Clinicopathologic Study of Biliary Intraepithelial Neoplasia in Cholangiocarcinoma

Dig Surg. 2018;35(2):116-120. doi: 10.1159/000475848. Epub 2017 May 11.

Abstract

Backgrounds and aims: Biliary intraepithelial neoplasia (BilIN) is a precursor of cholangiocarcinoma (CC) and it has been associated with several chronic inflammatory conditions. This study aimed to elucidate the prevalence of BilIN in CC and its clinicopathological significance.

Methods: Medical records of 193 patients with histologically confirmed CC were analyzed. We reviewed the pathology findings of 48 patients who underwent curative surgery for CC.

Results: Of the 48 patients analyzed, 34 and 14 patients had extrahepatic and intrahepatic CC respectively. BilIN was detected in 28 patients (58%) and showed a significantly higher prevalence in extrahepatic CC (75%) than in intrahepatic CC (21%; p < 0.001). In the subgroup of 34 patients with extrahepatic CC, 25 and 9 patients were BilIN positive and negative respectively. Poor differentiation and T3 stage were significantly more common in the BilIN-negative group than in the BilIN-positive group (p < 0.05). The expression of MUC5AC, p53, and loss of Smad4 showed no difference between BilIN-positive CC and in BilIN-negative CC, but the Ki-67 expression was significantly higher (p < 0.05).

Conclusion: BilIN-positive CC showed less invasiveness than negative cases. The Ki-67 expression was significantly higher in BilIN-positive CC.

Keywords: Biliary intraepithelial neoplasia; Cholangiocarcinoma; Ki-67.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Bile Duct Neoplasms / epidemiology*
  • Bile Duct Neoplasms / pathology*
  • Bile Duct Neoplasms / surgery
  • Bile Ducts, Extrahepatic / pathology
  • Bile Ducts, Intrahepatic / pathology
  • Biopsy, Needle
  • Carcinoma in Situ / epidemiology
  • Carcinoma in Situ / pathology*
  • Carcinoma in Situ / surgery
  • Cholangiocarcinoma / epidemiology*
  • Cholangiocarcinoma / pathology*
  • Cholangiocarcinoma / surgery
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Immunohistochemistry
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / pathology*
  • Prognosis
  • Republic of Korea
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome