Can the growth rate of a gallbladder polyp predict a neoplastic polyp?
OBJECTIVE
The aim of this study was to evaluate whether the growth rate of a gallbladder (GB) polyp is a predictive indicator for neoplastic polyps.


BACKGROUND
Cholecystectomy for GB polyps that are larger than 10 mm is generally recommended because of the high probability of neoplasm. In contrast, a follow-up strategy is preferred for GB polyps smaller than 10 mm. However, there are no treatment guidelines for polyps that grow in size during the follow-up period.


METHODS
We retrospectively investigated 145 patients with GB polyps who underwent at least 1 ultrasonographic follow-up examination over an interval greater than 6 months, before cholecystectomy at Samsung medical center, South Korea, from 1994 to 2007. The growth rate was determined based on the change in size per time interval between 2 ultrasonographic examinations (mm/mo).


RESULTS
The median age of the patients was 48 years (range: 25 to 75). One hundred twenty-five non-neoplastic polyps and 20 neoplastic polyps were found. Neoplastic polyps were more frequently found in patients older than 60 years, those with hypertension, a polyp size greater than 10 mm, and a rapid growth rate greater than 0.6 mm/mo. On multivariate analysis, however, the growth rate was not related to the neoplastic nature of a polyp, but older age (>60 y) and large size (>10 mm) were significantly associated with neoplastic polyps.


CONCLUSIONS
Patient's age (>60 y) and large polyp size (>10 mm) were significant predictive factors for neoplastic GB polyps. GB polyps less than 10 mm in diameter do not require surgical intervention simply because they grow.
Shin
Su Rin
SR
Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Lee
Jong Kyun
JK
Lee
Kwang Hyuck
KH
Lee
Kyu Taek
KT
Rhee
Jong Chul
JC
Jang
Kee-Taek
KT
Kim
Seong Hyun
SH
Choi
Dong Wook
DW
D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002763:Cholecystectomy; D018450:Disease Progression; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011127:Polyps / Q000601:surgery / Q000648:ultrastructure*; D011230:Precancerous Conditions / Q000000981:diagnostic imaging* / Q000601:surgery; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography