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Masato Nagino - One of the best experts on this subject based on the ideXlab platform.
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diagnostic and prognostic value of immunohistochemical expression of s100p and imp3 in transpapillary biliary forceps biopsy samples of extrahepatic Bile Duct Carcinoma
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Hiroki Kawashima, Tsutomu Tanaka, Tomoki Ebata, Akihiro Itoh, Eizaburo Ohno, Ryoji Miyahara, Naoki Ohmiya, Yoshie Shimoyama, Shigeo Nakamura, Masato NaginoAbstract:Background Because the biopsy specimen of extrahepatic Bile Duct Carcinoma (EHBDC) is small and shows reactive changes, the histological distinction between malignant and benign tissue can be difficult. Recent studies reported that S100P and insulin-like growth factor II mRNA-binding protein 3 (IMP3) were not only diagnostic molecules but also prognostic biomarkers in several organs. The objective of this study is to clarify the diagnostic and prognostic value of immunohistochemical expression of S100P and IMP3 in transpapillary biliary forceps biopsy (TBFB) samples.
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diagnostic and prognostic value of immunohistochemical expression of s100p and imp3 in transpapillary biliary forceps biopsy samples of extrahepatic Bile Duct Carcinoma
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Hiroki Kawashima, Tsutomu Tanaka, Tomoki Ebata, Akihiro Itoh, Eizaburo Ohno, Ryoji Miyahara, Naoki Ohmiya, Yoshie Shimoyama, Shigeo Nakamura, Masato NaginoAbstract:Because the biopsy specimen of extrahepatic Bile Duct Carcinoma (EHBDC) is small and shows reactive changes, the histological distinction between malignant and benign tissue can be difficult. Recent studies reported that S100P and insulin-like growth factor II mRNA-binding protein 3 (IMP3) were not only diagnostic molecules but also prognostic biomarkers in several organs. The objective of this study is to clarify the diagnostic and prognostic value of immunohistochemical expression of S100P and IMP3 in transpapillary biliary forceps biopsy (TBFB) samples. The TBFB samples were collected from 80 patients (EHBDC, 68 patients; benign, 12 patients), retrospectively. When using cytoplasmic-positive staining for IMP3 as a marker of malignancy, the sensitivity and specificity reached 79.4 and 91.7 %, respectively. The sensitivity, specificity and accuracy achieved 89.7, 91.7 and 90.0 %, respectively, when using positive staining for IMP3 and/or positive histology as a maker of malignancy. While univariate (P = 0.033) and multivariate (P = 0.039) analysis revealed that S100P-positive EHBDC patients showed significantly shorter survival. The results of this study suggest that immunohistochemical staining for IMP3 is useful in the diagnosis of EHBDC and that of S100P is useful as a prognostic marker for EHBDC.
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choleretic effect of inchinkoto a herbal medicine on livers of patients with biliary obstruction due to Bile Duct Carcinoma
Hepatology Research, 2009Co-Authors: Shinya Watanabe, Yukihiro Yokoyama, Koji Oda, Toshio Kokuryo, Junichi Shoda, Kosuke Okada, Hirotoshi Utsunomiya, Masato NaginoAbstract:Aim: To investigate the choleretic effects of inchinkoto (ICKT) on livers of patients with biliary obstruction due to Bile Duct Carcinoma. Methods: Twenty-seven patients with Bile Duct Carcinoma who were due to undergo biliary drainage and subsequent major hepatectomy were randomly assigned to preoperative ICKT (n = 13) or untreated (n = 14) groups. ICKT was administered from the day of admission until one day before surgery. Changes in Bile constituents, expression of multidrug resistance-associated protein (MRP) 2, MRP3 and MRP4 in the liver, and the incidence of postoperative complications were included as end-points. Results: The biliary concentration of total bilirubin was significantly increased after administration of ICKT (23.7 ± 2.8 mg/dL before ICKT; 34.0 ± 4.0 mg/dL after ICKT, P < 0.05). The biliary concentration of total Bile acids was also significantly increased. Protein levels of MRP2 and MRP3 in the crude plasma membrane fraction of livers of treated patients were significantly higher than those without treatment. MRP2 staining in the livers of patients without ICKT treatment was weak and diffuse around the Bile canaliculi, whereas staining in patients with ICKT treatment was strong and restricted to the Bile canaliculi. Conclusion: ICKT exerts a choleretic effect on the livers of patients with biliary obstruction. This beneficial effect was associated with increased expression of MRP2. ICKT thus has therapeutic potential for treatment for obstructive cholestasis due to Bile Duct Carcinoma.
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Bile Duct Carcinoma arising in metaplastic biliary epithelium of the intestinal type a case report
Hepato-gastroenterology, 2003Co-Authors: Tsuyoshi Sano, Masato Nagino, Junichi Kamiya, Katsuhiko Uesaka, Koji Oda, Michio Kanai, Yuji NimuraAbstract:We report herein a case of distal Bile Duct Carcinoma showing intestinal differentiation diagnosed 3 years after endoscopic sphincterotomy for choledocholithiasis. The diagnostic problem in this case was that the granular mucosa, which is a typical finding of superficial mucosal extension of Bile Duct Carcinoma in general, was interpreted as hyperplasia accompanying metaplasia in cholangioscopic biopsy. Discrimination of superficial mucosal cancer extension from hyperplastic mucosa with metaplastic changes was impossible using cholangioscopic examination. In our case, reflux and stasis of the duodenal and pancreatic juice into the biliary tract might have occurred because of abnormal function of the papilla of Vater following endoscopic sphincterotomy. It might be suggested that endoscopic sphincterotomy contributed to the metaplastic changes in the Bile Duct mucosa in our case.
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Carcinoma of the common Bile Duct with superficial spread to the intrahepatic segmental Bile Ducts a case report
American Surgeon, 1997Co-Authors: M Kato, Masato Nagino, Satoshi Kondo, Michio Kanai, Y Nimura, J Kamiya, Masahiko Miyachi, H Igaki, S MaedaAbstract:A 54-year-old woman presented with jaundice. Percutaneous transhepatic biliary drainage, cholangiography via a percutaneous transhepatic biliary, drainage catheter, and percutaneous transhepatic cholangioscopy were performed to alleviate the jaundice and to evaluate her biliary system. A diffuse-type tumor was detected in the common Bile Duct. The tumor had spread superficially up to the right anterior segmental Duct and the left hepatic Duct and involved the caudate branches. Curative surgery, which included a right anterior segmentectomy, total caudate lobectomy, and pylorus-preserving pancreatoduodenectomy, was performed. The histopathologic diagnosis was moderately differentiated tubular adenoCarcinoma originating at the common Bile Duct. The extent of the superficial spread of the tumor corresponded to our preoperative determination. Her postoperative recovery was uneventful. In this case report, we discuss the accurate preoperative diagnosis and rational surgical treatment of Bile Duct Carcinoma with superficial spread.
Seungmo Hong - One of the best experts on this subject based on the ideXlab platform.
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clinicopathological significance of olfactomedin 4 in extrahepatic Bile Duct Carcinoma
Pathology Research and Practice, 2020Co-Authors: Sunyoung Jun, Tom Huh, Joonyong Chung, Seungmo HongAbstract:Abstract The clinicopathological and prognostic significance of olfactomedin-4 (OLFM4) expression has not yet been elucidated in extrahepatic Bile Duct Carcinomas (EBDCs). Immunohistochemical analysis of OLFM4 expression in 31 normal biliary epithelia, 33 biliary intraepithelial neoplasias (BilINs), and 180 surgically resected EBDCs (54 perihilar and 126 distal) was performed and was used to analyze clinicopathological variables including patient survival. The expression of OLFM4 showed a progressive increase from normal biliary epithelia (0.2 ± 0.4) to BilINs (2.8 ± 3.2) to EBDCs (4.6 ± 4.2; P
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validation of the eighth american joint committee on cancer staging system for distal Bile Duct Carcinoma
Cancer Research and Treatment, 2019Co-Authors: Sunyoung Jun, Jae Hoon Lee, Youna Sung, Kwangmin Park, Youngjoo Lee, Seungmo HongAbstract:PURPOSE T category of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system for distal Bile Duct Carcinoma (DBDC) was changed to include tumor invasion depth measurement, while the N category adopted a 3-tier classification system based on the number of metastatic nodes. Materials and Methods To validate cancer staging, a total of 200 surgically resected DBDCs were staged and compared according to the seventh and eighth editions. RESULTS T categories included T1 (n=37, 18.5%), T2 (n=114, 57.0%), and T3 (n=49, 24.5%). N categories included N0 (n=133, 66.5%), N1 (n=50, 25.0%), and N2 (n=17, 8.5%). Stage groupings included I (n=33, 16.5%), II (n=150, 75.0%), and III (n=17, 8.5%). The overall 5-year survival rates (5-YSRs) of T1, T2, and T3 were 59.3%, 42.4%, and 12.2%, respectively. T category could discriminate patient survival by both pairwise (T1 and T2, p=0.011; T2 and T3, p < 0.001) and overall (p < 0.001) comparisons. The overall 5-YSRs of N0, N1, and N2 were 47.3%, 17.0%, and 14.7%, respectively. N category could partly discriminate patient survival by both pairwise (N0 and N1, p < 0.001; N1 and N2, p=0.579) and overall (p < 0.001) comparisons. The overall 5-YSRs of stages I, II, and III were 59.0%, 35.4%, and 14.7%, respectively. Stages could distinguish patient survival by both pairwise (I and II, p=0.002; II and III, p=0.015) and overall (p < 0.001) comparisons. On multivariate analyses, T and N categories (p=0.014 and p=0.029) and pancreatic invasion (p=0.006) remained significant prognostic factors. CONCLUSION The T andNcategories of the eighth edition AJCC staging system for DBDC accurately predict patient prognosis.
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incidentally detected pancreatic neuroendocrine microadenoma with lymph node metastasis
Virchows Archiv, 2018Co-Authors: Jeong Hwa Kwon, Ralph H Hruban, Youngjoo Lee, Hyoung Jung Kim, Do Hyun Park, Christopher M Heaphy, Gunter Kloppel, Seungmo HongAbstract:Pancreatic neuroendocrine microadenomas (NEMAs) are non-functioning neuroendocrine tumors < 0.5 cm with a low proliferation rate and are considered benign. We report on a pancreatic NEMA with lymph node metastasis. A male in his 70s had pylorus-preserving pancreaticoduodenectomy for a distal Bile Duct Carcinoma, which was a 2.1 cm well-differentiated-infiltrating adenoCarcinoma with invasion limited to the Bile Duct wall. An incidental separate 0.4 cm well-differentiated NEMA was found in the pancreatic head with metastatic well-differentiated neuroendocrine tumor in one peripancreatic lymph node. Both neuroendocrine tumors in the pancreatic head and in the lymph node were composed of nests of uniform neoplastic cells with a fine chromatin pattern. The Ki-67 labeling index of NEMA was 0.85%. The neoplastic neuroendocrine cells in both the pancreas and node were diffusely positive for synaptophysin, chromogranin, and insulin. Therefore, this unusual case provides an exception to the current classification system which regards NEMAs as benign lesions.
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depth of tumor invasion better predicts prognosis than the current american joint committee on cancer t classification for distal Bile Duct Carcinoma
Surgery, 2009Co-Authors: Seungmo Hong, Bhuvnesh Aggarwal, Ralph H Hruban, Timothy M Pawlik, Michael Goggins, Robert A AndersAbstract:Background The American Joint Committee on Cancer (AJCC) T classification system for cholangioCarcinoma does not take into account the unique pathologic features of the Bile Duct. As such, the current AJCC T classification for distal cholangioCarcinoma may be inaccurate. Methods A total of 147 patients with distal cholangioCarcinoma were identified from a single institution database. The prognostic importance of depth of tumor invasion relative to the AJCC T classification system was assessed. Results The AJCC T classification was T1 (n = 11, 7.5%), T2 (n = 6, 4.1%), T3 (n = 73, 49.7%), or T4 (n = 57, 38.8%). When cases were analyzed according to depth of tumor invasion, most lesions were ≥5 mm ( 12 mm, 39.5%). The AJCC T classification was not associated with survival outcome (median survival, T1, 40.1 months; T2, 14.8 months; T3, 16.5 months; T4, 20.2 months; P = .17). In contrast, depth of tumor invasion was associated with a worse outcome as tumor depth increased (median survival, 12 mm, 12.9 months; P = .001). On multivariate analyses, tumor depth remained the factor most associated with outcome ( 12 mm; HR = 6.7 mm; P = .001). Conclusion The AJCC T classification for distal cholangioCarcinoma does not accurately predict prognosis. Depth of the Bile Duct Carcinoma invasion is a better alternative method to determine prognosis and should be incorporated into the pathologic assessment of resected distal cholangioCarcinoma.
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clinical and prognostic significances of nuclear and cytoplasmic kit expressions in extrahepatic Bile Duct Carcinomas
Modern Pathology, 2007Co-Authors: Seungmo Hong, Ilseon Hwang, Dong Eun Song, Jene ChoiAbstract:After receiving FDA approval as a therapeutic regimen in gastrointestinal stromal tumors, the tyrosine kinase inhibitor imatinib mesylate has been applied to the treatment of other solid malignant neoplasms. To evaluate the usefulness of imatinib mesylate as a possible therapeutic regimen in extrahepatic Bile Duct Carcinomas, an immunohistochemical study for KIT was performed in 289 cases of extrahepatic Bile Duct Carcinomas, and mutational analysis of exon 11 of the c-kit gene was performed in 20 cases that were arbitrarily retrieved from the cases with KIT expression. Cytoplasmic KIT expression was observed in 54 cases (19%) and nuclear KIT in 58 cases (20%) of extrahepatic Bile Duct Carcinoma. Nuclear KIT expression was more frequent in cases with vascular invasion (P<0.001), whereas cytoplasmic KIT expression was more common in tumors of T1–T3 than in those of T4 (P=0.04), and was more frequently observed in cases with a papillary growth pattern (P=0.03). Patients with cytoplasmic KIT-positive tumors had significantly better survival both by univariate (P=0.01) and multivariate analyses (P=0.04). Infrequent cytoplasmic KIT expression without mutation of exon 11 suggests that imatinib mesylate may not be effective for the treatment of extrahepatic Bile Duct Carcinoma. However, immunohistochemical study for KIT may be helpful in routine pathologic examinations for evaluating better prognosis for patients with extrahepatic Bile Duct Carcinoma. In addition, more frequent nuclear expression of KIT in cases with vascular invasion suggests that nuclear KIT expression may contribute to the progression of extrahepatic Bile Duct Carcinoma.
Naoyuki Taniguchi - One of the best experts on this subject based on the ideXlab platform.
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transcriptional regulation of the n acetylglucosaminyltransferase v gene in human Bile Duct Carcinoma cells hucc t1 is mediated by ets 1
Journal of Biological Chemistry, 1996Co-Authors: Rujun Kang, Yin Sheng, Nobuto Koyama, Yoshito Ihara, Eiji Miyoshi, Hiroyuki Saito, Naoyuki TaniguchiAbstract:Abstract N-Acetylglucosaminyltransferase V (GnT-V) catalyzes the transfer of N-acetylglucosamine from UDP-N-acetylglucosamine to α-6-D-mannoside to produce the β1-6 linked branching of N-glycan oligosaccharides, which controls the polylactosamine content. The expression of N-acetylglucosaminyltransferase V, which contains 17 exons and spans 155 kilobase pairs, is expressed in a tissue- and cell type-specific manner and is regulated at the level of transcription by multiple promoters (Saito, H., Gu, J., Nishikawa, A., Ihara, Y., Fujii, J., Kohgo, Y., and Taniguchi, N. (1995) Eur. J. Biochem. 233, 18-26). To elucidate the mechanism by which the GnT-V gene is expressed in a cell- and tissue-specific manner, cell-restricted expression was analyzed using the 5′-upstream regions of the human GnT-V gene spanning base pairs −2760 to +23 in a human Bile Duct Carcinoma cell line, HuCC-T1. We characterized two cis-acting elements that are potentially important in HuCC-T1 cell-specific expression. The two elements each contain an Ets-1 binding site, 5′-GGA-3′. Specific binding of Ets-1 to the respective elements was demonstrated by competition analysis as well as by antibody supershift experiments. Cotransfection of an Ets-1 expression plasmid along with a GnT-V promoter-luciferase reporter plasmid revealed the participation of Ets-1 in the regulation of the GnT-V gene transcription. These data indicated that the transcriptional regulation of the GnT-V gene was mediated by transcription factor Ets-1.
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transcriptional regulation of the n acetylglucosaminyltransferase v gene in human Bile Duct Carcinoma cells hucc t1 is mediated by ets 1
Journal of Biological Chemistry, 1996Co-Authors: Rujun Kang, Yin Sheng, Nobuto Koyama, Yoshito Ihara, Eiji Miyoshi, Hiroyuki Saito, Naoyuki TaniguchiAbstract:Abstract N-Acetylglucosaminyltransferase V (GnT-V) catalyzes the transfer of N-acetylglucosamine from UDP-N-acetylglucosamine to α-6-D-mannoside to produce the β1-6 linked branching of N-glycan oligosaccharides, which controls the polylactosamine content. The expression of N-acetylglucosaminyltransferase V, which contains 17 exons and spans 155 kilobase pairs, is expressed in a tissue- and cell type-specific manner and is regulated at the level of transcription by multiple promoters (Saito, H., Gu, J., Nishikawa, A., Ihara, Y., Fujii, J., Kohgo, Y., and Taniguchi, N. (1995) Eur. J. Biochem. 233, 18-26). To elucidate the mechanism by which the GnT-V gene is expressed in a cell- and tissue-specific manner, cell-restricted expression was analyzed using the 5′-upstream regions of the human GnT-V gene spanning base pairs −2760 to +23 in a human Bile Duct Carcinoma cell line, HuCC-T1. We characterized two cis-acting elements that are potentially important in HuCC-T1 cell-specific expression. The two elements each contain an Ets-1 binding site, 5′-GGA-3′. Specific binding of Ets-1 to the respective elements was demonstrated by competition analysis as well as by antibody supershift experiments. Cotransfection of an Ets-1 expression plasmid along with a GnT-V promoter-luciferase reporter plasmid revealed the participation of Ets-1 in the regulation of the GnT-V gene transcription. These data indicated that the transcriptional regulation of the GnT-V gene was mediated by transcription factor Ets-1.
Hiroki Kawashima - One of the best experts on this subject based on the ideXlab platform.
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diagnostic and prognostic value of immunohistochemical expression of s100p and imp3 in transpapillary biliary forceps biopsy samples of extrahepatic Bile Duct Carcinoma
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Hiroki Kawashima, Tsutomu Tanaka, Tomoki Ebata, Akihiro Itoh, Eizaburo Ohno, Ryoji Miyahara, Naoki Ohmiya, Yoshie Shimoyama, Shigeo Nakamura, Masato NaginoAbstract:Background Because the biopsy specimen of extrahepatic Bile Duct Carcinoma (EHBDC) is small and shows reactive changes, the histological distinction between malignant and benign tissue can be difficult. Recent studies reported that S100P and insulin-like growth factor II mRNA-binding protein 3 (IMP3) were not only diagnostic molecules but also prognostic biomarkers in several organs. The objective of this study is to clarify the diagnostic and prognostic value of immunohistochemical expression of S100P and IMP3 in transpapillary biliary forceps biopsy (TBFB) samples.
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diagnostic and prognostic value of immunohistochemical expression of s100p and imp3 in transpapillary biliary forceps biopsy samples of extrahepatic Bile Duct Carcinoma
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Hiroki Kawashima, Tsutomu Tanaka, Tomoki Ebata, Akihiro Itoh, Eizaburo Ohno, Ryoji Miyahara, Naoki Ohmiya, Yoshie Shimoyama, Shigeo Nakamura, Masato NaginoAbstract:Because the biopsy specimen of extrahepatic Bile Duct Carcinoma (EHBDC) is small and shows reactive changes, the histological distinction between malignant and benign tissue can be difficult. Recent studies reported that S100P and insulin-like growth factor II mRNA-binding protein 3 (IMP3) were not only diagnostic molecules but also prognostic biomarkers in several organs. The objective of this study is to clarify the diagnostic and prognostic value of immunohistochemical expression of S100P and IMP3 in transpapillary biliary forceps biopsy (TBFB) samples. The TBFB samples were collected from 80 patients (EHBDC, 68 patients; benign, 12 patients), retrospectively. When using cytoplasmic-positive staining for IMP3 as a marker of malignancy, the sensitivity and specificity reached 79.4 and 91.7 %, respectively. The sensitivity, specificity and accuracy achieved 89.7, 91.7 and 90.0 %, respectively, when using positive staining for IMP3 and/or positive histology as a maker of malignancy. While univariate (P = 0.033) and multivariate (P = 0.039) analysis revealed that S100P-positive EHBDC patients showed significantly shorter survival. The results of this study suggest that immunohistochemical staining for IMP3 is useful in the diagnosis of EHBDC and that of S100P is useful as a prognostic marker for EHBDC.
Satoshi Kondo - One of the best experts on this subject based on the ideXlab platform.
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impact of residual in situ Carcinoma on postoperative survival in 125 patients with extrahepatic Bile Duct Carcinoma
Journal of Hepato-biliary-pancreatic Sciences, 2010Co-Authors: Satoshi Kondo, Eiichi Tanaka, Satoshi Hirano, Yoshitsugu Nakanishi, Hiroshi Kawakami, Kanako Kubota, Yoh Zen, Atsuya Yonemori, Tomoo ItohAbstract:Purpose The aim of this study was to determine the impact of the presence of Carcinoma in situ at the Bile Duct stump on postoperative survival in patients who underwent resection of extrahepatic Bile Duct Carcinoma.
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Extrahepatic Bile Duct Carcinoma with extensive intraepithelial spread: a clinicopathological study of 21 cases
Modern Pathology, 2008Co-Authors: Yoshitsugu Nakanishi, Eiichi Tanaka, Satoshi Hirano, Yasuni Nakanuma, Hiroshi Kawakami, Kanako Kubota, Tomoo Itoh, Satoshi KondoAbstract:Extrahepatic Bile Duct Carcinoma occasionally presents with intraepithelial spread for a considerable area around the main tumor. In this study, we compared clinicopathological features of extrahepatic Bile Duct Carcinoma with and without extensive intraepithelial spread (≥20 mm from the main tumor). Out of 117 cases of extrahepatic Bile Duct Carcinoma, 21 (18%) were found to have extensive intraepithelial spread. Those cases were pathologically characterized by a papillary or nodular main tumor, a more differentiated histological grade, less deep invasion, and infrequent portal vein or hepatic invasion in comparison with cases without intraepithelial spread. Areas of intraepithelial spread histologically consisted of low-papillary growth (17 cases, 81%) and completely flat growth (4 cases, 19%) of Carcinoma cells. The former histology corresponded to a macroscopic granular mucosa, whereas the latter growth was hardly detected by gross examination. Immunohistochemically, in 16 of 21 cases (76%), at least one of p53, CEA, and MUC1 was expressed in both the main tumor and the spreading area. Interestingly, patients with intraepithelial spread had a better postoperative prognosis than those without intraepithelial spread ( P =0.009). However, three patients had anastomotic recurrence 54–130 months after surgery. In conclusion, intraepithelial-spreading Bile Duct Carcinoma is characterized by papillary or nodular main lesions, a more differentiated histological grade, and less invasiveness. The presence of intraepithelial spread was not an indicator of a poor prognosis, but Carcinoma in situ at the Bile Duct stump could cause late anastomotic recurrence after surgery.
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prognostic value of intratumoral cd8 t lymphocyte in extrahepatic Bile Duct Carcinoma as essential immune response
Journal of Surgical Oncology, 2003Co-Authors: Taro Oshikiri, Satoshi Kondo, Tomoo Itoh, Masaki Miyamoto, Toshiaki Shichinohe, Masato Suzuoki, Kei Hiraoka, Yoshihiro Nakakubo, Toshiya Shinohara, Hiroyuki KatohAbstract:Background and Objectives Tumor-infiltrating lymphocytes form an important aspect of the host defense against an expanding neoplasm. CD8+ T cells have been identified as a prognostic factor in several cancers. Here, we investigate that the influence of CD8+ T cells on extrahepatic Bile Duct Carcinoma (EBDC) patient survival. Methods CD8+ T cell immunoreactivity in 58 surgically resected EBDC specimens was investigated. The relationship between CD8+ T cell immunoreactivity and clinical and histopathologic features was analyzed. Results Thirty-two tumors (55%) possessed intratumoral CD8+ T cells. The degree of intratumoral CD8+ T cell immunoreactivity demonstrated a significant relationship to lower numbers of lymph node metastasis, reduced venous invasion, decreased perineural invasion, and better pTNM staging. Intratumoral CD8+ T cells were also associated with increased patient survival. Multivariate analysis indicated that the presence of intratumoral CD8+ T cells was an independent prognostic factors. Conclusions The infiltration of a cancer cell nest by CD8+ T cells is a reliable marker predicting increased survival of patients with EBDC. J. Surg. Oncol. 2003;84:224–228. © 2003 Wiley-Liss, Inc.
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Carcinoma of the common Bile Duct with superficial spread to the intrahepatic segmental Bile Ducts a case report
American Surgeon, 1997Co-Authors: M Kato, Masato Nagino, Satoshi Kondo, Michio Kanai, Y Nimura, J Kamiya, Masahiko Miyachi, H Igaki, S MaedaAbstract:A 54-year-old woman presented with jaundice. Percutaneous transhepatic biliary drainage, cholangiography via a percutaneous transhepatic biliary, drainage catheter, and percutaneous transhepatic cholangioscopy were performed to alleviate the jaundice and to evaluate her biliary system. A diffuse-type tumor was detected in the common Bile Duct. The tumor had spread superficially up to the right anterior segmental Duct and the left hepatic Duct and involved the caudate branches. Curative surgery, which included a right anterior segmentectomy, total caudate lobectomy, and pylorus-preserving pancreatoduodenectomy, was performed. The histopathologic diagnosis was moderately differentiated tubular adenoCarcinoma originating at the common Bile Duct. The extent of the superficial spread of the tumor corresponded to our preoperative determination. Her postoperative recovery was uneventful. In this case report, we discuss the accurate preoperative diagnosis and rational surgical treatment of Bile Duct Carcinoma with superficial spread.
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right or left trisegment portal vein embolization before hepatic trisegmentectomy for hilar Bile Duct Carcinoma
Surgery, 1995Co-Authors: Masato Nagino, Yuji Nimura, Junichi Kamiya, Satoshi Kondo, Katsuhiko Uesaka, Yasushi Kutsuna, Naokazu Hayakawa, Hideo YamamotoAbstract:BACKGROUND: Percutaneous transhepatic embolization of the right portal vein plus the left medial portal branch (R3-PE) and the left portal vein plus the right anterior portal branch (L3-PE) is not well described. METHODS: Four patients with far advanced Carcinoma of the hepatic hilus underwent R3-PE (n = 1) or L3-PE (n = 3) as preoperative management for right hepatic trisegmentectomy or left hepatic trisegmentectomy. The portal vein embolization was performed with the ipsilateral approach through the right anterior portal branch. RESULTS: In all patients the embolizations were successful without complications. Volumetric study with computed tomography showed sufficient hypertrophy of the nonembolized hepatic segments. Three of the four patients eventually underwent trisegmentectomy. The postoperative courses in two of the patients were uneventful. The remaining patient suffered from posthepatectomy liver failure but recovered. CONCLUSIONS: R3-PE or L3-PE is advisable as preoperative management for trisegmentectomy and appears effective for increasing the safety of the operation. This embolization is achievable only through the ipsilateral approach.