title: Predictors of incidental gallbladder cancer in elderly patients.
abstract: BACKGROUND
  At the time of diagnosis, most patients with gallbladder cancer are in advanced stage and the cancer is unresectable. Long-term survivors are usually seen in a small number of patients with incidental gallbladder cancer. This study aimed to identify preoperative predictors of incidental gallbladder cancer in elderly patients.
  
  
  METHODS
  A total of 4014 patients of more than 44 years old who had undergone cholecystectomy at our department from January 2000 to December 2010 were retrospectively reviewed. Univariate and multivariate modalities were used to identify the predictive factors of incidental gallbladder cancer.
  
  
  RESULTS
  Twenty-nine of the 4014 patients who had undergone cholecystectomy for benign gallbladder diseases were histologically diagnosed as having incidental gallbladder cancer. Multivariate analysis identified that elevated carbohydrate antigen 19-9 combined with carcinoembryonic antigen and/or carbohydrate antigen 125 (P=0.045), a gallbladder polyp greater than or equal to 1.2 cm (P=0.043) and focal gallbladder wall thickening of more than or equal to 5 mm (P=0.002) were predictive factors of incidental gallbladder cancer.
  
  
  CONCLUSIONS
  Cholecystectomy is suggested for patients with these predictive factors and intraoperative frozen section should be considered to rule out carcinoma.
authors: Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongtinan Road, Chaoyang District, Beijing 100020, China. heqiang349@sina.com.
authors: Ji-Qiao
authors: JQ
authors: Zhu
authors: Dong-Dong
authors: DD
authors: Han
authors: Xian-Liang
authors: XL
authors: Li
authors: Jian-Tao
authors: JT
authors: Kou
authors: Hua
authors: H
authors: Fan
authors: Qiang
authors: Q
authors: He
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D018394:CA-125 Antigen / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002681:China; D002763:Cholecystectomy; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008565:Membrane Proteins / Q000097:blood; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins