Background: The primary aim was to assess the diagnostic accuracy of routine ultrasound assessment for gallbladder polyps. The secondary aim was to identify the characteristics that differentiate neoplastic polyps from nonneoplastic polyps. Methods: A total of 156 patients with histopathologically proven gallbladder polyps in 4 Dutch hospitals between 2003 and 2013 were included. Sensitivity and specificity of ultrasound for polyp size, number of polyps, and polyp type were assessed using histopathological findings as a reference standard. In addition, diagnostic accuracy of sonographic size ≥1 cm for neoplasia was assessed. Subgroup analysis for patients with polyps as primary indication for cholecystectomy was performed. The sonographic polyp characteristics on preoperative routine ultrasound were described. Results: Fifty-six percent of gallbladder polyps were preoperatively identified on ultrasound, of which 31% were neoplastic. Sensitivity and specificity of ultrasound to estimate polyp size were 93 and 43% (subgroup; 92 and 33%). Sensitivity and specificity of sonographic polyp size ≥1 cm for neoplasia were 86 and 32% (subgroup; 94 and 26%). No specific sonographic characteristics for neoplastic polyps could be established due to lack of reporting. Conclusion: Routine ultrasound assessment of polyps is associated with overestimation of polyp size and low specificity of sonographic size ≥1 cm for neoplasia, which contributes to surgical overtreatment of nonneoplastic polyps.

中文翻译：

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由于常规超声评估不充分导致非肿瘤性胆囊息肉的过度治疗

背景：主要目的是评估胆囊息肉常规超声评估的诊断准确性。次要目的是确定区分肿瘤性息肉和非肿瘤性息肉的特征。方法：2003-2013年荷兰4家医院共156例经病理证实为胆囊息肉的患者。使用组织病理学结果作为参考标准评估超声对息肉大小、息肉数量和息肉类型的敏感性和特异性。此外，还评估了超声尺寸 ≥ 1 cm 对肿瘤的诊断准确性。对作为胆囊切除术主要指征的息肉患者进行了亚组分析。描述了术前常规超声的超声息肉特征。结果：56% 的胆囊息肉术前通过超声发现，其中 31% 是肿瘤性的。超声估计息肉大小的敏感性和特异性分别为 93% 和 43%（亚组；92% 和 33%）。超声息肉大小≥1 cm 对肿瘤的敏感性和特异性分别为 86% 和 32%（亚组；94% 和 26%）。由于缺乏报告，无法确定肿瘤性息肉的特定超声特征。结论：息肉的常规超声评估与息肉大小的高估和超声大小≥1 cm 对肿瘤的低特异性相关，这有助于非肿瘤性息肉的手术过度治疗。92% 和 33%）。超声息肉大小≥1 cm 对肿瘤的敏感性和特异性分别为 86% 和 32%（亚组；94% 和 26%）。由于缺乏报告，无法确定肿瘤性息肉的特定超声特征。结论：息肉的常规超声评估与息肉大小的高估和超声大小≥1 cm 对肿瘤的低特异性相关，这有助于非肿瘤性息肉的手术过度治疗。92% 和 33%）。超声息肉大小≥1 cm 对肿瘤的敏感性和特异性分别为 86% 和 32%（亚组；94% 和 26%）。由于缺乏报告，无法确定肿瘤性息肉的特定超声特征。结论：息肉的常规超声评估与息肉大小的高估和超声大小≥1 cm 对肿瘤的低特异性相关，这有助于非肿瘤性息肉的手术过度治疗。