Analysis of predictive factors for gallbladder cholesterol polyp and gallbladder adenoma before surgery

Abstract

Abstract:

ObjectiveTo analyze the factors related to gallbladder cholesterol polyp (GCP) and gallbladder adenoma (GA) and establish predictive model for distinction between GCP and GA before surgery.MethodsPatients with gallbladder polyps diameter≥10 mm diagnosed by ultrasonography in Xuanwu Hospital Capital Medical University and the First Hospital of Peking University from January 2015 to December 2019 were studied. There were GCP group and GA group based pathological diagnosis. Univariate and multivariate analyses were used to study the factors related to GCP and GA. Logistic linear regression was used to establish a predictive model and to evaluate the diagnostic effect.ResultsA total of 384 patients with gallbladder polyp were in this study with male to female ratio of 1:1.49 and age of (50.32±14.15) years. There were 250 patients (65.1%) in GCP group and 134 patients (34.9%) in GA group. Univariate analysis showed that five factors in quantitative data including age, blood glucose, low density lipoprotein, albumin, and total bile acid and three factors in count data including age 50 years or older, low density lipoprotein ≥3.1 mmol/L and total bile acid ≥10.0 μmol/L had significant difference statistically between two groups (P<0.05). Three factors were gotten as age, low density lipoprotein and total bile acid with significant difference statistically in multivariate analysis. The sensitivity of predictive regression equation were 74.8%, whenP≥0.601 was used to diagnose cholesterol polyps. The regression equation was fitted by ROC curve and the area under curve was 0.662.ConclusionsThe equation on the factors of age, low density lipoprotein and total bile acid could be used to predict cholesterol polyps and adenomas preoperatively for patients with gallbladder polyps.

Key words:Gallbladder polyp,Gallbladder cholesterol polyp,Gallbladder adenoma,Predictive model

CLC Number:

WANG Jiaqi, MA Youwei, XIAO Shuangtao, HUANG Yuda, YU Zhihao, LI Zheng, ZHENG Yamin. Analysis of predictive factors for gallbladder cholesterol polyp and gallbladder adenoma before surgery[J]. Journal of Surgery Concepts & Practice, 2021, 26(02): 144-148.

Figures/Tables5

项目	GCP组（n=250）	GA组（n=134）	t值	P值
年龄（岁）	48.18±13.22	54.31±14.99	-4.125	<0.001^a)
BMI	24.67±3.56	24.33±4.11	0.770	0.442
收缩压（mm Hg）	128.50±15.42	127.98±19.79	0.227	0.821
舒张压（mm Hg）	76.78±11.32	76.64±10.40	0.098	0.922
血糖（mmol/L）	5.37±1.27	5.82±1.62	-2.999	0.003^a)
总胆固醇（mmol/L）	4.54±1.05	4.51±0.99	0.238	0.812
三酰甘油（mmol/L）	1.36±1.02	2.30±9.94	-1.080	0.282
LDL（mmol/L）	2.91±0.98	2.71±0.86	2.023	0.044^a)
HDL（mmol/L）	1.34±0.80	1.23±0.45	1.517	0.130
LDL/HDL	2.36±0.89	2.52±1.42	-1.185	0.238
白细胞（×10⁹/L）	6.76±3.05	6.28±2.41	1.561	0.119
ALT（U/L）	25.99±22.53	34.92±71.60	-1.407	0.162
AST（U/L）	26.76±20.11	29.82±39.02	-0.849	0.397
白蛋白（g/L）	42.49±5.92	44.57±7.98	-2.890	0.004^a)
总胆红素（mmol/L）	13.64±5.74	19.14±39.89	-1.529	0.114
TBA（μmol/L）	2.68±2.56	8.88±30.10	-2.368	0.019^a)

项目	分界值	GCP组（n=250）	GA组（n=134）	总计（n=384）	χ²值	P值
年龄	≥50岁	122(48.8)	91(67.9)	213(55.5)	12.899	<0.001^a)
性别	女	151(60.4)	79(59.0)	230(59.9)	0.076	0.783
BMI	≥28.0	56(22.4)	27(20.1)	83(21.6)	0.261	0.610
收缩压	≥140 mm Hg	89(35.6)	39(29.1)	128(33.3)	1.656	0.198
舒张压	≥90 mm Hg	41(16.4)	18(13.4)	59(15.4)	0.591	0.442
血糖	≥6.1 mmol/L	40(16.0)	32(23.9)	72(18.8)	3.566	0.059
总胆固醇	≥5.7 mmol/L	34(13.6)	22(16.4)	56(14.6)	0.556	0.456
三酰甘油	≥2.25 mmol/L	27(10.8)	14(10.4)	41(10.7)	0.011	0.915
LDL	≥3.1 mmol/L	110(44.0)	44(32.8)	154(40.1)	4.527	0.033^a)
HDL	≤0.9 mmol/L	27(10.8)	23(17.2)	50(13.0)	3.120	0.077
白细胞	≥10.0×10⁹/L	20(8.0)	10(7.5)	30(7.8)	0.035	0.852
ALT	≥40.0 U/L	44(17.6)	23(17.2)	67(17.4)	0.012	0.915
AST	≥40.0 U/L	27(10.8)	16(11.9)	43(11.2)	0.114	0.736
白蛋白	≥48.0 g/L	35(14.0)	26(19.4)	61(15.9)	1.906	0.167
总胆红素	≥23.34 mmol/L	17(6.8)	10(7.5)	27(7.0)	0.059	0.809
TBA	≥10.0 μmol/L	6(2.4)	14(10.4)	20(5.2)	11.444	0.001^a)

项目	分界值	回归系数	标准误	OR值	95%CI	P值
年龄	≥50岁	-0.857	0.231	0.425	(0.270~0.668)	<0.001
LDL	≥3.1 mmol/L	0.580	0.233	1.750	(1.108~2.766)	0.016
TBA	≥10.0 μmol/L	-1.486	0.510	0.226	(0.083~0.615)	0.004
常数		0.993	0.193	2.699		<0.001

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