Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan; Department of Diagnostic Pathology, Fukui Prefecture Saiseikai Hospital, Fukui, Japan.
Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan.
Ann Diagn Pathol. 2022 Jun;58:151911. doi: 10.1016/j.anndiagpath.2022.151911. Epub 2022 Feb 18.
The current WHO classification proposed high-grade biliary intraepithelial neoplasm (BilIN) and intracholecystic papillary neoplasm (ICPN) as precursors of the gallbladder carcinoma (GBC). Herein, conventional GBCs (cGBCs) were pathologically examined with respect to these two precursors.
Forty-seven cases of GBC with grossly visible invasions were collected from Fukui Saiseikai Hospital. The association of two precursors was analyzed referring to pathologic features of cGBCs and post-operative survival.
20 cGBCa (42.6%) were associated with either of two precursors in the surrounding mucosa: high-grade BilIN in 15 cases (31.9%) or ICPN in 5 cases (10.6%). Association of precursors was not related to gross types of and histological differentiation of cGBC. cGBCs without precursors showed frequent vascular/perineural invasion and lymph node metastasis, though cGBCs with and without precursors presented a similar post-operative survival. High-grade BilIN and ICPN associated with cGBCs showed more complicated cytoarchitectural features compared with those with no or focal invasion.
More than 40% of cGBCs were associated with high-grade BilIN or ICPN, and the former was a frequent precursor. cGBCs without precursors showed aggressive pathologic features. Clinical detection of these precursors may make early treatment of cGBCs possible.
目前的世界卫生组织分类将高级胆管上皮内肿瘤（BilIN）和胆囊内乳头状肿瘤（ICPN）作为胆囊癌（GBC）的前体。在此，通过病理检查对这两种前体与常规 GBC（cGBC）进行了研究。
从福井癌学会医院收集了 47 例有明显肉眼浸润的 GBC 病例。分析了 cGBC 的病理特征和术后生存与两种前体的关系。
20 例 cGBCa（42.6%）与周围黏膜中的两种前体之一有关：高级 BilIN 15 例（31.9%）或 ICPN 5 例（10.6%）。前体的存在与 cGBC 的大体类型和组织学分化无关。无前体的 cGBC 更常发生血管/神经周围侵犯和淋巴结转移，尽管有或无前体的 cGBC 术后生存相似。与 cGBC 相关的高级 BilIN 和 ICPN 显示出比无或局灶性浸润的前体更复杂的细胞结构特征。
超过 40%的 cGBC 与高级 BilIN 或 ICPN 有关，前者是常见的前体。无前体的 cGBC 具有侵袭性的病理特征。这些前体的临床检测可能使 cGBC 的早期治疗成为可能。
