Histopathological Characteristics and Risk Factors of Gallbladder Polyps with Malignant Potential
Öz
Background: Gallbladder polyps (GBPs) are commonly detected lesions that are predominantly benign; however, some carry a risk of premalignant or malignant transformation. Accurate identification of high-risk polyps is essential for appropriate clinical management.
Methods: A retrospective analysis was conducted on patients who underwent elective cholecystectomy between March 2015 and March 2026 at the our center. Patients with GBPs confirmed by postoperative histopathological examination were included. Demographic data, laboratory parameters, polyp characteristics, gallbladder wall thickness, and histopathological findings were analyzed. Statistical analyses included one-way analysis of variance, Kruskal–Wallis test, chi-square or Fisher’s exact test, and receiver operating characteristic (ROC) curve analysis.
Results: A total of 103 patients were included. Histopathological examination revealed adenocarcinoma in 4 patients (3.9%), adenoma in 5 (4.9%), hyperplastic polyps in 8 (7.8%), inflammatory polyps in 6 (5.8%), and cholesterol polyps in 80 patients (77.7%). Polyp size, age, gallbladder wall thickness, and serum CA 19-9 levels were significantly higher in malignant cases. ROC analysis showed that polyp size (AUC = 0.97) and age (AUC = 0.93) had excellent diagnostic performance for predicting malignancy.
Conclusion: Polyp size remains the most reliable predictor of malignancy in gallbladder polyps. Advanced age, increased gallbladder wall thickness, and elevated CA 19-9 levels are additional risk factors that should be considered in clinical decision-making.
Anahtar Kelimeler
Gallbladder polyp, Adenocarcinoma, Adenoma, Polyp size, CA19-9
Destekleyen Kurum
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Etik Beyan
This study was approved by the Non-Interventional Clinical Research Ethics Committee of Afyonkarahisar Health Sciences University (Meeting No. 2026/1 Decision Date: 09/01/2026). The study was conducted in accordance with the principles of the Declaration of Helsinki. All patient data were anonymized before analysis, and no identifiable personal information was included. The requirement for informed consent was waived by the ethics committee because of the retrospective design of the study and the use of anonymized data.
Teşekkür
There was no acknowledgements to declare.
Malign Potansiyele Sahip Safra Kesesi Poliplerinin Histopatolojik Özellikleri ve Risk Faktörleri
Öz
Amaç: Safra kesesi polipleri (SKP) çoğunlukla benign olmakla birlikte bazı olgularda malign dönüşüm riski taşımaktadır. Bu çalışmanın amacı, SKP’lerin histopatolojik özelliklerini incelemek, malignite ile ilişkili risk faktörlerini belirlemek ve sonuçları literatür ile karşılaştırmaktır.
Gereç ve Yöntem: Bu retrospektif çalışmaya, Mart 2015–Mart 2026 tarihleri arasında Afyonkarahisar Sağlık Bilimleri Üniversitesi Genel Cerrahi Kliniğinde elektif kolesistektomi yapılan ve postoperatif patoloji raporlarında SKP saptanan hastalar dahil edildi. Hastaların demografik verileri, laboratuvar parametreleri, polip boyutu ve sayısı, safra kesesi duvar kalınlığı ve histopatolojik özellikleri analiz edildi. İstatistiksel analizlerde ANOVA, Kruskal–Wallis, ki-kare testleri ve ROC analizi kullanıldı.
Bulgular: Toplam 103 hasta çalışmaya dahil edildi. Histopatolojik incelemede 4 hastada (%3,9) adenokarsinom, 5 hastada (%4,9) adenom, 8 hastada (%7,8) hiperplastik polip, 6 hastada (%5,8) inflamatuvar polip ve 80 hastada (%77,7) kolesterol polibi saptandı. Malign grupta polip boyutu, yaş, safra kesesi duvar kalınlığı ve serum CA 19-9 düzeyleri anlamlı olarak daha yüksekti. ROC analizinde polip boyutu (AUC=0,97) ve yaşın (AUC=0,93) maligniteyi öngörmede yüksek tanısal değere sahip olduğu gösterildi.
Sonuç: SKP maligniteyi öngörmede en güvenilir parametre polip boyutudur. İleri yaş, artmış safra kesesi duvar kalınlığı ve yüksek CA 19-9 düzeyleri ek risk faktörleridir. Bu parametreler tedavi ve takip planlamasında mutlaka dikkate alınmalıdır.
Anahtar Kelimeler
Safrakesesi polipleri, Adenokanser, Adenom, Polip boyutu, CA 19-9