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Factors Associated with Premalignant Epithelial Changes in Chronic Calculous Cholecystitis: A Case-Control Study
Muhibullah Bangash1, Abdul Rehman Alvi1, Noman Shahzad2
1Aga Khan University Hospital, General Surgery Office, Link Building, Stadium Road, Karachi, 74800, Pakistan.
World Journal of Surgery
|November 17, 2017
Summary
Gallstones can lead to premalignant gallbladder changes. A thickened gallbladder wall (over 3mm) significantly increases the risk of these precancerous lesions, suggesting prophylactic surgery may be beneficial.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Oncology
Background:
- Gallstones are linked to premalignant changes in the gallbladder epithelium, including atypical hyperplasia, metaplasia, and dysplasia.
- Identifying factors associated with these changes is crucial for preventing gallbladder carcinoma.
Purpose of the Study:
- To identify factors associated with premalignant epithelial changes in gallbladder mucosa among patients with chronic calculus cholecystitis.
Main Methods:
- A retrospective case-control study was conducted over 10 years (2004-2014).
- Cases had histopathological premalignant changes and chronic calculus cholecystitis; controls had chronic calculus cholecystitis without premalignant changes (2:1 ratio).
Main Results:
- 92 cases and 184 controls were analyzed.
- A gallbladder wall thickness exceeding 3 mm was a significant independent variable associated with premalignant lesions (Odds Ratio = 4.14, p < 0.001).
- Atypical hyperplasia was the most common premalignant change (66%), followed by metaplasia (28%) and dysplasia (5%).
Conclusions:
- Patients with gallbladder wall thickness > 3 mm have a fourfold increased odds of premalignant epithelial changes.
- Prophylactic cholecystectomy should be considered for patients with thickened gallbladder walls to reduce carcinoma risk.
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