Clinical And Pathological Analysis Of Potential Risk Factors Of Malignant Polypoid Lesions Of Gallbladder

BackgroundPolypoid lesions of the gallbladder（PLG） is an elevation on the gallbladdermucosa.With the extensive development of ultrasound screening, polypoid lesions ofthe gallbladder populations increase. How to determine the nature of polypoid lesions ofgallbladder and its processing strategy before operation is a difficult clinical problemunsolved.ObjectiveTo explore potential risk factors of malignant gallbladder polypoid lesions，andevaluate the value of ultrasound in differential diagnosis of malignant and benigngallbladder polypoid lesions.Methods356cases of gallbladder polypoid lesions were collected and retrospectivelyanalysed the clinical and pathological features by data of operative pathology andpreoperative ultrasonic examination.ResultThe operative pathological findings revealed that pseudotumor polyps was themost major pathological type (335cases,94.1%), benign adenomas and malignantpolyp of gallbladder were12(3.4%) and9cases (2.6%) respectively. In malignantgroup of the gallbladder polyps, the majority (88.9%) of patients was over50years old,papillary or tubulovillous adenoma was the most common polypoid lesions (OR17.5,P <0.01). With the increase of the polyp size, the rate of malignancy was increased.When the polyp size was greater than or equal to2cm, the malignancy rate wasgreater than or equal to50%. Preoperative ultrasonic examination revealedcomplicated gallstone and size of PLG were important impact factors of ultrasound diagnosis of gallbladder polyps. Color doppler flow imaging (CDFI) is a independentpredictive factor for differential diagnosis of malignant and benign polyps.ConclusionMore than50years old, increased gallbladder diameters and the color Dopplerflow imaging were malignant potential risk factors. Gallbladder calculi and smallpolyps can impact the preoperative ultrasound false negative rate.