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.	陈勇, 何勇, 赵建, 等.胰管结石的外科分型及处理对策.中华外科杂志, 2004, 42(7): 417-420.
2.	淦宇, 李宁, 鲁稳柱, 等.胰管结石的诊断及治疗.华西医学, 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, 张小文, 李晓, 等.慢性胰腺炎的诊断和治疗.外科理论与实践, 2004, 9(4): 301-303.
6.	杨骥, 黄强, 林先盛, 等.慢性胰腺炎合并胰管结石的诊断及治疗分析.中国普通外科杂志, 2014, 23(3): 379-382.
7.	虞名旭, 李金海, 戴华卫.胰腺结石25例临床分析.中国普外基础与临床杂志, 2012, 19(3): 330-332.
8.	刘续宝.慢性胰腺炎的胰头炎性包块的外科治疗.中国普外基础与临床杂志, 2013, 20(2): 121-123.
9.	李安, 李立.胰管结石的总体认识.云南医药杂志, 2006, 27(3): 293-295.
10.	李振凯, 张炳远, 代冬冬, 等.肝门部胆管癌神经浸润动物模型的建立.中国普外基础与临床杂志, 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, 周宁新, 肖梅, 等.伴神经浸润的肝门部胆管癌的病理和临床分析.临床外科杂志, 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.	王大东, 黄志强, 周宁新, 等.胆管癌神经浸润转移模式的三维重建.中华外科杂志, 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. 陈勇, 何勇, 赵建, 等.胰管结石的外科分型及处理对策.中华外科杂志, 2004, 42(7): 417-420.
2. 淦宇, 李宁, 鲁稳柱, 等.胰管结石的诊断及治疗.华西医学, 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, 张小文, 李晓, 等.慢性胰腺炎的诊断和治疗.外科理论与实践, 2004, 9(4): 301-303.
6. 杨骥, 黄强, 林先盛, 等.慢性胰腺炎合并胰管结石的诊断及治疗分析.中国普通外科杂志, 2014, 23(3): 379-382.
7. 虞名旭, 李金海, 戴华卫.胰腺结石25例临床分析.中国普外基础与临床杂志, 2012, 19(3): 330-332.
8. 刘续宝.慢性胰腺炎的胰头炎性包块的外科治疗.中国普外基础与临床杂志, 2013, 20(2): 121-123.
9. 李安, 李立.胰管结石的总体认识.云南医药杂志, 2006, 27(3): 293-295.
10. 李振凯, 张炳远, 代冬冬, 等.肝门部胆管癌神经浸润动物模型的建立.中国普外基础与临床杂志, 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, 周宁新, 肖梅, 等.伴神经浸润的肝门部胆管癌的病理和临床分析.临床外科杂志, 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. 王大东, 黄志强, 周宁新, 等.胆管癌神经浸润转移模式的三维重建.中华外科杂志, 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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