Gallbladder papillary neoplasms share pathological features with intraductal papillary neoplasm of the bile duct
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Xueshuai Wan1,*, Jie Shi2,*, Anqiang Wang1,*, Yuan Xie1, Xiaobo Yang1, Chengpei Zhu1, Haohai Zhang1, Liangcai Wu1, Shanshan Wang1, Hanchun Huang1, Jianzhen Lin1, Yongchang Zheng1, Zhiyong Liang2, Xinting Sang1, Haitao Zhao1
1Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
*These authors contributed equally to this work
Haitao Zhao, email: firstname.lastname@example.org
Xinting Sang, email: email@example.com
Zhiyong Liang, email: firstname.lastname@example.org
Keywords: gallbladder, papillary, mucin, cytokeratin, CDX2
Received: October 26, 2016 Accepted: March 09, 2017 Published: March 18, 2017
Intraductal papillary neoplasm of the bile duct (IPNB) has been widely recognized. However, the knowledge of intracystic papillary neoplasm of the gallbladder (IPNG) including papillary adenoma and adenocarcinoma is not well defined. In this study, we compared the clinicopathological and immunohistochemical features between 32 IPNG cases and 32 IPNB cases. IPNG-1 (low-high grade dysplasia) exhibited an earlier onset age, smaller tumor size and lower level of CK20 expression compared to IPNG-2 (invasive carcinoma). Histologically, pancreaticobiliary and intestinal subtype accounted for nearly half of IPNG or IPNB (44.4% and 48.1% vs. 44.0% and 44.0%), respectively. Immunohistochemically, 88.9% of IPNG and 92.0% of IPNB cases were positive for MUC1, and 96.3% and 92.0% for CK7, respectively. CDX2 and MUC2 were more highly expressed in the intestinal subtype than in other subtypes. CK20 expression increased in parallel with tumor progression. In addition, 53.1% of IPNG cases and 68.6% of IPNB cases exhibited invasive carcinoma, and showed significant survival advantages to conventional gallbladder adenocarcinoma and cholangiocarcinoma, respectively. In conclusion, papillary adenoma and adenocarcinoma of the gallbladder can be recognized as different pathological stages of IPNG, and they share pathological features with IPNB.
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