Nanashima Atsushi, Sumida Yorihisa, Tobinaga Syuuichi, Abo Takafumi, Takeshita Hiroaki, Sawai Terumitsu, Hidaka Shigekazu, Fukuoka Hidetoshi, Nagayasu Takeshi
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
World J Surg. 2009 Jun;33(6):1255-8. doi: 10.1007/s00268-009-9993-6.
Longitudinal tumor extension from the main tumor involves intramural or superficial spread along the bile duct, which influences surgical curability. Identifying the range of superficial extension is difficult by preoperative imaging. To clarify specific characteristics of bile duct carcinoma (BDC) with superficial extension of epithelium in the bile duct, we examined clinicopathologic features and patient outcomes in BDC patients with or without superficial extension who underwent surgical resection.
Between 1994 and 2008, we retrospectively examined clinicopathologic findings and outcomes for 42 BDC patients who underwent surgical resection and divided them into two groups: (1) superficial extension (SE) group (n = 10); and (2) non-SE group (n = 32).
In terms of macroscopic growth of the main tumor, the papillary type was more common in the SE group than in the non-SE group, whereas the nodular type was dominant in the non-SE group. The prevalence of cancer-positive findings at the cut end of the bile duct was higher in the SE group. Portal vein invasion was not observed in the SE group, and the prevalence of regional lymph node metastasis was significantly greater in the non-SE group than in the SE group. No patients died of cancer in the SE group, who tended to show better survival than the non-SE group.
The present results suggest that a good prognosis may be achieved in BDC patients with SE when complete resection is accomplished.
肿瘤自主要肿瘤纵向扩展涉及沿胆管壁内或表面扩散，这会影响手术可治愈性。术前影像学检查难以确定表面扩散范围。为阐明胆管上皮有表面扩散的胆管癌（BDC）的具体特征，我们研究了接受手术切除的有或无表面扩散的BDC患者的临床病理特征及患者预后。
1994年至2008年期间，我们回顾性研究了42例行手术切除的BDC患者的临床病理结果，并将他们分为两组：（1）表面扩散（SE）组（n = 10）；（2）非SE组（n = 32）。
就主要肿瘤的宏观生长而言，SE组乳头状类型比非SE组更常见，而非SE组以结节型为主。SE组胆管切端癌阳性结果的发生率更高。SE组未观察到门静脉侵犯，非SE组区域淋巴结转移的发生率明显高于SE组。SE组无患者死于癌症，该组患者的生存率往往优于非SE组。
目前的结果表明，完成完全切除时，有表面扩散的BDC患者可能预后良好。
