Invasive micropapillary carcinomas of the ampullo-pancreatobiliary region and their association with tumor-infiltrating neutrophils
Invasive micropapillary carcinomas of the ampullo-pancreatobiliary region and their association with tumor-infiltrating neutrophils
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DOI：
10.1038/modpathol.3800460
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发表时间：
2005-11-01
期刊：
影响因子：
7.5
通讯作者：
Adsay, NV
中科院分区：
文献类型：
--
作者：
Khayyata, S;Basturk, O;Adsay, NV
浸润性微乳头状癌，最初被描述为乳腺浸润性癌的一种独特类型，越来越多地被认为是许多其他器官的独立实体；然而，在胰腺或壶腹周围区域尚未有文献记载。在这项研究中，我们回顾了313例胰腺癌和73例壶腹周围癌，以探讨该部位的微乳头状结构。8例壶腹周围和8例胰腺（4%）至少由局灶性（bbb20 %）浸润性微乳头状癌组成。患者男10例，女6例，平均年龄69岁。肿瘤平均大小为3.2 cm。11/15例有淋巴结转移。中位生存期为8个月（全部切除）。浸润性微乳头状癌的特征是位于裂隙内的小而紧密堆积的微乳头状簇（没有纤维血管核心）。细胞有中度核异型性。在9例中，肿瘤细胞周围有大量由中性粒细胞组成的炎症，包括上皮内（“同类相食”）和间质。11/11和9/11病例细胞质中分别表达与肿瘤细胞间质粘附异常相关的分子、半乳糖凝集素-3和E-cadherin。在所有11例测试中，MUC - 1观察到细胞极性的逆转，这表明在微乳头簇的基质表面有标记，也证实了裂缝不仅仅是一个加工伪影，而是一个真正的生物改变。总之，浸润性微乳头状癌占胰腺/壶腹周围癌的4%，通常伴有大量嗜中性粒细胞浸润。浸润性微乳头状癌在壶腹周围比胰腺浸润性微乳头状癌更常见，无论从类型还是中位生存期（8个月）来看，浸润性微乳头状癌都属于低分化。
Invasive micropapillary carcinoma, originally described as a distinctive type of invasive carcinoma in the breast, is being increasingly recognized as a separate entity in many other organs; however, it has not yet been documented in the pancreas or periampullary region. In this study, 313 pancreatic and 73 periampullary carcinomas were reviewed to investigate the micropapillary pattern in this location. Eight periampullary and eight pancreatic cases (4%) were composed at least focally (>20%) of invasive micropapillary carcinoma. The patients were 10 males and six females, mean age 69 years. The mean tumor size was 3.2 cm. Lymph node metastasis was detected in 11/15 cases. The median survival was 8 months ( all were resected). Invasive micropapillary carcinoma was characterized by small, closely packed micropapillary clusters ( without fibrovascular cores) lying within clefts. The cells had moderate degree of nuclear atypia. In nine cases, there was abundant inflammation composed of neutrophils concentrating around the tumor cells, both intraepithelial ('cannibalism') and stromal. Molecules implicated in abnormalities of tumor cell - stroma adhesion, galectin-3 and E-cadherin were expressed in the cytoplasm of 11/11 and 9/11 cases, respectively. Reversal of cell polarity was observed by MUC 1 in all 11 cases tested, which showed labeling in the stroma-facing surfaces of the micropapillary clusters, also confirming that the clefts are not merely a processing artifact, but indeed a true biologic alteration. In conclusion, invasive micropapillary carcinoma constitutes 4% of carcinomas in the pancreatic/periampullary region and is commonly associated with abundant neutrophilic infiltrates. Invasive miropapillary carcinoma appears to be more common in periampullary than in pancreatic invasive micropapillary carcinoma would qualify as poorly differentiated both based on pattern and the median survival ( 8 months).