Surgical Indications for Polypoid Lesions of the Gallbladder

PURPOSE: Polyps and polypoid lesions of the gallbladder are now increasingly detected. However the nature of disease is hard to define before operation and the indications for surgical intervention remain controversial. We attempted to differentiate between benign polyps and neoplastic lesions by comparing their clinical data and pathological findings. METHODS: The study comprised 128 consecutive patients who underwent resection for polypoid lesions of the gallbladder. The lesions were classified into five groups histologically, and the clinico-pathological characteristics were compared among the groups. RESULTS: We found cholesterol polyps in 42 patients, inflammatory polyps in 13, adenomyomatoses in 14, adenomas in 15, and carcinomas in 44. The mean age of the patients with carcinoma, all of whom were over 40 years, was significantly higher than that of the other groups (P<0.05). Carcinoma patients showed a female preponderance. The incidences of gallstones and presenting symptoms were not different between the benign and malignant diseases. The mean diameters of cholesterol polyps and inflammatory polyps were less than 5 mm, those of adenomyomatoses and adenomas were around 1 cm, and that of carcinoma was over 2 cm (P<0.05). Most of the benign polyps were pedunculated, but sessile lesions were more frequent in the malignant polyps (P<0.05). Neoplastic polyps tended to be single. CONCLUSION: It is suggested that polypoid lesions of the gallbladder should be removed surgically when the lesion exceeds 1 cm in diameter, is single in number, or is sessile. The possibility for malignancy should be considered if the patient is female, and over 40 years of age.

Significance on the Expression of Cyclin, MIB-1 in Benign and Malignant Papillary Lesion of the Breast / 한국유방암학회지

PURPOSE: It is difficult at times to differentiate between a papillary carcinoma and benign papilloma of the breast, and papillomas can undergo malignant transformation. The authors investigated the expression of cyclin D1 and MIB-1 to assess the diagnostic value of these markers in distinguishing papillary carcinomas from papillomas of the breast, and in determining the clinical relevance of these markers as prognostic predictors. METHODS: The medical records of 38 patients treated for benign and malignant papillary lesions of the breast at Inje University Pusan Paik Hospital between January 1992 and December 1997 were reviewed. Immunohistochemical stains for cyclin D1 and MIB-1 were performed in 30 cases of papilloma and eight cases of papillary carcinoma of the breast. The authors performed a statistical analysis of the relationship between cyclin D1 and MIB-1 with respect to the size of tumors, pathologic lymph nodes, and postsurgical residual lesions, and the recurrence and survival rates. RESULTS: Breast cancer or ADH was associated with six cases (15.79%) of papillary lesions of the breast. The incidence of postsurgical residual lesions and their recurrence were 2.63% and 2.63% in all the patients with papillary lesions of the breast. The labeling index of cyclin D1 was significantly higher in the eight papillary carcinomas (36.7+/-27.0) than in the 30 papillomas (3.5+/-4.2) (P=0.001). There was a statistically significant difference betweenn the MIB-1 labeling index of the eight papillary carcinomas (4.9+/-5.9) and that of the 30 papillomas (0.4+/-1.4) (P=0.0225). The cyclin D1 and MIB-1 expressions of the single intraductal papillomas and multiple papillomas were not different. In addition, there was no statistically significant difference of cyclin D1 and MIB-1 in the eight papillary carcinomas with respect to the associated pathologies, size, positive lymph nodes, recurrence or survival. CONCLUSION: These results suggest that cyclin D1 and MIB-1 might be useful markers for distinguishing papillary carcinomas from papillomas of the breast.

Significance on the Expression of Cyclin, MIB-1 in Benign and Malignant Papillary Lesion of the Breast

PURPOSE: It is difficult at times to differentiate between a papillary carcinoma and benign papilloma of the breast, and papillomas can undergo malignant transformation. The authors investigated the expression of cyclin D1 and MIB-1 to assess the diagnostic value of these markers in distinguishing papillary carcinomas from papillomas of the breast, and in determining the clinical relevance of these markers as prognostic predictors. METHODS: The medical records of 38 patients treated for benign and malignant papillary lesions of the breast at Inje University Pusan Paik Hospital between January 1992 and December 1997 were reviewed. Immunohistochemical stains for cyclin D1 and MIB-1 were performed in 30 cases of papilloma and eight cases of papillary carcinoma of the breast. The authors performed a statistical analysis of the relationship between cyclin D1 and MIB-1 with respect to the size of tumors, pathologic lymph nodes, and postsurgical residual lesions, and the recurrence and survival rates. RESULTS: Breast cancer or ADH was associated with six cases (15.79%) of papillary lesions of the breast. The incidence of postsurgical residual lesions and their recurrence were 2.63% and 2.63% in all the patients with papillary lesions of the breast. The labeling index of cyclin D1 was significantly higher in the eight papillary carcinomas (36.7+/-27.0) than in the 30 papillomas (3.5+/-4.2) (P=0.001). There was a statistically significant difference betweenn the MIB-1 labeling index of the eight papillary carcinomas (4.9+/-5.9) and that of the 30 papillomas (0.4+/-1.4) (P=0.0225). The cyclin D1 and MIB-1 expressions of the single intraductalpapillomas and multiple papillomas were not different. In addition, there was no statistically significant difference of cyclin D1 and MIB-1 in the eight papillary carcinomas with respect to the associated pathologies, size, positive lymph nodes, recurrence or survival. CONCLUSION: These results suggest that cyclin D1 and MIB-1 might be useful markers for distinguishing papillary carcinomas from papillomas of the breast.