Association between cholesterolosis and gallbladder cancer

Abstract

Background: Cholesterolosis is frequently observed in cholecystectomies performed for lithiasis or chronic cholecystitis. Aim: To determine the degree of association between cholesterolosis and gallbladder cancer. Material and Methods: In a prospective study of gallbladder cancer, all gallbladders obtained during cholecystectomies were processed for pathological study, following a special protocol. As part of this study, 23304 surgical samples obtained between 1993 and 2002 were studied, looking for a relationship between cholesterolosis and chronic cholecystitis, adenomas, dysplasia and gallbladder cancer. Results: Seventy nine percent of patients were women. Cholesterolosis was observed in 3,123 cases (13.4%). Cholesterolosis was more common in women (14.2%) than in men (10.2%) (p < 0.001). In the same period, 29 patients were diagnosed with adenomas (0.12%), 179 cases with dysplasia not associated with gallbladder cancer (0.8%) and 739 gallbladder cancer (3.2%). The frequency of cholesterolosis was 13.8% in chronic cholecystitis, 13.7% in adenomas, 12.1% in dysplasias and 1.35% in patients with gallbladder cancer (p < 0.01). Of the thirteen cases with gallbladder cancer and cholesterolosis, 10 were early gallbladder carcinomas. Patients with cholesterolosis were 9.2 times less likely to have cancer than those who did not have cholesterolosis. Conclusions: Cholesterolosis has a strong negative association with gallbladder cancer.