胆囊息肉的处理策略：能否预测恶性胆囊息肉？
Management strategies for gallbladder polyps: is it possible to predict malignant gallbladder polyps?
机构信息
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
出版信息
Gut Liver. 2008 Sep;2(2):88-94. doi: 10.5009/gnl.2008.2.2.88. Epub 2008 Sep 30.
BACKGROUND/AIMS: Gallbladder (GB) polyps are commonly encountered in clinical practice, and are found more frequently as the number of medical screening examinations increases. The aim of this study was to determine optimal practice guideline for surgical treatment and follow-up of GB polyps.
METHODS
Data from healthy subjects of Seoul National University Hospital (SNUH) Health Care System of Gangnam Center were used to investigate the true prevalence of GB polyps. We also enrolled 689 patients with GB polyps diagnosed at SNUH from May 1(st), 1988 to April 30(th), 2006.
RESULTS
The GB polyp prevalence was 6.1% (7.1% in males and 4.8% in females). The median follow-up duration in the 689 study patients was 60 months, and 139 (20%) of them had polyps >/=10 mm in size. Twenty-five of the 180 patients who underwent cholecystectomy had adenocarcinomas. The chi(2) test was used to identify which of the following were risk factors of malignancy: age, sex, symptoms, size, rate of growth, multiplicity, accompanying stones, and shape. Age (>/=57 years), presence of symptoms, size (>/=10 mm), and shape (sessile) were found to be statistically significant risk factors by univariate analysis. However, multivariate analysis identified only age (>/=57 years) and size (>/=10 mm) as independent predictors of malignancy.
CONCLUSIONS
The present study shows that GB polyps >/=10 mm in size in patients aged >/=57 years are the independent factors predicting malignancy of the GB.
背景/目的：胆囊（GB）息肉在临床实践中很常见，随着医疗筛查检查次数的增加，其检出率也越来越高。本研究旨在确定胆囊息肉手术治疗和随访的最佳实践指南。
方法
我们使用首尔国立大学医院（SNUH）江南中心健康保健系统的健康受试者数据来调查 GB 息肉的真实患病率。我们还纳入了 1988 年 5 月 1 日至 2006 年 4 月 30 日在 SNUH 诊断为胆囊息肉的 689 例患者。
结果
GB 息肉的患病率为 6.1%（男性为 7.1%，女性为 4.8%）。689 例研究患者的中位随访时间为 60 个月，其中 139 例（20%）息肉>=/10mm。在接受胆囊切除术的 180 例患者中，有 25 例患有腺癌。采用卡方检验确定以下哪些因素是恶性肿瘤的危险因素：年龄、性别、症状、大小、生长速度、多发性、伴发结石和形状。单因素分析显示年龄（>=57 岁）、症状、大小（>=10mm）和形状（无蒂）是统计学上显著的危险因素。然而，多因素分析仅确定年龄（>=57 岁）和大小（>=10mm）是恶性肿瘤的独立预测因素。
结论
本研究表明，年龄>=57 岁且大小>=10mm 的胆囊息肉是预测胆囊恶性肿瘤的独立因素。
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