Development and validation of a preoperative nomogram for predicting gallbladder adenoma

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Surgical Oncology
• Diagnostic Imaging and Radiology

Background:

• Gallbladder cholesterol polyps (GCP) and gallbladder adenomas (GA) present diagnostic challenges.
• Accurate preoperative differentiation is crucial for appropriate patient management and surgical planning.

Purpose of the Study:

• To develop and validate a nomogram prediction model for the preoperative risk assessment of gallbladder adenoma (GA).
• To identify independent clinical predictors associated with the presence of GA.

Main Methods:

• Retrospective analysis of 497 patients undergoing laparoscopic cholecystectomy (LC) for suspected GCP or GA.
• Data split into training (70%) and validation (30%) sets.
• LASSO and Logistic regression identified risk factors; nomogram constructed and validated using ROC curves, Hosmer-Lemeshow tests, and DCA.

Main Results:

• Independent predictors for GA included blood type (O), solitary lesions, sessile polyp morphology, age, and lesion diameter.
• The nomogram achieved high predictive accuracy with AUCs of 0.843 (training) and 0.837 (validation).
• Model validation confirmed good calibration and clinical utility.

Conclusions:

• Blood type, lesion characteristics (number, morphology, diameter), and patient age are significant risk factors for GA.
• The developed nomogram provides a practical tool for preoperative GA risk prediction.
• This model can assist clinicians in guiding surgical decisions for gallbladder lesions.