Department of General Surgery, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey.
Department of Gastroenterological Surgery, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey.
J Coll Physicians Surg Pak. 2021 Dec;31(12):1422-1427. doi: 10.29271/jcpsp.2021.12.1422.
To determine the association of malignancy potential of gallbladder polyps with tumor markers and cholesterol levels, and at which value the presence of malignancy should be suspected.
Observational study.
University of Health Sciences, Adana City training and research Hospital from December 2017 to November 2020.
Ninety patients diagnosed with gallbladder polyp by abdominal ultrasonography, were included in the study. Patients were divided into subgroups of true pseudopolyp, cholesterol-non-cholesterolpolyp, malignant-non-malignant polyp. The groups were compared in terms of age, gender, polyp size, number of polyps, preoperative total cholesterol, HDL (high-density lipoprotein), LDL (low-density lipoprotein), triglyceride, Ca 19-9 (carbohydrate antigen 19-9), Ca 72-4 (carbohydrate antigen 72-4), Cea (carcinoembryonic antigen) levels.
In the true polyp group, polyp size, Ca 19-9, Ca 72-4 and Cea median values were significantly higher (p=0.001, p=0.029, p=0.003, and p=0.007, respectively); whereas, triglyceride levels were significantly lower compared to the pseudopolyp group (p=0.002). Polyp size was significantly lower in cholesterol polyp group compared to non-cholesterol polyp group (p= 0.032), and LDL and triglyceride medians were significantly higher (p=0.031, and p<0.001) in cholesterol group. Among the true polyps, polyp size, Ca 19-9, Ca 72-4 and Cea levels were significantly higher in adenocarcinoma group than non-malignant polyp groups (p<0.05). Cut-off values were determined as >11 mm AUC: 0.906 for size, >24.1 U/mL. AUC: 1.00 for Ca 19-9, >9.6 U/mL AUC: 1.00 for Ca 72-4, and >40 ng/mL AUC: 0.984 for CEA, respectively.
Polyps larger than 11mm with high levels of CEA, Ca 72-4, Ca 19-9, evaluated together, may act as a guide for the clinician in predicting malignancy. The availability of economical and accessible parameters may allow a new algorithm to be developed in the treatment and follow-up approach of gallbladder polyps. Key Words: Gallbladder polpys, Ca 19-9 antigen, Ca 72-4 antigen, Tumor marker, Gallbladder cancer.
确定胆囊息肉的恶性潜能与肿瘤标志物和胆固醇水平的关系，以及在何种情况下应怀疑存在恶性肿瘤。
观察性研究。
2017 年 12 月至 2020 年 11 月，在阿德亚那城市健康科学大学培训和研究医院进行。
通过腹部超声检查诊断为胆囊息肉的 90 例患者纳入研究。患者被分为真性假性息肉、胆固醇性非胆固醇性息肉、恶性非恶性息肉亚组。比较各组的年龄、性别、息肉大小、息肉数量、术前总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯、CA19-9（糖类抗原 19-9）、CA72-4（糖类抗原 72-4）、CEA（癌胚抗原）水平。
在真性息肉组中，息肉大小、CA19-9、CA72-4 和 CEA 的中位数显著升高（p=0.001、p=0.029、p=0.003 和 p=0.007，分别）；而甘油三酯水平显著低于假性息肉组（p=0.002）。与非胆固醇性息肉组相比，胆固醇性息肉组的息肉大小显著降低（p=0.032），而胆固醇组的 LDL 和甘油三酯中位数显著升高（p=0.031 和 p<0.001）。在真性息肉中，腺癌组的息肉大小、CA19-9、CA72-4 和 CEA 水平显著高于非恶性息肉组（p<0.05）。确定截断值为>11mm AUC：0.906 用于大小，>24.1 U/mL AUC：1.00 用于 CA19-9，>9.6 U/mL AUC：1.00 用于 CA72-4，和>40ng/mL AUC：0.984 用于 CEA。
直径大于 11mm 且 CEA、CA72-4、CA19-9 水平升高的息肉，联合评估可能有助于临床医生预测恶性肿瘤。经济实惠、易于获得的参数的可用性可能允许为胆囊息肉的治疗和随访方法开发新的算法。
胆囊息肉，CA19-9 抗原，CA72-4 抗原，肿瘤标志物，胆囊癌。
