Cancerization of ducts in hilar cholangiocarcinoma
Cancerization of ducts in hilar cholangiocarcinoma
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肝门部胆管癌的导管癌化
DOI：
10.1007/s00428-022-03333-4
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发表时间：
2022
期刊：
影响因子：
3.5
通讯作者：
Oshima Kiyoko
中科院分区：
文献类型：
--
作者：
Lee Jae W.;Zhang Yang;Yoshizawa Tadashi;Argani Pedram;Wood Laura D.;Oshima Kiyoko
由导管结构引起的侵袭性癌症可以在称为导管癌变（COD）的过程中浸润并定殖预先存在的导管。胆管癌的COD是一个研究不足的过程，其临床意义仍然知之甚少。尽管癌变导管和胆管上皮内瘤形成（BilIN）均显示出发育异常变化，但COD的标志是（i）从正常/反应性上皮突然转变为重度发育异常，以及（ii）与具有相似细胞学特征的浸润性癌非常接近。我们调查了113例手术切除的肝门部胆管癌，并确定了37例（33%）的COD。应用免疫组化方法，我们发现COD和邻近浸润癌分别在95%（21/22）和100%（21/21）的病例中具有一致的p53和SMAD 4染色模式。相比之下，BilIN和癌变导管在p53和SMAD 4染色中显示出显著较低的一致性水平，分别为44%（8/18）和47%（8/17）的病例（分别为P= 0.0007和0.0001）。通过单因素分析，淋巴结转移阳性（P= 0.027）、胆管切缘阳性（P= 0.021）和存在COD（P= 0.020）与总生存率降低相关。我们进一步进行了多变量分析，证明淋巴结转移阳性（P= 0.031）、最终胆管切缘阳性（P= 0.035）和COD（P= 0.0051）与总生存期下降相关。总之，我们的研究强调，COD是肝门部胆管癌的一个具有临床意义的过程，可以使用形态学标准结合p53和SMAD 4免疫标记进行鉴定。
Invasive cancers that arise from ductal structures can infiltrate and colonize pre-existing ducts in a process referred to as cancerization of ducts (COD). COD in cholangiocarcinoma is an under-studied process whose clinical significance remains poorly understood. Even though both cancerized ducts and biliary intraepithelial neoplasias (BilINs) show dysplastic changes, hallmarks of COD are (i) an abrupt transition from the normal/reactive epithelium to severe dysplasia and (ii) close proximity to invasive carcinoma with similar cytologic features. We investigated 113 cases of surgically resected hilar cholangiocarcinoma and identified COD in 37 cases (33%). Using immunohistochemistry, we found that COD and adjacent invasive carcinoma had a concordant pattern of p53 and SMAD4 staining in 95% (21/22) and 100% (21/21) of cases, respectively. In contrast, BilINs and cancerized ducts showed significantly lower levels of concordance in p53 and SMAD4 staining at 44% (8/18) and 47% (8/17) of cases, respectively (P= 0.0007 and 0.0001, respectively). By univariate analysis, positive lymph node metastasis (P= 0.027), positive final bile duct margin (P= 0.021), and the presence of COD (P= 0.020) were associated with decreased overall survival. We further performed multivariate analysis to demonstrate that positive lymph node metastasis (P= 0.031), positive final bile duct margin (P= 0.035), and COD (P= 0.0051) were correlated with decreased overall survival. Together, our study highlights that COD is a clinically significant process in hilar cholangiocarcinoma that can be identified using morphological criteria in conjunction with p53 and SMAD4 immunolabeling.
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DOI：
--
发表时间：
2011
期刊：
Pancreatology (Print)
影响因子：
--
作者：
Shigetaka Yamasaki;K. Suda;B. Nobukawa;H. Sonoue
通讯作者：
H. Sonoue
影响因子：
8
作者：
Soares, Kevin C;Kamel, Ihab;Pawlik, Timothy M
通讯作者：
Pawlik, Timothy M
DOI：
10.1097/pas.0000000000000533
发表时间：
2015-12
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Basturk O;Hong SM;Wood LD;Adsay NV;Albores-Saavedra J;Biankin AV;Brosens LA;Fukushima N;Goggins M;Hruban RH;Kato Y;Klimstra DS;Klöppel G;Krasinskas A;Longnecker DS;Matthaei H;Offerhaus GJ;Shimizu M;Takaori K;Terris B;Yachida S;Esposito I;Furukawa T;Baltimore Consensus Meeting
通讯作者：
Baltimore Consensus Meeting
影响因子：
5.6
作者：
Danielle A. Hutchings;Kevin M. Waters;M. Weiss;elliot k fishman;M. Makary;Jin He;J. Cameron;L. Wood;R. Hruban
通讯作者：
R. Hruban
浸润性乳腺癌导管内扩散与c-erb B-2过表达和血管侵犯呈正相关
影响因子：
6.2
作者：
X. Jing;K. Kakudo;Maki Murakami;Yasushi Nakamura;Misa Nakamura;T. Yokoi;Qifeng Yang;S. Oura;T. Sakurai
通讯作者：
T. Sakurai