胆囊息肉恶变风险评估模型及超声内镜预测恶变风险的应用进展

Advances in gallbladder polyp malignant transformation risk assessment models and applications of endoscopic ultrasound for malignant risk prediction

摘要:

胆囊息肉恶变风险的评估是临床决策的关键和难点，目前缺少有效的手段。胆囊息肉可分为非肿瘤性和肿瘤性两大类，其中肿瘤性息肉是胆囊癌的癌前病变。胆囊息肉的恶变与息肉直径、数量、形态、血流以及患者年龄等有关。由于胆囊癌预后差，早期识别和干预胆囊息肉恶变至关重要。相比常规超声检查，超声内镜能够更精确地评估息肉的大小、形态和血流特征，在评估胆囊息肉恶变风险中显示出独特优势。本文系统综述了胆囊息肉恶变的危险因素、预测模型以及超声内镜在评估胆囊息肉恶变风险中的优势和前景，旨在为临床决策和临床研究提供线索。

Abstract:

The assessment of malignant transformation risk in gallbladder polyps remains a key clinical challenge, as there is currently a lack of effective methods for accurate prediction. Gallbladder polyps are broadly classified into non-neoplastic and neoplastic categories, with neoplastic polyps recognized as precancerous lesions for gallbladder cancer. Malignant transformation is associated with polyp characteristics such as diameter, number, morphology, vascularity, and patient age. Given the poor prognosis of gallbladder cancer, early identification and intervention for high-risk polyps are crucial. Compared to conventional ultrasound, endoscopic ultrasound (EUS) offers superior precision in evaluating polyp size, morphology, and vascular features, demonstrating unique advantages in risk stratification. This systematic review summarizes current evidence on risk factors, predictive models, and the clinical utility of EUS in assessing malignant potential, aiming to provide insights for clinical decision-making and future research directions.