Kinoshita Masahiko, Kubo Shoji, Nakanuma Yasuni, Sato Yasunori, Takemura Shigekazu, Tanaka Shogo, Hamano Genya, Ito Tokuji, Terajima Hiroaki, Yamada Terumasa, Nakamori Shoji, Arimoto Akira, Fujikawa Masahiro, Sugawara Yasuhiko, Yamamoto Takatsugu, Abue Makoto, Nakagawa Kei, Unno Michiaki, Mizuguchi Toru, Takenaka Kenji, Shirabe Ken, Shibata Toshihiko
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.
J Hepatobiliary Pancreat Sci. 2016 Feb;23(2):92-101. doi: 10.1002/jhbp.305. Epub 2015 Dec 30.
We aimed to identify the pathological characteristics of occupational cholangiocarcinoma.
We examined the location and distribution of the carcinomas: atypical epithelium including biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the bile duct (IPNB); and chronic bile duct injuries in operative or autopsy liver specimens from 16 patients. We examined the detailed pathological findings and diagnostic imaging of three patients. Immunohistochemical analysis using primary antibodies against γH2AX and S100P was performed.
BilIN and chronic bile duct injury were observed in 16 patients, and IPNB or invasive IPNB was observed in 11 patients. BilIN, IPNB, and/or chronic bile duct injury were observed in almost all the large bile ducts. Regional dilatation of the bile ducts without tumor-induced obstruction revealed such pathological changes. Highly positive results for the γH2AX and S100P markers were noted in invasive carcinoma, BilIN, and IPNB, whereas positive results for γH2AX and negative results for S100P were noted in non-neoplastic biliary epithelium.
The carcinogenic process of occupational cholangiocarcinoma comprised chronic bile duct injury and DNA damage in almost all the large bile ducts, along with induction of precancerous lesions and development of invasive carcinoma. Such pathological findings reflected radiological changes on diagnostic imaging.
我们旨在确定职业性胆管癌的病理特征。
我们检查了16例手术或尸检肝脏标本中癌的位置和分布、非典型上皮，包括胆管上皮内瘤变（BilIN）和胆管内乳头状肿瘤（IPNB），以及慢性胆管损伤。我们检查了3例患者的详细病理结果和诊断性影像学表现。使用抗γH2AX和S100P的一抗进行免疫组化分析。
16例患者观察到BilIN和慢性胆管损伤，11例患者观察到IPNB或浸润性IPNB。几乎在所有大的胆管中均观察到BilIN、IPNB和/或慢性胆管损伤。胆管的局灶性扩张而无肿瘤引起的梗阻显示出此类病理变化。在浸润性癌、BilIN和IPNB中γH2AX和S100P标记物呈高度阳性结果，而在非肿瘤性胆管上皮中γH2AX呈阳性结果，S100P呈阴性结果。
职业性胆管癌的致癌过程包括几乎所有大的胆管中的慢性胆管损伤和DNA损伤，以及癌前病变的诱导和浸润性癌的发生。此类病理结果反映了诊断性影像学上的放射学变化。
