大小和胆结石的存在是肿瘤性息肉的危险因素。直径大于或等于10 mm的息肉发生恶性病变的风险是直径小于10 mm息肉的24.2倍。然而，33例肿瘤性息肉中有15例（45.5%）在诊断GBP时直径小于10 mm。在1027例患者的随访中，36例（3.5%）检测到息肉大小增加；其中9例（25%）有肿瘤性息肉。