ABSTRACT
AIM: To compare the cells of mucosal extension (ME) and radial invasion (RI) in hilar cholangiocarcinoma (HCCA) for optimal resection. MATERIALS AND METHODS: Forty-six patients underwent surgery for HCCA between 1992 and 2004. Immunohistochemical expressions of p53, Ki-67, matrix metalloproteinase-7 (MMP7), mucin 1 (MUC1), and E-cadherin were assessed at five different sites of the tumour and compared between the recurrence and non-recurrence groups. RESULTS: Expression of E-cadherin was significantly lower in RI cells than in ME cells, and that of MMP7 and MUC1 was significantly higher in RI cells than in ME cells. Ki-67 expression was higher in ME cells than in RI cells. During the 11-year follow-up, recurrence in patients with R0 resection was associated with significantly lower E-cadherin, higher MMP7, and higher Ki-67 expression. CONCLUSION: Removal of as many RI cells as possible should be a priority in resection of HCCA, followed by removal of ME cells. E-Cadherin appears to be associated with recurrence of HCCA.
Subject(s)
Bile Duct Neoplasms/chemistry , Bile Duct Neoplasms/pathology , Biomarkers, Tumor/analysis , Immunohistochemistry , Klatskin Tumor/chemistry , Klatskin Tumor/pathology , Mucous Membrane/pathology , Aged , Antigens, CD , Bile Duct Neoplasms/surgery , Cadherins/analysis , Female , Humans , Ki-67 Antigen/analysis , Klatskin Tumor/surgery , Male , Matrix Metalloproteinase 7/analysis , Middle Aged , Mucin-1/analysis , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Predictive Value of Tests , Retrospective Studies , Risk Factors , Time Factors , Treatment Outcome , Tumor Suppressor Protein p53/analysisABSTRACT
We report a case of a 75-year-old man with cystic micropapillary neoplasm of peribiliary glands detected preoperatively by radiologic examination. Enhanced computed tomography showed a low-density mass 2.2 cm in diameter in the right hepatic hilum and a cystic lesion around the common hepatic duct. Under a diagnosis of perihilar cholangiocarcinoma, right hepatectomy with caudate lobectomy and bile duct resection were performed. Pathological examination revealed perihilar cholangiocarcinoma mainly involving the right hepatic duct. The cystic lesion was multilocular and covered by columnar lining epithelia exhibiting increased proliferative activity and p53 nuclear expression; it also contained foci of micropapillary and glandular proliferation. Therefore, the lesion was diagnosed as a cystic micropapillary neoplasm of peribiliary glands and resembled flat branch-type intraductal papillary mucinous neoplasm of the pancreas. Histological examination showed the lesion was discontinuous with the perihilar cholangiocarcinoma. Immunohistochemistry showed the cystic neoplasm was strongly positive for MUC6 and that the cholangiocarcinoma was strongly positive for MUC5AC and S100P. These results suggest these two lesions have different origins. This case warrants further study on whether this type of neoplasm is associated with concomitant cholangiocarcinoma as observed in pancreatic intraductal papillary mucinous neoplasm with concomitant pancreatic duct adenocarcinoma.
Subject(s)
Adenocarcinoma, Papillary/pathology , Bile Duct Neoplasms/pathology , Hepatic Duct, Common/pathology , Klatskin Tumor/pathology , Neoplasms, Cystic, Mucinous, and Serous/pathology , Neoplasms, Multiple Primary , Adenocarcinoma, Papillary/chemistry , Adenocarcinoma, Papillary/diagnostic imaging , Adenocarcinoma, Papillary/surgery , Aged , Bile Duct Neoplasms/chemistry , Bile Duct Neoplasms/diagnostic imaging , Bile Duct Neoplasms/surgery , Biliary Tract Surgical Procedures , Biomarkers, Tumor/analysis , Biopsy , Hepatectomy , Hepatic Duct, Common/chemistry , Hepatic Duct, Common/diagnostic imaging , Hepatic Duct, Common/surgery , Humans , Immunohistochemistry , Klatskin Tumor/chemistry , Klatskin Tumor/diagnostic imaging , Klatskin Tumor/surgery , Male , Neoplasms, Cystic, Mucinous, and Serous/chemistry , Neoplasms, Cystic, Mucinous, and Serous/diagnostic imaging , Neoplasms, Cystic, Mucinous, and Serous/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9) and neovascularization have been implicated to be associated with biological processes, especially cancer progression. However, few studies have investigated the role of IL-8 in human hilar cholangiocarcinoma. In this study we detected the expression of IL-8 combined with MMP-9 and microvessel density (MVD) in hilar cholangiocarcinoma to evaluate their clinicopathological significance and prognostic value. A total of 62 patients with hilar cholangiocarcinoma who underwent curative surgery were enrolled in this study. The expression of IL-8, MMP-9 and MVD were examined immunohistochemically. The correlation of IL-8 with MMP-9 expression, MVD, clinicopathological features and survival time of patients were then analyzed. Expression of IL-8 was observed in 56.5% tumors, which was related to advanced TNM stage (P = 0.026) and tumor recurrence (P = 0.018). IL-8 had a positive correlation with MMP-9 expression and MVD. Furthermore, patients with high IL-8 expression had a significantly shorter overall survival than those with low IL-8 expression (P = 0.01). Multivariate analysis confirmed IL-8 as an independent prognostic factor (P = 0.005). In conclusion, IL-8 expression significantly correlated with MMP-9 expression and MVD, and IL-8 was a valuable prognostic factor for human hilar cholangiocarcinoma.
