非胆汁性肝硬化中的胆管上皮内瘤变——来自100例移植肝脏的报告：单中心经验
Biliary Intraepithelial Neoplasia in Non-biliary Cirrhosis-Report From 100 Explanted Livers: A Single Center Experience.
作者信息
Zarei Maryam, Shasaeefar Alireza, Kazemi Kurosh, Dehghani Masoud, Malekhosseini Seyed-Ali, Geramizadeh Bita
机构信息
Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Surgery (Hepatobiliary), School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Clin Pathol. 2019 Sep 17;12:2632010X19876934. doi: 10.1177/2632010X19876934. eCollection 2019 Jan-Dec.
BACKGROUND
Intrahepatic cholangiocarcinoma is a highly malignant tumor with a very short 5-year survival. Multistep carcinogenesis has been suggested as the main pathway for the development of this tumor. Main suggested precursors have been (1) biliary intraepithelial neoplasia (BilIN) and (2) intraductal papillary neoplasm of bile duct (IPNB). The former is flat and does not produce grossly and radiologically detectable mass lesion, but the latter produces grossly identifiable lesion.
OBJECTIVES
The development of bile duct dysplasia (BilIN) in chronic biliary diseases has been investigated and proved, but the incidence of BilIN in non-biliary causes of cirrhosis such as hepatitis B and non-alcoholic steatohepatitis has very rarely been investigated. In this study, we have tried to find out the prevalence of BilIN in non-biliary cirrhosis.
PATIENTS AND METHODS
During the study period (2017-2018) in 100 explanted livers with the diagnosis of non-biliary cirrhosis, thorough sampling (at least 20 sections) was performed, and pathologic sections were studied for the presence of BilIN.
RESULTS
In the 100 studied livers with different diagnoses of non-biliary causes of cirrhosis, 31% of cases showed BilIN-1 and 2% of cases showed BiliIN-2. No case of BilIN-3 has been identified.
DISCUSSION AND CONCLUSIONS
Non-biliary causes of cirrhosis should be considered as precursors of cholangiocarcinoma (BilIN); however, the incidence of this occurrence is low.
背景
肝内胆管癌是一种高度恶性的肿瘤，5年生存率极低。多步骤致癌作用被认为是该肿瘤发生发展的主要途径。主要的推测前体包括：（1）胆管上皮内瘤变（BilIN）和（2）胆管内乳头状肿瘤（IPNB）。前者为扁平状，不会产生肉眼及影像学可检测到的肿块病变，而后者会产生肉眼可识别的病变。
目的
慢性胆道疾病中胆管发育异常（BilIN）的发生情况已得到研究和证实，但在乙型肝炎和非酒精性脂肪性肝炎等非胆道原因引起的肝硬化中，BilIN的发生率极少被研究。在本研究中，我们试图找出非胆道性肝硬化中BilIN的患病率。
患者和方法
在研究期间（2017 - 2018年），对100例诊断为非胆道性肝硬化的移植肝脏进行了全面采样（至少20个切片），并对病理切片进行BilIN检测。
结果
在100例诊断为不同非胆道原因肝硬化的研究肝脏中，31%的病例显示有BilIN - 1，2%的病例显示有BilIN - 2。未发现BilIN - 3病例。
讨论与结论
非胆道原因引起的肝硬化应被视为胆管癌（BilIN）的前体；然而，这种情况的发生率较低。
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