肝内胆管癌外科切除例の臨床病理学的研究-末梢型と肝門型の比較検討-

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Twenty-six resected cases of cholangiocarcinoma were classified into two types, peripheral type (18 cases) and hilar type (8 cases) according to the location of the main tumor and were studied clinicopathologically. The incidence of cholangiocarcinoma was 7.0% among the resected primary liver cancer and the mean age was 60.6±9.5SD years old. Main clinical symptom was abdominal pain in the peripheral type, and obstructive jaundice in the hilar type, respectively. The positive rate of CA19-9 was 46% in the peripheral type and 75 in the hilar type, respectively. Grossly they were classified into three types: nodular type, periductally proliferationg type and massive type. Nodular type and periductally proliferating type were common. Histologically, the majority of the tumors were well-differentiated tubular adenocarcinoma with an abundant fibrous stroma. Hepatolithiasis was seen in four cases (15%) among the twenty-six resected cases and dysplastic change of the bile duct epithelium around stone was observed in 1 case of the peripheral type. The high degree of vascular involvement, lymph node metastasis and perineural invasion (peripheral type * 83%, 43% and 56%, respectively, hilar type: 88%, 86% and 75% respectively) were seen in resected cases, it seems to be closely resected to poor prognosis of cholangiocarcinoma.
社団法人日本肝臓学会の論文