Grikyte Ieva, Ignatavicius Povilas
Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Str. 2, Kaunas, 50009, Lithuania.
Langenbecks Arch Surg. 2025 Jul 9;410(1):216. doi: 10.1007/s00423-025-03678-9.
To review, evaluate and summarize data from the literature presenting the risk of developing gallbladder cancer in patients with PSC and gallbladder polyps.
The systematic review was performed according to PRISMA recommendations and registered in the PROSPERO database. The PubMed, ScienceDirect, Web of Science, Biomed Central and EBSCOhost databases were used. Studies analysing patients with PSC and gallbladder polyps, their association with malignancy and outcomes were included.
Five retrospective studies and one case-control study with a total of 3415 patients diagnosed with PSC were included. Radiological examination of these 3324 patients with PSC revealed 207 (6.2%) gallbladder polyps, of which 34 (16.4%) were identified as gallbladder mass lesions. Of available histology results, 116 (34%) had gallbladder polyps. Out of these 116 patients with gallbladder polyps, gallbladder carcinoma (GBC) was found in 48 (41.4%) patients. The mean size of gallbladder polyps with adenocarcinoma ranged from 2.1 cm to 2.4 cm, whereas benign polyps ranged from 0.6 cm to 1.5 cm.
Gallbladder polyps with malignant changes are often observed in patients diagnosed with PSC. This supports international recommendations that cholecystectomy should be performed regardless of gallbladder polyp's size in PSC patients.
回顾、评估和总结文献中有关原发性硬化性胆管炎（PSC）和胆囊息肉患者发生胆囊癌风险的数据。
根据PRISMA指南进行系统评价，并在PROSPERO数据库中注册。使用了PubMed、ScienceDirect、Web of Science、Biomed Central和EBSCOhost数据库。纳入分析PSC和胆囊息肉患者、它们与恶性肿瘤的关联及结局的研究。
纳入了5项回顾性研究和1项病例对照研究，共有3415例诊断为PSC的患者。对这3324例PSC患者进行的影像学检查发现207例（6.2%）有胆囊息肉，其中34例（16.4%）被确定为胆囊占位性病变。在可获得的组织学结果中，116例（34%）有胆囊息肉。在这116例有胆囊息肉的患者中，48例（41.4%）发现有胆囊癌（GBC）。腺癌性胆囊息肉的平均大小在2.1厘米至2.4厘米之间，而良性息肉的平均大小在0.6厘米至1.5厘米之间。
在诊断为PSC的患者中经常观察到有恶变的胆囊息肉。这支持了国际上关于无论PSC患者胆囊息肉大小如何均应行胆囊切除术的建议。
