Daniels Jason A, Coad James E, Payne William D, Kosari Kambiz, Sielaff Timothy D
Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Dig Dis Sci. 2006 Mar;51(3):623-8. doi: 10.1007/s10620-006-3181-4.
Biliary cystadenomas with mesenchymal stroma are neoplasms whose growth may be hormone sensitive. This study profiled the immunohistochemistry of these lesions to clarify the pathophysiology and define clinical management. Twelve patients with biliary cystadenomas were identified. Tissue was tested with a panel of probes including estrogen and progesterone receptors and compared to pancreatic and ovarian cystadenomas. Epithelial ER, PR, CD117, or SMA expression was negative in all three tumors. Epithelial CD10 expression was seen in 60% biliary, 75% pancreatic, and 0% ovarian tumors. Biliary cystadenoma stromal expression was ER+ (70%), PR+ (60%), CD10+ (40%), and c-kit+ (0%). Symptoms were seen in 92% patients. Percutaneous sclerotherapy and incomplete resection were associated with recurrence. Enucleation was the least morbid surgical technique. A role for hormonally mediated growth of biliary cystadenomas occurring through the stroma, rather than the epithelium, is suggested. Management remains complete surgical resection.
伴有间充质基质的胆管囊腺瘤是其生长可能对激素敏感的肿瘤。本研究对这些病变进行免疫组织化学分析，以阐明其病理生理学并确定临床管理方法。共确定了12例胆管囊腺瘤患者。用一组包括雌激素和孕激素受体的探针检测组织，并与胰腺和卵巢囊腺瘤进行比较。在所有三种肿瘤中，上皮细胞的雌激素受体（ER）、孕激素受体（PR）、CD117或平滑肌肌动蛋白（SMA）表达均为阴性。在60%的胆管肿瘤、75%的胰腺肿瘤和0%的卵巢肿瘤中可见上皮细胞CD10表达。胆管囊腺瘤间质表达为ER阳性（70%）、PR阳性（60%）、CD10阳性（40%），c-kit阳性（0%）。92%的患者出现症状。经皮硬化治疗和不完全切除与复发有关。摘除术是创伤最小的手术技术。提示胆管囊腺瘤通过间质而非上皮发生激素介导生长。治疗仍为完整手术切除。
