Okano Kensuke, Yoshizawa Tadashi, Miura Takuya, Ishido Keinosuke, Kudo Daisuke, Kimura Norihisa, Wakiya Tai-Ichi, Wu Yunyan, Morohashi Satoko, Hakamada Kenichi, Kijima Hiroshi
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan.
Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan.
Mol Clin Oncol. 2018 Jan;8(1):54-60. doi: 10.3892/mco.2017.1472. Epub 2017 Oct 27.
The classification of histological phenotypes was originally conceived for pancreatic intraductal papillary mucinous neoplasms. Recently, it has been introduced for extrahepatic cholangiocarcinoma. The aim of the present study was to clarify the associations between histological phenotype and clinicopathological features of extrahepatic cholangiocarcinoma, using 99 cases of surgically-resected extrahepatic cholangiocarcinoma. All cases were divided into one of two histological phenotypes: Biliary-type (BT; 56 cases, 56.6%) or metaplastic-type (MT; 43 cases, 43.4%). The clinicopathological features were compared between these two phenotypes. BT tumors exhibited significantly poorer differentiation, more frequent lymph node metastasis (BT vs. MT, 42.9 vs. 30.2%; P=0.042), more severe venous invasion (v2-3: BT vs. MT, 64.3 vs. 23.3%; P<0.001), and more severe perineural invasion (ne2-3: BT vs. MT, 78.6 vs. 48.8%, P=0.002). Furthermore, the overall (P=0.015) and disease-free (P=0.003) survival times were significantly decreased in patients with BT vs. MT tumors. In conclusion, extrahepatic cholangiocarcinoma with a BT phenotype has greater malignant potential, and may be an important predictive factor for poor prognosis.
组织学表型分类最初是针对胰腺导管内乳头状黏液性肿瘤提出的。最近，它被引入用于肝外胆管癌。本研究的目的是通过99例手术切除的肝外胆管癌病例，阐明肝外胆管癌组织学表型与临床病理特征之间的关联。所有病例被分为两种组织学表型之一：胆管型（BT；56例，56.6%）或化生型（MT；43例，43.4%）。比较了这两种表型之间的临床病理特征。BT肿瘤表现出明显较差的分化、更频繁的淋巴结转移（BT与MT相比，42.9%对30.2%；P = 0.042）、更严重的静脉侵犯（v2 - 3：BT与MT相比，64.3%对23.3%；P < 0.001）以及更严重的神经周围侵犯（ne2 - 3：BT与MT相比，78.6%对48.8%，P = 0.002）。此外，BT肿瘤患者的总生存期（P = 0.015）和无病生存期（P = 0.003）明显缩短。总之，具有BT表型的肝外胆管癌具有更大的恶性潜能，可能是预后不良的重要预测因素。
