Bile cholesterol and viscosity, the keys to discriminating adenomatous polyps from cholesterol polyps by a novel predictive scoring model.

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background: Adenomatous gallbladder polyps, premalignant lesions of the gallbladder, have fatal outcomes, whereas cholesterol polyps have benign features. Herein, we proposed a novel, predictive scoring model of adenomatous polyps to distinguish them from cholesterol polyps, by analyzing bile components and bile viscosity. Methods: Patients with gallbladder polyp pathologically confirmed after cholecystectomies were analyzed. After dividing patients into two groups (adenomatous or cholesterol polyps), the clinicopathologic profiles and bile nature, including components and viscosity were compared and a predictive scoring model for adenomatous polyps was assessed. Results: 11 adenomatous polyps and 96 cholesterol polyps were analyzed. The variables significantly associated with adenomatous polyps were age&gt;55years (OR=23.550, p=0.020 ), bile viscosity&lt;7.5sec -1 (OR=22.539, p=0.012 ), and bile cholesterol&lt;414.5mg/dl (OR=10.004, p=0.023 ) and the points for each variable in the predictive scoring model were allocated as 3, 3, and 2, respectively. Final scores ranged from 0 to 8 points and the best performance of model at a cutoff of ≥6 points had 90.9% of sensitivity and 80.2% of specificity. Conclusions: Bile viscosity and bile cholesterol accompanied by age were revealed as significant predictors of adenomatous polyps, distinguishing them from cholesterol polyps of gallbladder. It can be the cornerstone for creating accurate guidelines for preoperatively determining treatment strategies of gallbladder polyps.</jats:p>

Risk factors for cholesterol polyps in the gallbladder: a multicenter retrospective case-control study

“…Concerning increased body weight, several studies which set non-polyp subjects as the control group found this to be associated with GPs [14,37,38]. Interestingly, the positive relationship was hardly reported in other studies which compared CPs with neoplastic polyps as controls [12,19,39]. Indeed, it is well known that CPs and neoplasms progress in entirely different pathological processes, and this inconsistency needs more research to con rm.…”

“…Previous studies have profoundly investigated the risk factors for GPs formation, including middle age, male gender, obesity, fatty liver, abnormal body fat distribution, and dyslipidemia, but most of them were based on ultrasound results rather than specifying the exact histological classi cation [9][10][11]. Given that risk factors and the mechanisms of pathophysiologic mechanisms are quite different in various GPs, pathology-oriented analysis is undoubtedly more convincing [12]. However, so far, there is a paucity of data from high-level studies lucubrating CPs [13,14].…”