AI Article Synopsis
- Intracholecystic papillary neoplasm (ICPN) is a non-invasive tumor in the gallbladder that can develop into invasive carcinoma, with limited research on its characteristics compared to conventional gallbladder adenocarcinomas (cGBAs).
- In a study of 42 ICPNs and 41 cGBAs, ICPNs showed a significantly lower rate of subserosa or deeper invasion (61.9% vs. 90.2%), indicating a less aggressive nature.
- Lymph node metastasis and positive margins were identified as key independent prognostic factors for ICPN, with ICPN patients without lymph node involvement having a better prognosis than cGBA patients, highlighting the importance of hist
Article Abstract
Intracholecystic papillary neoplasm (ICPN) is a non-invasive epithelial tumor that presents as a grossly identifiable mass arising in the mucosa and protruding into the lumen. ICPN is associated with invasive carcinoma. There are few studies on the clinicopathological features of ICPN, including that with invasive carcinoma. We evaluated the clinicopathological characteristics of 42 ICPNs and 41 conventional gallbladder adenocarcinomas (cGBAs). Subserosa or deeper (≥ss) invasion was significantly lower in ICPN (61.9%) than that in cGBA (90.2%) (P = 0.004). Cox regression analysis revealed that lymph node metastasis (hazard ratio [HR] [95% confidence interval (CI)]: 2.610 [1.131, 6.024], P = 0.025) and positive margin (HR [95% CI]: 5.143 [2.113, 12.516], P < 0.001), but not ≥ss invasion (HR [95% CI]: 1.541 [0.479, 4.959], P = 0.469), were independent prognostic factors. In addition, there was a significant interaction between histological type and lymph node metastasis (HR [95% CI]: 0.191 [0.042, 0.983], P = 0.033). In cGBA, the presence or absence of lymph node metastasis did not affect prognosis; however, ICPN without lymph node metastasis had better prognosis. Therefore, the histological classification of ICPN and cGBA and the pathological evaluation of lymph node metastasis in ICPN are crucial for determining prognosis.
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| http://dx.doi.org/10.1016/j.humpath.2023.04.013 | DOI Listing |
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