A New Risk Scoring System to Predict Malignancy in Gallbladder Polyps: a Single-Center Study

Güneş, Yasin; Taşdelen, İksan; Ergin, Anıl; Çakmak, Ahmet; Bilgili, Ali; Ağar, Mustafa; Aydın, Mehmet Timuçin

doi:10.1007/s11605-022-05351-8

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…In addition, Yuan et al [26] established an ultrasound radiomic model based on the spatial and morphological features extracted from ultrasound images, which effectively contributed to the preoperative diagnosis of true and pseudo GPs with an AUC of 0.898. Although the AUCs of our linear scoring models for different age groups were slightly lower than the above studies [14,25,26], we consider the variables included in our study to be relatively less compared to their studies.…”

Section: Discussionmentioning

confidence: 69%

“…Ma et al [14] established a linear scoring system based on age, positive blood ow signal, and cross-sectional area of GPs for identifying true polyps, which were accurate with an AUC of 0.883. Güneş et al [25] established a linear scoring system based on age ≥50, presence of symptoms, polyp size >12.5 mm, single polyp, concomitant gallstones, and gallbladder wall thickness ≥4mm for identifying the GPs with malignant potential with an AUC of 0.958 for risk scores. In addition, Yuan et al [26] established an ultrasound radiomic model based on the spatial and morphological features extracted from ultrasound images, which effectively contributed to the preoperative diagnosis of true and pseudo GPs with an AUC of 0.898.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study

Dou

Liu

et al. 2023

Preprint

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Background: The prevalence of neoplastic polyps in gallbladder polyps (GPs) increases sharply with age and is associated with gallbladder carcinoma (GBC). This study aims to predict neoplastic polyps and provide appropriate treatment strategies based on preoperative ultrasound features in patients with different age level. Methods: According to the age classification of WHO, 1523 patients with GPs who underwent cholecystectomy from January 2015 to December 2019 at 11 tertiary hospitals in China were divided into young adults group (n=622), middle-aged group (n=665) and elderly group (n=236). Linear scoring models were established based on independent risk variables screened by Logistic regression model in different age groups. The area under ROC (AUC) to evaluate the predictive ability of linear scoring models, long- and short diameter of GPs. Results: Independent risk factors for neoplastic polyps included number of polyps, polyp size (long diameter), and fundus in young adults and elderly groups, while number of polyps, polyp size (long diameter), and polyp size (short diameter) in middle-aged groups. In different age groups, the AUCs of its linear scoring model was higher than the AUCs of the long- and short diameter of GPs for differentiating neoplastic and non-neoplastic polyps (all P<0.05), and Hosmer-Lemeshow goodness of fit test showed that the prediction accuracy of the linear scoring models was higher than the long- and short diameter of GPs (all P>0.05). Conclusion: The linear scoring models of young adults, middle-aged and elderly groups can effectively distinguish neoplastic polyps from non-neoplastic polyps based on preoperative ultrasound features.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study

Dou

Liu

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In addition, Yuan et al [ 26 ] established an ultrasound radiomic model based on the spatial and morphological features extracted from ultrasound images, which effectively contributed to the preoperative diagnosis of true and pseudo GPs with an AUC of 0.898. Although the AUCs of our linear scoring models for different age groups were slightly lower than the above studies [ 14 , 25 , 26 ], we consider the variables included in our study to be relatively less compared to their studies.…”

Section: Discussionmentioning

confidence: 71%

“…Ma et al [ 14 ] established a linear scoring system based on age, positive blood flow signal, and cross-sectional area of GPs for identifying true polyps, which were accurate with an AUC of 0.883. Güneş et al [ 25 ] established a linear scoring system based on age ≥50, presence of symptoms, polyp size >12.5 mm, single polyp, concomitant gallstones, and gallbladder wall thickness ≥4mm for identifying the GPs with malignant potential with an AUC of 0.958 for risk scores. In addition, Yuan et al [ 26 ] established an ultrasound radiomic model based on the spatial and morphological features extracted from ultrasound images, which effectively contributed to the preoperative diagnosis of true and pseudo GPs with an AUC of 0.898.…”

Section: Discussionmentioning

confidence: 99%

Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study

Li,

Dou,

Liu

et al. 2024

BMC Gastroenterol

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Background The prevalence of neoplastic polyps in gallbladder polyps (GPs) increases sharply with age and is associated with gallbladder carcinoma (GBC). This study aims to predict neoplastic polyps and provide appropriate treatment strategies based on preoperative ultrasound features in patients with different age level. Methods According to the age classification of WHO, 1523 patients with GPs who underwent cholecystectomy from January 2015 to December 2019 at 11 tertiary hospitals in China were divided into young adults group (n=622), middle-aged group (n=665) and elderly group (n=236). Linear scoring models were established based on independent risk variables screened by the Logistic regression model in different age groups. The area under ROC (AUC) to evaluate the predictive ability of linear scoring models, long- and short- diameter of GPs. Results Independent risk factors for neoplastic polyps included the number of polyps, polyp size (long diameter), and fundus in the young adults and elderly groups, while the number of polyps, polyp size (long diameter), and polyp size (short diameter) in the middle-aged groups. In different age groups, the AUCs of its linear scoring model were higher than the AUCs of the long- and short- diameter of GPs for differentiating neoplastic and non-neoplastic polyps (all P<0.05), and Hosmer-Lemeshow goodness of fit test showed that the prediction accuracy of the linear scoring models was higher than the long- and short- diameter of GPs (all P>0.05). Conclusion The linear scoring models of the young adults, middle-aged and elderly groups can effectively distinguish neoplastic polyps from non-neoplastic polyps based on preoperative ultrasound features.

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“…[87] Size is the main risk factor, while multiplicity is related to benign disease. [88] Another proposed scoring system can accurately predict true polyps. It includes the following parameters evaluated by multivariate analysis: cross-sectional area more than 123 mm 2 , positive blood flow signal, age more than 55.5 years, alanine aminotransferase (ALT) levels above 50 U/L and an ALT/AST (aspartate aminotransferase) ratio greater than 0.77.…”

Section: Diagnosismentioning

confidence: 99%

Contemporary diagnosis and management of gallbladder polyps

Pavlidis,

Galanis,

Pavlidis

2023

Gastroenterol Funct Med

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Gallbladder (GB) polyps are present in 5%–10% of the general population and consist of true neoplastic polyps (adenomas) and pseudopolyps (predominantly cholesterol, inflammatory, hyperplastic, focal adenomyomatosis). True polyps, although relatively rare neoplastic lesions (0.5%) are considered an important factor in malignant transformation and cancer development (5%) when their size is ≥ 1 cm. Given that it is essential to diagnose GB adenocarcinoma at an early stage to optimize therapeutic management, controversy exists about whether cholecystectomy is always necessary. Their imaging characteristics, size ≥ 1 cm, age > 50 years and genetic predisposition determine the indications for immediate cholecystectomy. In younger patients with polyps < 1 cm in size and without a familial history of GB carcinoma, imaging follow-up by ultrasound (US) seems to be a reasonable recommended policy. A scoring system by multivariate analysis (cross-sectional area > 123 mm2, positive blood flow signal, age > 55.5 years, alanine aminotransferase (ALT) levels > 50 U/L and an ALT/AST (aspartate aminotransferase) ratio > 0.77) can accurately predict true polyps. The widely accepted size threshold for US follow-up is 7 mm, and for intervention, it is 10 mm. Computed tomography or better magnetic resonance imaging can overcome any misdiagnosis of conventional US incidental findings alone that may lead to potentially unnecessary operations. In challenging cases, high-resolution US, novel three-dimensional US, endoscopic US or contrast-enhanced endoscopic US could be helpful. Novel microflow imaging can safely predict polyps. Risk factors for malignancy include age > 60 years, large gallstones, primary sclerosing cholangitis, Asian ethnicity and sessile polyps accompanied by focal gallbladder wall thickening > 4 mm. For polyps sized 6–9 mm, the absence of growth at recommended follow-up (6 months, one year, and two years) indicates treatment discontinuation; however, it is not required for size < 5 mm without risk factors. In addition to laparoscopic cholecystectomy, the standard management, novel interventional modalities preserving the GB in selected cases include per-oral transmural endoscopic resection of GB polyps after a bridge of endoscopic US-guided cholecystostomy or laparoscopic gallbladder-preserving polypectomy. Generally, there are still no precise and strong evidence-based guidelines; thus, the management policy of GB polyps should be individualized in ambiguous cases.

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A New Risk Scoring System to Predict Malignancy in Gallbladder Polyps: a Single-Center Study

Cited by 4 publications

References 32 publications

Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study

Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study

Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study

Contemporary diagnosis and management of gallbladder polyps

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