Pathological survey of precursor lesions in cholangiocarcinoma.

Abstract

BACKGROUND:

To clarify the pathological significance of two precursors (high-grade biliary intraepithelial neoplasm [BilIN] and intraductal papillary neoplasm of bile duct [IPNB]) in cholangiocarcinomas (CCAs).

METHODS:

Ninety-one cases of CCA (47 distal CCAs [dCCAs], 31 perihilar CCAs [pCCAs] and 13 intrahepatic CCAs of large duct type [LD-iCCAs]) were examined for their association with precursors. Neoplastic intraepithelial lesions without underlying infiltrating carcinoma in the surrounding mucosa of CCAs were considered to reflect high-grade BilIN. High-grade BilIN and IPNB were subdivided into gastric, biliary, intestinal and oncocytic subtypes, while CCAs were subdivided into gastrobiliary, intestinal and oncocytic subtypes. The postoperative overall survival (OS) was examined.

RESULTS:

Fifty-four and 8 of 91 CCAs were associated with high-grade BilIN and IPNB, respectively, while these precursors were unidentifiable in the remaining CCAs. A majority of CCAs were of the gastrobiliary subtype, while the intestinal subtype was occasionally detected, and the oncocytic subtype was rare. CCAs with high-grade BilIN showed a similar postoperative OS to CCAs without precursors, while CCAs with IPNB showed a favorable postoperative OS compared to CCAs without precursors.

CONCLUSIONS:

CCAs were frequently associated with precursors; high-grade BilIN may be a major precursor and IPNB a minor one. CCAs with IPNB showed a favorable postoperative OS compared to CCAs with high-grade BilIN.

• Authors: Yasuni Nakanuma, Takashi Sugino, Yuko Kakuda, Yoshikatsu Nomura, Hiroyuki Watanabe, Takuro Terada, Yasunori Sato, Yoshifumi Ohnishi, Yuki Fukumura
• Journal: Journal of hepato-biliary-pancreatic sciences (J Hepatobiliary Pancreat Sci) Vol. 30 Issue 7 Pg. 893-903 (Jul 2023) ISSN: 1868-6982 [Electronic] Japan
• PMID: 36707055 (Publication Type: Journal Article)
• Copyright: © 2023 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Chemical References

• Bile Pigments

Topics

• Humans
• Bile Ducts, Intrahepatic (pathology)
• Bile Duct Neoplasms (surgery, pathology)
• Cholangiocarcinoma (surgery, pathology)
• Bile Ducts (pathology)
• Carcinoma in Situ (pathology)
• Bile Pigments