胆管内乳头状瘤患者的临床病理特征及诊断问题

Clinicopathological Aspects and Diagnostic Problems in Patients with Intraductal Papillary Neoplasm of the Bile Duct.

作者信息

Nanashima Atsushi, Imamura Naoya, Sumida Yorihisa, Hiyoshi Masahide, Hamada Takeomi, Nagayasu Takeshi

机构信息

Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Kiyotake, Japan

Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Kiyotake, Japan.

出版信息

Anticancer Res. 2018 Apr;38(4):2343-2352. doi: 10.21873/anticanres.12481.

DOI:10.21873/anticanres.12481

PMID:29599359

Abstract

BACKGROUND/AIM: Intraductal papillary neoplasm of the bile duct (IPNB) is defined as a non-invasive malignancy and disparity of its histological diagnosis with related diseases remains.

PATIENTS AND METHODS

Twenty-six cases of IPNB and 12 of papillary adenocarcinomas (PAC) at two Institutes were investigated.

RESULTS

The prevalence of biliary dilatation and mucin secretion in the group with IPNB was significantly higher compared to the group with PAC (p<0.01). IPNB was predominantly located in the proximal bile duct compared to the location of PAC (p<0.01). Mis-matching of a second histological diagnosis was observed in 27% of IPNB and 25% of PAC, respectively. The prevalence of tumor relapse was significantly higher in PAC than in IPNB (p<0.05), and the overall survival was significantly better in IPNB than in PAC (p<0.01).

CONCLUSION

Although IPNB is currently defined under histological criteria, morphologies were various and disparity in histological diagnosis for IPNB remains problematic when the clinical strategy is contemplated.

摘要

背景/目的：胆管内乳头状肿瘤（IPNB）被定义为一种非侵袭性恶性肿瘤，其组织学诊断与相关疾病之间仍存在差异。

患者与方法

对两家机构的26例IPNB病例和12例乳头状腺癌（PAC）病例进行了研究。

结果

与PAC组相比，IPNB组的胆管扩张和黏液分泌发生率显著更高（p<0.01）。与PAC的位置相比，IPNB主要位于近端胆管（p<0.01）。分别在27%的IPNB和25%的PAC中观察到二次组织学诊断不匹配。PAC的肿瘤复发率显著高于IPNB（p<0.05），IPNB的总生存率显著优于PAC（p<0.01）。