Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder

Table 1 Comparative data for the prevalence of the demographic, laboratory and sonographic findings between the non-neoplastic polyp group and the neoplastic polyp group (mean ± SD) n (%)

	Total (n = 210)	Non-neoplastic (n = 146)	Neoplastic (n = 64)	P
Age (yr)	51.8 ± 13.7	49.1 ± 12.3	57.9 ± 14.7	< 0.001
Age > 65 yr	49 (23.3)	22 (15.1)	27 (42.2)	< 0.001
Gender, male	109 (51.9)	77 (52.7)	32 (50.0)	0.785
BMI (kg/m2)	24.0 ± 2.97	23.9 ± 3.01	24.1 ± 2.89	0.620
Obesity	79 (38.2)	53 (36.6)	26 (41.9)	0.465
Hypertension	34 (16.3)	20 (13.7)	14 (22.2)	0.126
Diabetes mellitus	46 (21.9)	21 (13.0)	27 (42.1)	< 0.001
Hypercholesterolemia	77 (36.7)	57 (39.0)	20 (31.3)	0.135
RUQ pain	37 (17.6)	24 (16.4)	13 (20.3)	0.498
Total bilirubin (g/dL)	1.22 ± 3.41	0.91 ± 0.41	1.93 ± 6.17	0.189
ALP (g/dL)	69.4 ± 60.9	62.5 ± 20.2	84.7 ± 104.7	0.097
AST (IU/dL)	33.2 ± 61.9	26.2 ± 21.4	49.2 ± 105.9	0.090
ALT (IU/dL)	34.5 ± 42.0	29.1 ± 23.3	47.0 ± 66.2	0.041
Size ( mm)	16.1 ± 8.20	13.5 ± 4.5	22.1 ± 11.1	< 0.001
Size > 15 mm	78 (37.1)	33 (22.3)	45 (70.3)	< 0.001
Location				0.977
Fundus	156 (74.3)	109 (74.7)	47 (73.4)
Body	44 (21.0)	30 (20.5)	14 (21.9)
Neck	10 (4.8)	7 (4.8)	3 (4.7)
No. of polyps				0.002
Multiple	76 (36.2)	63 (43.2)	13 (20.3)
Solitary	134 (63.8)	83 (56.8)	51 (79.7)
Hyperechoic spots				0.315
No	172 (81.9)	117 (80.1)	55 (85.9)
Yes	38 (18.1)	29 (19.9)	9 (14.1)
Echogenecity				0.125
Anechoic or hyperechoic	130 (61.9)	96 (65.8)	34 (53.1)
Hypoechoic or isoechoic	80 (38.1)	50 (34.2)	30 (46.9)
Echo pattern				0.093
Homogeneous	115 (52.9)	85 (58.2)	30 (46.9)
Inhomogeneous	95 (45.2)	60 (41.1)	35 (54.7)
Sonographic surface pattern				< 0.001
Smooth surface	174 (82.9)	131 (89.7)	43 (67.2)
Nodular surface	36 (17.1)	15 (10.3)	21 (32.8)

BMI: Body mass index; RUQ: Right upper quadrant; ALP: Alkaline phosphatase; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase. Obesity: BMI higher than 25 kg/m².

Table 2 Results of the multivariate logistic regression analysis for the factors that were significantly associated with neoplastic polypoid lesions of the gallbladder on univariate analysis

	Hazard ratio	95% CI	P-value
Age ≥ 65 yr old	2.27	1.02-5.06	0.044
Gender, male	1.08	0.57-2.51	0.617
DM	2.64	1.15-6.03	0.021
ALT level	1.008	0.99-1.02	0.168
Polyp size > 15 mm	4.94	2.43-10.02	< 0.001
Solitary polyp	0.59	0.26-1.33	0.205
Nodular surface pattern	2.31	0.97-5.50	0.058

DM: Diabetes mellitus; ALT: Alanine transaminase.

Table 3 Comparative data for the prevalence of the demographic, laboratory and sonographic findings between the benign polyp group and the malignant polyp group for the 65 neoplastic polypoid lesions of the gallbladder (mean ± SD) n (%)

	Total(n = 65)	Benign(n = 35)	Malignant(n = 30)	P
Age (yr)	49.8 ± 13.5	47.2 ± 12.4	65.6 ± 7.39	< 0.001
Age > 65 yr	51 (24.3)	31 (17.2)	20 (66.7)	0.002
Gender, male	109 (51.9)	95 (52.6)	14 (46.7)	0.535
BMI (kg/m2)	23.9 ± 2.97	24.0 ± 3.03	23.8 ± 2.66	0.835
Obesity	79 (38.2)	67 (37.2)	12 (40.0)	0.583
Hypertension	34 (16.3)	25 (13.8)	9 (30.0)	0.244
Diabetes mellitus	46 (21.9)	25 (13.8)	21 (70.0)	< 0.001
Hypercholesterolemia	19 (29.2)	10 (28.6)	7 (10.9)	0.830
RUQ pain	13 (6.2)	6 (4.1)	7 (10.9)	0.534
Total bilirubin (g/dL)	1.22 ± 3.41	0.89 ± 0.41	3.2 ± 6.17	0.166
ALP (g/dL)	69.3 ± 60.9	63.4 ± 20.0	104.9 ± 150.5	0.142
AST (IU/dL)	33.2 ± 61.9	26.6 ± 20.9	72.8 ± 151.3	0.106
ALT (IU/dL)	34.5 ± 42.0	29.2 ± 23.3	67.3 ± 9.09	0.033
Size (mm)	16.1 ± 8.20	14.3 ± 6.3	26.7 ± 10.0	< 0.001
Size >15 mm	45 (69.2)	17 (48.6)	28 (93.3)	< 0.001
Location				0.705
Fundus	40 (61.5)	21 (60.0)	20 (66.7)
Body	18 (27.7)	10 (28.6)	8 (26.7)
Neck	3 (6.0)	2 (4.2)	1 (1.5)
No. of polyps				0.534
Multiple	13 (20.0)	8 (22.9)	5 (16.7)
Solitary	52 (80.0)	27 (77.1)	25 (83.3)
Hyperechoic spots				0.912
No	56 (86.2)	30 (85.7)	26 (86.7)
Yes	9 (13.8)	5 (14.3)	4 (13.3)
Echogenecity				0.180
Hyperechoic	34 (52.3)	21 (60.0)	13 (43.3)
Hypoechoic or isoechoic	31 (47.7)	14 (40.0)	17 (56.7)
Echo pattern				0.016
Homogeneous	30 (46.2)	21 (60.0)	9 (30.0)
Inhomogeneous	35 (53.8)	14 (40.0)	21 (70.0)
Sonographic surface pattern				0.135
Smooth surface	45 (69.2)	27 (77.1)	18 (60.0)
Nodular surface	20 (30.8)	8 (22.9)	12 (40.0)

BMI: Body mass index; RUQ: Right upper quadrant; ALP: Alkaline phosphatase; AST: Aspartate aminotransferase; ALT: Alanine transaminase; Obesity: BMI higher than 25 kg/m².

Table 4 Results of the multivariate logistic regression analysis for the factors that were significantly associated with the malignant gallbladder polyps for the 65 neoplastic polypoid lesions of the gallbladder on univariate analysis

	Hazard ratio	95% CI	P-value
Age ≥ 65 yr old	4.97	1.58-15.61	0.005
Gender, male	1.19	0.38-3.73	0.764
DM	6.13	1.98-18.94	0.001
ALT level	1.01	0.99-1.02	0.075
Polyp size > 15 mm	20.55	4.25-99.39	< 0.001
Inhomogeneous echo pattern	1.60	0.50-5.09	0.418

DM: Diabetes mellitus; ALT: Alanine aminotransferase.