Clinical Pathology Research on Perineural Invasion in Hilar Cholangiocarcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 DONGMao-sheng ¹ ,  LIZhen-kai ¹ , XUXiao-ya ¹ , LIAi-min ² , SUNSuo-zhu ³ , CHENGBo ³

1. Department of General Surgery, The Second Artillery General Hospital PLA, Beijing 100088, China;
2. Department of Hepatobiliary Surgery, The Second Artillery General Hospital PLA, Beijing 100088, China;
3. Department of Pathology, The Second Artillery General Hospital PLA, Beijing 100088, China;

Corresponding?author：

LIZhen-kai, Email: li-zhen-kai@163.com

Keywords：

Hilar cholangiocarcinoma; Perineural invasion; Pathological type

DOI：

10.7507/1007-9424.20150057

Video：

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Objective To summarize the incidence, patterns and laws of perineural invasion, and explore the path and the influencing factors of perineural invasion in hilar cholangiocarcinoma. Methods A clinicopathologic study was conducted on sections from 52 patients with hilar cholangiocarcinoma to summarize the incidence and patterns of perineural invasion. The relationship of perineural invasion to lymph node metastasis, serum CA19-9, CEA, total bilirubin (TBIL) level, Bismuth-Corllet classification, or tumor penetration depth of bile duct walls was analyzed by association analysis. Results The overall incidence of perineural invasion was 90.38% (47/52). However, the incidences of perineural invasion had no significant differences among various differentiated adenocarcinoma groups (P > 0.05). The incidences of perineural invasion were not correlated with the lymph node metastasis, serum CA19-9, CEA, TBIL level, and Bismuth-Corlette classification (P > 0.05), which was correlated with the tumor penetration depth of bile duct walls (P < 0.01). There were four patterns of perineural invasion, sequenced them according their incidences from high to low as follows: typeⅡ> typeⅢ> typeⅣ> typeⅠ. The pattern of perineural invasion was correlated with the degree of tumor differentiation (χ²=31.04, P < 0.01). Conclusions The incidence of perineural invasion is very high in hilar cholangiocarcinoma. The patterns of perineural invasion are similar in the same patient, and a variety of invasion patterns might coexist. While the pattern of perineural invasion is correlated with the degree of tumor differentiation. The incidence of perineural invasion is correlated with the tumor penetration depth of bile duct walls.

Citation： DONGMao-sheng, LIZhen-kai, XUXiao-ya, LIAi-min, SUNSuo-zhu, CHENGBo. Clinical Pathology Research on Perineural Invasion in Hilar Cholangiocarcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(2): 212-215. doi: 10.7507/1007-9424.20150057 Copy

1.	?陳勇, 何勇, 趙建, 等.胰管結石的外科分型及處理對策.中華外科雜志, 2004, 42(7): 417-420.
2.	淦宇, 李寧, 魯穩柱, 等.胰管結石的診斷及治療.華西醫學, 2011, 26(8): 1170-1173.
3.	Fang WL, Shyr YM, Su CH, et al. Long-term follow-up study of surgical treatment for pancreatic stones. Hepatogastroenterology, 2007, 54(73): 246-249.
4.	Jin CX, Naruse S, Kitagawa M, et al. Pancreatic stone protein of pancreatic calculi in chronic calcified pancreatitis in man. JOP, 2002, 3(2): 54-61.
5.	王炳煌, 張小文, 李曉, 等.慢性胰腺炎的診斷和治療.外科理論與實踐, 2004, 9(4): 301-303.
6.	楊驥, 黃強, 林先盛, 等.慢性胰腺炎合并胰管結石的診斷及治療分析.中國普通外科雜志, 2014, 23(3): 379-382.
7.	虞名旭, 李金海, 戴華衛.胰腺結石25例臨床分析.中國普外基礎與臨床雜志, 2012, 19(3): 330-332.
8.	劉續寶.慢性胰腺炎的胰頭炎性包塊的外科治療.中國普外基礎與臨床雜志, 2013, 20(2): 121-123.
9.	李安, 李立.胰管結石的總體認識.云南醫藥雜志, 2006, 27(3): 293-295.
10.	李振凱, 張炳遠, 代冬冬, 等.肝門部膽管癌神經浸潤動物模型的建立.中國普外基礎與臨床雜志, 2013, 20(5): 487-491.
11.	Nakagohri T, Asano T, Kinoshita H, et al. Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma. World J Surg, 2003, 27(3): 289-293.
12.	丁振昊, 周寧新, 肖梅, 等.伴神經浸潤的肝門部膽管癌的病理和臨床分析.臨床外科雜志, 2006, 14(2): 97-99．.
13.	Aishima S, Kuroda Y, Nishihara Y, et al. Proposal of progression model for intrahepatic cholangiocarcinoma: clinicopathologic differences between hilar type and peripheral type. Am J Surg Pathol, 2007, 31(7): 1059-1067.
14.	Takahashi S, Hasebe T, Oda T, et al. Extra-tumor perineural invasion predicts postoperative development of peritoneal dissemination in pancreatic ductal adenocarcinoma. Anticancer Res, 2001, 21(2B): 1407-1412.
15.	Hassan MO, Maksem J. The prostatic perineural space and its relation to tumor spread: an ultrastructural study. Am J Surg Pathol, 1980, 4(2): 143-148.
16.	Maxwell P, Hamilton PW, Sloan JM. Three-dimensional reconstruction of perineural invasion in carcinoma of the extrahepatic bile ducts. J Pathol, 1996, 180(2): 142-145.
17.	Yamaguchi R, Nagino M, Oda K, et al. Perineural invasion has a negative impact on survival of patients with gallbladder carcinoma. Br J Surg, 2002, 89(9): 1130-1136．.
18.	王大東, 黃志強, 周寧新, 等.膽管癌神經浸潤轉移模式的三維重建.中華外科雜志, 2000, 38(3): 207-208.
19.	Ogura Y, Mizumoto R, Tabata M, et al. Surgical treatment of carcinoma of the hepatic duct confluence: analysis of 55 resected carcinomas. World J Surg, 1993, 17(1): 85-93.

1. ?陳勇, 何勇, 趙建, 等.胰管結石的外科分型及處理對策.中華外科雜志, 2004, 42(7): 417-420.
2. 淦宇, 李寧, 魯穩柱, 等.胰管結石的診斷及治療.華西醫學, 2011, 26(8): 1170-1173.
3. Fang WL, Shyr YM, Su CH, et al. Long-term follow-up study of surgical treatment for pancreatic stones. Hepatogastroenterology, 2007, 54(73): 246-249.
4. Jin CX, Naruse S, Kitagawa M, et al. Pancreatic stone protein of pancreatic calculi in chronic calcified pancreatitis in man. JOP, 2002, 3(2): 54-61.
5. 王炳煌, 張小文, 李曉, 等.慢性胰腺炎的診斷和治療.外科理論與實踐, 2004, 9(4): 301-303.
6. 楊驥, 黃強, 林先盛, 等.慢性胰腺炎合并胰管結石的診斷及治療分析.中國普通外科雜志, 2014, 23(3): 379-382.
7. 虞名旭, 李金海, 戴華衛.胰腺結石25例臨床分析.中國普外基礎與臨床雜志, 2012, 19(3): 330-332.
8. 劉續寶.慢性胰腺炎的胰頭炎性包塊的外科治療.中國普外基礎與臨床雜志, 2013, 20(2): 121-123.
9. 李安, 李立.胰管結石的總體認識.云南醫藥雜志, 2006, 27(3): 293-295.
10. 李振凱, 張炳遠, 代冬冬, 等.肝門部膽管癌神經浸潤動物模型的建立.中國普外基礎與臨床雜志, 2013, 20(5): 487-491.
11. Nakagohri T, Asano T, Kinoshita H, et al. Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma. World J Surg, 2003, 27(3): 289-293.
12. 丁振昊, 周寧新, 肖梅, 等.伴神經浸潤的肝門部膽管癌的病理和臨床分析.臨床外科雜志, 2006, 14(2): 97-99．.
13. Aishima S, Kuroda Y, Nishihara Y, et al. Proposal of progression model for intrahepatic cholangiocarcinoma: clinicopathologic differences between hilar type and peripheral type. Am J Surg Pathol, 2007, 31(7): 1059-1067.
14. Takahashi S, Hasebe T, Oda T, et al. Extra-tumor perineural invasion predicts postoperative development of peritoneal dissemination in pancreatic ductal adenocarcinoma. Anticancer Res, 2001, 21(2B): 1407-1412.
15. Hassan MO, Maksem J. The prostatic perineural space and its relation to tumor spread: an ultrastructural study. Am J Surg Pathol, 1980, 4(2): 143-148.
16. Maxwell P, Hamilton PW, Sloan JM. Three-dimensional reconstruction of perineural invasion in carcinoma of the extrahepatic bile ducts. J Pathol, 1996, 180(2): 142-145.
17. Yamaguchi R, Nagino M, Oda K, et al. Perineural invasion has a negative impact on survival of patients with gallbladder carcinoma. Br J Surg, 2002, 89(9): 1130-1136．.
18. 王大東, 黃志強, 周寧新, 等.膽管癌神經浸潤轉移模式的三維重建.中華外科雜志, 2000, 38(3): 207-208.
19. Ogura Y, Mizumoto R, Tabata M, et al. Surgical treatment of carcinoma of the hepatic duct confluence: analysis of 55 resected carcinomas. World J Surg, 1993, 17(1): 85-93.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Pathology Research on Perineural Invasion in Hilar Cholangiocarcinoma

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