Aishima Shinichi, Iguchi Tomohiro, Nishihara Yunosuke, Fujita Nobuhiro, Taguchi Kenichi, Taketomi Akinobu, Maehara Yoshihiko, Tsuneyoshi Masazumi
Laboratory of Cancer Pathology, Institute for Clinical Research, National Kyushu Cancer Centre, Fukuoka, Japan.
Histopathology. 2009 Mar;54(4):452-61. doi: 10.1111/j.1365-2559.2009.03240.x.
To assess the relationship between arterial blood supply and the progression of intrahepatic cholangiocarcinoma (ICC).
The intratumoral arterial vessel density (AVD) was assessed in 76 cases of mass-forming type of ICC using anti-h-caldesmon antibody, a marker of smooth muscle cells, and AVD compared with pathological findings. AVD was directly correlated with the presence of intratumoral portal tracts (P < 0.0001) and inversely correlated with the grade of tumour necrosis (P = 0.0013). AVD was inversely correlated with vascular invasion and lymph node metastasis (P = 0.0159 and P = 0.0023, respectively). The hilar type of ICC had lower AVD regardless of tumour size, whereas the peripheral type with high AVD showed branching ductular formation composed of cuboidal cells with mild nuclear atypia. AVD was found to be an independent prognostic factor on multivariate survival analysis (P = 0.0013).
This study demonstrates that intratumoral arterial vessels reflect engulfed portal tracts in ICC and decreased arterial vessels indicate aggressive tumour behaviour. Our results could contribute to clinical tumour staging and more effective therapy.
评估肝内胆管癌（ICC）的动脉血供与肿瘤进展之间的关系。
使用平滑肌细胞标志物抗人钙调蛋白抗体评估76例肿块型ICC的瘤内动脉血管密度（AVD），并将AVD与病理结果进行比较。AVD与瘤内门静脉分支的存在直接相关（P < 0.0001），与肿瘤坏死程度呈负相关（P = 0.0013）。AVD与血管侵犯和淋巴结转移呈负相关（分别为P = 0.0159和P = 0.0023）。无论肿瘤大小如何，肝门部ICC的AVD较低，而具有高AVD的外周型ICC表现为由立方体细胞组成的分支胆管样结构，细胞核异型性较轻。多因素生存分析发现AVD是一个独立的预后因素（P = 0.0013）。
本研究表明，ICC的瘤内动脉血管反映了被包绕的门静脉分支，动脉血管减少表明肿瘤行为具有侵袭性。我们的结果有助于临床肿瘤分期和更有效的治疗。
