Publication: CK20 and lymph node involvement predict adverse outcome of malignant intraductal papillary neoplasm of the bile duct
Authors
Shi, Jie ; Wan, Xueshuai ; Xie, Yuan ; Lin, Jianzhen ; Long, Junyu ; Xu, Weiyu ; Liang, Zhiyong ; Sang, Xinting ; Zhao, Haitao
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Publisher
Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-18-179
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info:eu-repo/semantics/article
Description
Abstract
Objectives. To identify prognostic factors of
malignant intraductal papillary neoplasm of the bile duct
(m-IPNB).
Materials and Methods. We included 38 consecutive
cases which underwent surgical resection and diagnosed
as IPNB with malignant component from January 2003
to January 2017. Clinicopathological variables were
collected to conduct survival analysis and identify
prognostic factors.
Results. The median overall survival (OS) of m-
IPNB was 76.0 months, with 1-, 3-, and 5-year survival
rates of 97.2%, 73.5%, and 59.8%, respectively. The
median recurrence-free survival (RFS) was 48.0 months
with 1-, 3-, and 5-year RFS rate was 83.2%, 59.8%, and
44.6%, respectively. Univariate analysis showed that
elevation of carcinoembrionic antigen (CEA), lymph
node involvement, resection margin status, degree of
periductal invasion, and positive expression of CK20
were associated with both OS and RFS of m-IPNB.
After multivariate Cox models analysis, lymph node
involvement and positive expression of CK20 were
identified as independent prognostic factors for OS,
while lymph node involvement and resection margin
status were independent prognostic factors for RFS. The
median OS of patients with m-IPNB involving
lymphatic metastases and positive expression of CK20
was 27.0±8.8 months and 51.0±12.4 months,
respectively. The median RFS of cases with lymph node
involvement and R1 resection was 10.0±3.3 months and
25.0±6.9 months, respectively. However, there was no
significant difference in OS or RFS between cases of
pancreaticobiliary and intestinal subtype.
Conclusions. Lymph node involvement and positive
expression of CK20 are independent prognostic factors
for shorter OS of m-IPNB, while patients with lymph
node involvement and positive resection margin are at
higher risk of tumor recurrence.
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Citation
Histology and Histopathology Vol. 35, nº5 (2020)
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