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.

Identification of neutrophil‐related genes and development of a prognostic model for cholangiocarcinoma

“…1 It accounts for approximately 3% of all gastrointestinal malignancies, and its incidence has been steadily increasing over the past few decades. 2 Despite advances in diagnosis and treatment, the overall prognosis of CCA remains poor, with a 5 year survival rate of less than 10%. [3][4][5] There is an urgent need to better understand the molecular mechanisms underlying CCA pathogenesis and identify novel prognostic biomarkers and therapeutic targets.…”

“…Cholangiocarcinoma (CCA), also known as bile duct cancer, is a rare and aggressive malignancy that arises from the epithelial cells of the bile ducts 1 . It accounts for approximately 3% of all gastrointestinal malignancies, and its incidence has been steadily increasing over the past few decades 2 . Despite advances in diagnosis and treatment, the overall prognosis of CCA remains poor, with a 5 year survival rate of less than 10% 3–5 .…”

Current considerations on intraductal papillary neoplasms of the bile duct and pancreatic duct

“…IBNB, first described by Chen et al [ 6 ] in 2001, is a slow-growing precancerous lesion that evolves into carcinoma[ 1 , 7 , 8 ]. The other precursor lesion of invasive cholangiocarcinoma, an aggressive disease with poor outcomes, is biliary intraepithelial neoplasia[ 7 , 9 ]. The mucin produced may cause transient ductal obstruction manifested by recurrent episodes of acute cholangitis, obstructive jaundice and bile duct dilatation[ 8 , 10 ].…”