Putative precursors of gallbladder dysplasia: a review of 400 routinely resected specimens.
BACKGROUND
Dysplasia is thought to be a precursor of invasive gallbladder carcinoma, but it is unsettled whether dysplasia arises from other precursor lesions.


OBJECTIVE
To ascertain the presence and nature of precursors of dysplasia in the gallbladder.


METHODS
Four hundred consecutive cholecystectomy specimens were processed and stained routinely for diagnosis. We retrospectively reviewed these cases to look for the presence of epithelial changes, including antral-type metaplasia, intestinal metaplasia, and dysplasia.


RESULTS
Antral-type metaplasia, intestinal metaplasia, and dysplasia were found in 238 (59.5%), 39 (9.8%), and 20 (5.0%) cases, respectively. The mean patient age was 47.7 years (range, 15-93 years). The mean ages for patients with antral-type metaplasia, intestinal metaplasia, and dysplasia were 49.4, 50.9, and 52.6 years, respectively. Statistically significant associations were found between antral-type metaplasia and intestinal metaplasia (P = .007, chi2 test) and between intestinal metaplasia and dysplasia (P < .001, chi2 test).


CONCLUSIONS
These associations, along with the age gradient from antral-type metaplasia to dysplasia, suggest a progression from antral-type metaplasia to dysplasia via intestinal metaplasia.
Mukhopadhyay
Sanjay
S
Department of Pathology, State University of New York Upstate Medical University, Syracuse 13210, USA.
Landas
Steve K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005704:Gallbladder / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D008679:Metaplasia / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies