Phenotypic characterization of early biliary tract carcinomas proposes two carcinogenesis pathways

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  • Haga Toshihiro
    Department of Pathology and Bioscience, Hirosaki University Graduates School of Medicine Department of Gastroenterology, Hirosaki University Graduates School of Medicine
  • Yoshizawa Tadashi
    Department of Pathology and Bioscience, Hirosaki University Graduates School of Medicine
  • Morohashi Satoko
    Department of Pathology and Bioscience, Hirosaki University Graduates School of Medicine
  • Hirai Hideaki
    Department of Pathology and Bioscience, Hirosaki University Graduates School of Medicine
  • Saitou Kensuke
    Department of Medical Oncology, Hirosaki University Graduates School of Medicine
  • Ota Rie
    Department of Gastroenterology, Hirosaki University Graduates School of Medicine
  • Takatsuna Masafumi
    Department of Pathology and Bioscience, Hirosaki University Graduates School of Medicine Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
  • Wu Yuyan
    Department of Pathology and Bioscience, Hirosaki University Graduates School of Medicine
  • Fukuda Shinsaku
    Department of Gastroenterology, Hirosaki University Graduates School of Medicine
  • Kijima Hiroshi
    Department of Pathology and Bioscience, Hirosaki University Graduates School of Medicine

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    Early biliary tract carcinomas (BTCs) are divided into three groups: early gallbladder carcinoma (GBC), early extrahepatic bile duct carcinoma (EBC), and early duodenal ampullary carcinoma (DAC). These early carcinomas frequently show metaplastic changes. However, phenotypic characterization has not yet been examined. We examined 76 lesions of surgically resected early biliary tract carcinomas (pTis/pT1 tumors according to TNM classification). The predominant carcinoma phenotypes were classified with hematoxylin and eosin (HE) stain, and immunohistochemical examinations (MUC1, MUC2, MUC5AC, MUC6, and CD10) were performed. We also analyzed phenotypes of the surrounding non-neoplastic mucosa. Of the 33 early GBCs, 18 (54.5%) were biliary type, and 15 (45.5%) were metaplastic type （gastric foveolar type/intestinal type） carcinoma. Of the 26 early EBCs, 18 (69.2%) were biliary type carcinoma, and eight (30.8%) were metaplastic type carcinoma. Of the 17 early DACs, eight (47.1%) were biliary type carcinoma, nine (52.9%) were metaplastic type carcinoma. Biliary type carcinomas less frequently showed metaplastic changes, while metaplastic type carcinomas were frequently surrounded by the metaplastic mucosa. Early GBC and early DAC more frequently showed metaplastic changes, compared to the early EBC. In conclusion, we speculated that two carcinogenesis pathways of early BTC (GBC, EBC, and DAC): (1) carcinomas arising from the proper epithelium (mainly EBC) and (2) carcinomas from the metaplastic epithelium (mainly GBC and DAC).

収録刊行物

  • 弘前医学

    弘前医学 67 (1), 28-38, 2016

    弘前大学大学院医学研究科・弘前医学会

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