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Prognostic implications of the coexisting precursor lesion types in invasive gallbladder cancer
- Source :
- Human Pathology. 114:44-53
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Invasive gallbladder carcinoma (GBC) is preceded by two main types of precursor lesions: intracholecystic papillary-tubular neoplasms (ICPNs) and biliary intraepithelial neoplasias (BilINs). Invasive GBCs with an ICPN component have more favorable prognoses than those without an ICPN component. Some BilINs show a relatively exophytic papillary pattern but do not meet the ICPN criteria; at our institution, we call these papillary neoplasias. To clarify the clinical significance of papillary neoplasia, we herein examined 80 invasive GBCs and classified them into three groups based on the type of preinvasive lesions: those with ICPN (ICPN group, n = 35), those with papillary neoplasia (pap-neoplasia group, n = 13), and those without ICPN/papillary neoplasia (group without ICPN/pap-neoplasia, n = 32). We then compared the prognostic differences and characterized the tumors of each group by determining the immunohistochemical expressions of various biomarkers. The overall survival periods of the ICPN and pap-neoplasia groups were significantly longer than that of the group without ICPN/pap-neoplasia (P 0.0001, P = 0.0036, respectively). Multivariate analysis revealed that lacking ICPN/papillary neoplasia was independently associated with poor prognosis (P = 0.0007), as were poor differentiation (P = 0.0395), presence of preoperative symptoms (P = 0.0488), and advanced stage (P = 0.0234). Invasive components of the ICPN and pap-neoplasia groups were characterized by higher expressions of p16 and p53 compared with those of the group without ICPN/pap-neoplasia. The prognoses of the invasive GBCs with either papillary neoplasia or ICPN were thus more favorable than those of the invasive GBCs without ICPN/pap-neoplasia. Invasive GBCs with exophytic papillary preinvasive lesions (ICPN and papillary neoplasia) may be biologically different from those without such lesions.
- Subjects :
- Male
0301 basic medicine
medicine.medical_specialty
Risk Assessment
Gastroenterology
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
Ribonucleoproteins, Small Nucleolar
Risk Factors
Internal medicine
Biomarkers, Tumor
medicine
Carcinoma
Humans
CDX2 Transcription Factor
Neoplasm Invasiveness
Clinical significance
Papillary pattern
Gallbladder cancer
Cyclin-Dependent Kinase Inhibitor p16
Aged
business.industry
Precursor lesion
Gallbladder
Mucins
Middle Aged
Prognosis
medicine.disease
Immunohistochemistry
030104 developmental biology
medicine.anatomical_structure
030220 oncology & carcinogenesis
Biliary Intraepithelial Neoplasia
Female
Gallbladder Neoplasms
Tumor Suppressor Protein p53
business
Precancerous Conditions
Subjects
Details
- ISSN :
- 00468177
- Volume :
- 114
- Database :
- OpenAIRE
- Journal :
- Human Pathology
- Accession number :
- edsair.doi.dedup.....5c914040ac9d519591b7e4aa473d667b