The correlation of contrast-enhanced ultrasound vascular mode with gallbladder polyp nature and size / 中华医学超声杂志（电子版）

Objective To evaluate the correlation between enhancement vascular mode and gallbladder polyp nature and size with contrast-enhance ultrasound (CEUS).Methods From December 2014 to May 2016,patients with gallbladder polyp lesions (GPL) larger than 1.0 cm were enrolled in this study.Before cholecystectomy,every patient underwent ultrasound (US) and CEUS examination.All features of US and CEUS were analyzed by two doctors who were blind to the patient clinical data.According to the pathological findings,GPL were divided into cholesterol polyp group and gallbladder adenoma group.The US features and enhancement vascular mode were analyzed statistically by t test and x2 test.The independent risk factors were analyzed by Logistic regression.The relationship between enhancement vascular mod and size of GPL were determined by bivariate correlation analysis.Results There were 103 patients with GPL larger than 1.0 cm.Eighty-two cases were cholesterol polyp and 21 cases were gallbladder adenoma.There were differences in size and color Doppler blood flow between two groups (t=-5.97 and 7.94,P ＜ 0.05).Dotted,branched vascular mod and irregular vascular mode were statistical different between two groups (x2=10.09 and 8.43,P ＜ 0.05).Regression analysis data proved that the size and branch vascular mod were the independent risk factors related with adenoma (P ＜ 0.05).In both cholesterol polyp group and adenoma group,there were weak positive correlation between enhancement vascular mode and size of GPL (r=0.188,0.397,P ＜ 0.05).Conclusions Branch vascular mod and size of GPL were help to distinguish gallbladder adenoma from cholesterol polyp.Comprehensive analysis of GPL's size and vascular mode could offer important guidance for differentiation diagnosis.

Histopathologic Analysis of Adenoma and Adenoma-related Lesions of the Gallbladder / 대한소화기학회지

BACKGROUND/AIMS: In order to determine the malignant potential of gallbladder adenoma for progression to carcinoma, we evaluated the histopathologic features of adenoma and adenoma-related lesions on cholecystectomized specimens. METHODS: Among 1,847 cholecystectomized specimens, 63 specimens from 26 benign adenomas, 9 carcinomas in situ (CIS), and 28 invasive carcinomas were selected. A pathologist reviewed all specimens and selected benign adenomas, CIS in the adenoma, and adenoma residue in invasive carcinomas. Adenomas and adenoma-related lesions were classified according to morphology (tubular, tubulopapillary, and papillary) and the consisting epithelium (biliary, pyloric metaplasia, and intestinal metaplasia). The age and the size of the benign adenomas and carcinomas in the adenoma were also compared. RESULTS: Adenoma and adenoma-related lesions were found in 34 out (1.8%) of all resected gallbladder. Among 9 CIS and 28 invasive carcinomas, adenoma-related lesions were detected in 7 and 1 case, respectively. All eight carcinomas arising in the adenoma were well-differentiated solitary tumors. The diameters of the carcinomas in the adenoma were, on average, larger than that of the benign adenomas (1.8 cm vs. 0.9 cm, p=0.01). The patients with carcinomas in the adenoma were, on average, older than those with benign adenomas, although the difference was insignificant (57 years vs. 47 years, p=0.09). The morphology and consisting epithelium did not differ between the benign adenomas and carcinomas in the adenoma. The malignant transformation occurred in 23.5% of adenomas. CONCLUSIONS: Gallbladder adenoma is a rare disease, although malignant transformation occurs frequently. Adenoma is a precancerous lesion and the adenoma-carcinoma sequence is one of the gallbladder cancer carcinogenesis.

Nuclear morphometry and PCNA analysis of adenoma and carcinoma in gallbladder / 中华肝胆外科杂志

Objective To make clear the relationship between adenoma,malignant transformation of ade- noma and carcinoma in gallbladder.Methodes The nuclear morphometry was performed with a TJTY-300 Auto- matic Image Analyser and PCNA was measured with immunohistochemisty in 25 cases of carcinoma,20 cases of adenoma and 3 cases of normal gallbladder.Results (1) Cell DNA content,atypia and PCNA index were in- creased gradually from the normal cell to dysplasia to malignant transformation of adenoma to carcinoma in gallblad- der;(2) Aneuploidy in gallbladder adenoma and PCNA index had significant relationship to the size of adenoma and gallstones (P