| Objective: To investigate the clinicopathological characteristics of Polypoid Lesions of the Gallbladder(PLG)and their risk factors in Handan area.Methods: A total of 236 patients admitted to Handan Central Hospital from September 2018 to August 2020 who underwent Laparoscopic Cholecystectomy(LC)during their hospitalization and were diagnosed with gallbladder polypoid disease were selected as the subjects.The clinicopathological data were retrospectively studied.The236 patients were grouped according to two grouping methods:(1)The 236 patients were divided into malignant polyp group and benign polyp group according to the pathological report of postoperative samples(2)According to the pathological classification criteria of gallbladder polyps published by Christensen and Ishak,236 patients were classified into neoplastic polyps group and non-neoplastic polyps group.The two groups of patients were compared by age,gender,symptoms,specific conditions of polyps,clinical features such as whether the patients were combined with clinical symptoms,whether the patients were combined with stones,and whether the polyps contained pedestals.At the same time,univariate analysis and multivariate Logistic linear regression were performed step by step to screen out the risk factors for gallbladder polyp lesions,and the Receiver operating characteristic curve(ROC curve)of the subject was analyzed.The area data under the ROC curve were calculated to determine the optimal critical value,so as to verify the accuracy of risk factors.Results:(1)There were 228 benign polyps,accounting for 96.6%(228/236),and 8malignant polyps,accounting for 3.4%(8/236).According to the analysis of single factor data of patients,age(P=0.008),symptoms(P=0.021),number of polyps(P=0.033),size of polyps(P=0.014),complicated gallstone(P=0.047),pedle containing or not(P=0.013)were malignant related risk factors(P<0.05).Multivariate regression analysis showed that age ≥50 years old(P=0.006)and polyp ≥1cm(P=0.014)were independent risk factors(P<0.05).The ROC curve of predicting malignant polyps by the size of polyps was drawn,P=0.014(P<0.05),which was statistically significant.The area under the curve(AUC)was 0.733,greater than 0.7,indicating that the prediction accuracy of malignant polyps by the size of polyps was relatively high.The optimal critical value was 1.523,which was adjusted to 1.5 for the convenience of clinical application.The ROC curve drawn by age to predict malignant polyps was statistically significant,P=0.026(P<0.05).The area under the curve(AUC)was 0.866,and the optimal critical value was 49.50,which was adjusted to 50 for the convenience of clinical application.(2)There were 44 cases of neoplastic polyps,accounting for about18%(44/236),and 192 cases of non-neoplastic polyps,accounting for 82%(192/236).According to univariate data analysis of patients,age(P=0.016),number of polyps(P=0.024)and size of polyps(P=0.011)were risk factors related to neoplastic polyps(P<0.05).Multivariate regression analysis showed that age ≥50 years(P=0.011)and polyp ≥1cm(P=0.001)were independent risk factors(P<0.05).The ROC curve used the size of polyps to predict neoplastic polyps,P =0.001,which was statistically significant.However,the area under the curve(AUC)was 0.666,less than 0.7,indicating that the prediction accuracy of neoplastic polyps using only the size of polyps was not high.The ROC curve of predicting neoplastic polyps based on age was drawn,and the AUC was0.623,less than 0.7,indicating that the prediction accuracy of neoplastic polyps based only on the patient’s age was also not high.Conclusion:(1)The possibility of neoplastic polyps should be considered when the patient’s age ≥50 years and the diameter of polyps ≥1cm;(2)Malignant polyps are highly suspected when they are older than 50 years,single and polyp diameter ≥1.5cm,and surgery should be performed as soon as possible. |
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