The Role of Benign Polyps in the Formation of a Precancerous State of the Gallbladder

Abstract

According to autopsy studies, gallbladder cancer is the most common malignant neoplasm of the biliary tract, accounting for 80–95% of all biliary cancer cases worldwide. Purpose of the study. Determine the role of benign polyps in the formation of a precancerous state of the gallbladder. Materials and research methods. To achieve this goal, the results of treatment of 45 patients with precancerous diseases of the gallbladder were analyzed. Depending on the cause of the etiological factor that caused the precancerous state of the gallbladder, all patients were divided into 2 groups: group 1 - patients who found stones in the gallbladder on ultrasound examination (n = 26), moreover, patients who had stones up to 3 cm was 17 people, and patients who, according to ultrasound, found stones more than 3 cm (n = 9), group 2 - patients who, according to microbiological studies, had a history of infectious processes (n = 19), and patients who, according to microbiological researches were identified as the causative agent of Hellicobacter billis - 11 patients, and 8 patients had chronic typhoid infection as an etiological factor. Research results. Among all examined (n = 45), divided by gender, 23 patients were men, 22 were women. Gallstones were more common in men than in women (14 vs 12). Biliary polyps were found in all examined patients (100%). The average age at the time of the examination was 49.3 ± 12.0 years. Among the examined patients, 2 (4.45%) had gallbladder hamartoma as an etiological factor, and 1 (2.23%) had mixed infection. 4 (8.89%) patients had a gallbladder adenoma, i.e. her hyperplasia. In the quality of heterotopia, pathology of the liver and gallbladder was found in 3 (6.67%). The following drugs can be used as adjuvant therapy after surgical treatment: gemcitabines, fluoropyrimidines. Monotherapy has a limited effect. The combination of chemotherapy with gemcitabines and cisplastins gives better survival than simple gemcitabine administration (p≤0.05, U-0.03467, r = 0.116528, χ2 = 0.87514). Conclusions: According to the conducted studies, as an etiological factor, the increased content of the triglyceride fraction was higher in patients with a body mass index of 24.32 ± 3.54 with a confidence interval of 95% (p≤0.05, U-0.07833), which indicates violation of fat metabolism and lipolysis in the liver, as a result of which the synthesis of apoliprotein E is disrupted, which leads to the accumulation of high-density lipoproteins and the possible formation of gallbladder polyps, as a possible harbinger of precancerous conditions of the gallbladder