title: Putative precursors of gallbladder dysplasia: a review of 400 routinely resected specimens.
abstract: 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.
authors.affiliation: Department of Pathology, State University of New York Upstate Medical University, Syracuse 13210, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Mukhopadhyay
authors.forename: Steve K
authors.initials: SK
authors.lastname: Landas
mesh_terms: 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