Abstract：
BACKGROUND: The current WHO classification proposed high-grade biliary intraepithelial neoplasm (BilIN) and intracholecystic papillary neoplasm (ICPN) as precursors of the gallbladder carcinoma (GBC). Herein, conventional GBCs (cGBCs) were pathologically examined with respect to these two precursors.
METHODS: Forty-seven cases of GBC with grossly visible invasions were collected from Fukui Saiseikai Hospital. The association of two precursors was analyzed referring to pathologic features of cGBCs and post-operative survival.
RESULTS: 20 cGBCa (42.6%) were associated with either of two precursors in the surrounding mucosa: high-grade BilIN in 15 cases (31.9%) or ICPN in 5 cases (10.6%). Association of precursors was not related to gross types of and histological differentiation of cGBC. cGBCs without precursors showed frequent vascular/perineural invasion and lymph node metastasis, though cGBCs with and without precursors presented a similar post-operative survival. High-grade BilIN and ICPN associated with cGBCs showed more complicated cytoarchitectural features compared with those with no or focal invasion.
CONCLUSIONS: More than 40% of cGBCs were associated with high-grade BilIN or ICPN, and the former was a frequent precursor. cGBCs without precursors showed aggressive pathologic features. Clinical detection of these precursors may make early treatment of cGBCs possible.
METHODS: Forty-seven cases of GBC with grossly visible invasions were collected from Fukui Saiseikai Hospital. The association of two precursors was analyzed referring to pathologic features of cGBCs and post-operative survival.
RESULTS: 20 cGBCa (42.6%) were associated with either of two precursors in the surrounding mucosa: high-grade BilIN in 15 cases (31.9%) or ICPN in 5 cases (10.6%). Association of precursors was not related to gross types of and histological differentiation of cGBC. cGBCs without precursors showed frequent vascular/perineural invasion and lymph node metastasis, though cGBCs with and without precursors presented a similar post-operative survival. High-grade BilIN and ICPN associated with cGBCs showed more complicated cytoarchitectural features compared with those with no or focal invasion.
CONCLUSIONS: More than 40% of cGBCs were associated with high-grade BilIN or ICPN, and the former was a frequent precursor. cGBCs without precursors showed aggressive pathologic features. Clinical detection of these precursors may make early treatment of cGBCs possible.
摘要：
背景：目前的WHO分类提出高级别胆管上皮内瘤（BilIN）和胆囊内乳头状瘤（ICPN）是胆囊癌（GBC）的前体。在这里，常规GBC(cGBC)对这两种前体进行了病理学检查。
方法：从福井市赛义凯医院收集了47例明显可见的GBC。根据cGBC的病理特征和术后生存率分析了两种前体的关联。
结果：20cGBCa（42.6％）与周围粘膜中的两个前体中的任何一个相关：15例（31.9％）中的高级BilIN或5例（10.6％）中的ICPN。前体的关联与cGBC的总体类型和组织学分化无关。无前体的cGBCs表现出频繁的血管/神经浸润和淋巴结转移，尽管有和没有前体的cGBC术后生存率相似。与cGBC相关的高级BilIN和ICPN与没有或局灶性侵袭相比，显示出更复杂的细胞结构特征。
结论：超过40％的cGBCs与高级Bilin或ICPN相关，前者是一个常见的先兆。无前体的cGBCs表现出侵袭性病理特征。这些前体的临床检测可能使早期治疗cGBCs成为可能。
方法：从福井市赛义凯医院收集了47例明显可见的GBC。根据cGBC的病理特征和术后生存率分析了两种前体的关联。
结果：20cGBCa（42.6％）与周围粘膜中的两个前体中的任何一个相关：15例（31.9％）中的高级BilIN或5例（10.6％）中的ICPN。前体的关联与cGBC的总体类型和组织学分化无关。无前体的cGBCs表现出频繁的血管/神经浸润和淋巴结转移，尽管有和没有前体的cGBC术后生存率相似。与cGBC相关的高级BilIN和ICPN与没有或局灶性侵袭相比，显示出更复杂的细胞结构特征。
结论：超过40％的cGBCs与高级Bilin或ICPN相关，前者是一个常见的先兆。无前体的cGBCs表现出侵袭性病理特征。这些前体的临床检测可能使早期治疗cGBCs成为可能。
