J Med Assoc Thai 2018; 101 (11):1537-41

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Clinical Factors Predictive of GB Adenoma/Carcinoma in Patients with GB Polyps
Ungarreevittaya P , Thammaroj J , Jenwitheesuk K Mail

Objective: To evaluate clinical risk factors of gallbladder adenoma or adenocarcinoma in Thai patients with gallbladder polyps.

Materials and Methods: The present study was conducted as a cross-sectional analytical study at the Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand. The inclusion criteria were adult patients that underwent laparoscopic cholecystectomy, diagnosed as gallbladder polyps by any of the radiographical modalities, with available pathological results. Factors associated with gallbladder adenoma/carcinoma were analyzed by using multivariate logistic regression analysis.

Results: Eighty-five eligible patients were included in the present study. Of those, 19 patients (22.4%) had adenoma polyp, while 66 patients (77.7%) were in cholesterol polyp group. Five patients were gallbladder carcinoma (5.9%). After adjusted, there were two independent factors associated with adenoma polyp including imaging size and pain or biliary colic symptom. Neutrophil lymphocyte ratio [NLR] and imaging polyp size were significant predictors for gallbladder carcinoma with adjusted odds ratio of 4.28 (95% CI 1.01 to 17.57) and 1.31 (95% CI 1.01 to 1.72), respectively.

Conclusion: Clinical factors are important predictors for gallbladder adenoma/carcinoma. Imaging gallbladder polyp size and biliary colic pain are indicators for gallbladder adenoma, while NLR and the imaging gallbladder polyp size are suggestive for gallbladder adenocarcinoma.

Keywords: Biliary colic, Neutrophil lymphocyte ratio, Sensitivity, Specificity


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