Intrahepatic cholangiocarcinoma: relationship between tumor imaging enhancement by measuring attenuation and clinicopathologic characteristics

详细信息    查看全文

• 作者：Atsushi Nanashima (1)
  Takafumi Abo (1)
  Goushi Murakami (1)
  Aya Matsumoto (1)
  Kazuo Tou (1)
  Hiroaki Takeshita (1)
  Masaki Kunizaki (1)
  Shigekazu Hidaka (1)
  Ichiro Sakamoto (2)
  Hideyuki Hayashi (2)
  Toru Fukuda (3)
  Takashi Kudo (2) (4)
  Takeshi Nagayasu (1)
  
• 关键词：Intrahepatic cholangiocarcinoma ; Tumor enhancement ; Multidetector computed tomography ; Prognosis ; hepatectomy
• 刊名：Abdominal Imaging
• 出版年：2013
• 出版时间：August 2013
• 年：2013
• 卷：38
• 期：4
• 页码：785-792
• 全文大小：435KB
• 参考文献：1. Su CH, Tsay SH, Wu CC, et al. (1996) Factors influencing postoperative morbidity, mortality, and survival after resection for hilar cholangiocarcinoma. Ann Surg 223:384-94 CrossRef
  2. Isa T, Kusano T, Shimoji H, et al. (2001) Predictive factors for long-term survival in patients with intrahepatic cholangiocarcinoma. Am J Surg 181:507-11 CrossRef
  3. Kawarada Y, Yamagiwa K, Das BC (2002) Analysis of the relationships between clinicopathologic factors and survival time in intrahepatic cholangiocarcinoma. Am J Surg 183:679-85 CrossRef
  4. Kozaka K, Sasaki M, Fujii T, et al. (2007) A subgroup of intrahepatic cholangiocarcinoma with an infiltrating replacement growth pattern and a resemblance to reactive proliferating bile ductules: ‘bile ductular carcinoma- Histopathology 51:390-00 CrossRef
  5. Roskams T (2006) Liver stem cells and their implication in hepatocellular and cholangiocarcinoma. Oncogene 25:3818-822 CrossRef
  6. Sempoux C, Jibara G, Ward SC, et al. (2011) Intrahepatic cholangiocarcinoma: new insights in pathology. Semin Liver Dis 31:49-0 CrossRef
  7. de Martel C, Plummer M, Franceschi S (2010) Cholangiocarcinoma: descriptive epidemiology and risk factors. Gastroenterol Clin Biol 34:173-80 CrossRef
  8. Khan SA, Davidson BR, Goldin R, et al. (2002) Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut 51:1- CrossRef
  9. Sano T, Kamiya J, Nagino M, et al. (1999) Macroscopic classification and preoperative diagnosis of intrahepatic cholangiocarcinoma in Japan. J Hepatobiliary Pancreat Surg 6:101-07 CrossRef
  10. Hirohashi K, Uenishi T, Kubo S, et al. (2002) Macroscopic types of intrahepatic cholangiocarcinoma: clinicopathologic features and surgical outcomes. Hepatogastroenterology 49:326-29
  11. Suzuki S, Sakaguchi T, Yokoi Y, et al. (2002) Clinicopathological prognostic factors and impact of surgical treatment of mass-forming intrahepatic cholangiocarcinoma. World J Surg 26:687-93 CrossRef
  12. Ohtsuka M, Ito H, Kimura F, et al. (2002) Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 89:1525-531 CrossRef
  13. Thelen A, Scholz A, Weichert W, et al. (2010) Tumor-associated angiogenesis and lymphangiogenesis correlate with progression of intrahepaticcholangiocarcinoma. Am J Gastroenterol 105:1123-132 CrossRef
  14. Miura F, Okazumi S, Takayama W, et al. (2004) Hemodynamics of intrahepatic cholangiocarcinoma: evaluation with single-level dynamic CT during hepatic arteriography. Abdom Imaging 29:467-71 CrossRef
  15. Kim JE, Kim SH, Lee SJ, Rhim H (2011) Hypervascular hepatocellular carcinoma 1?cm or smaller in patients with chronic liver disease: characterization with gadoxetic acid-enhanced MRI that includes diffusion-weighted imaging. AJR Am J Roentgenol 196:W758–W765 CrossRef
  16. Nanashima A, Sumida Y, Abo T, et al. (2008) Relationship between pattern of tumor enhancement and clinicopathologic characteristics in intrahepatic cholangiocarcinoma. J Surg Oncol 98:535-39 CrossRef
  17. Nanashima A, Shibata K, Nakayama T, et al. (2009) Relationship between microvessel count and postoperative survival in patients with intrahepaticcholangiocarcinoma. Ann Surg Oncol 16:2123-129 CrossRef
  18. Nanashima A, Yoshinaga M, Yamaguchi H, et al. (2003) An immunohistochemical study of tumor vascularity and proliferation activity in cholangiocellular carcinoma: relationship to clinicopathological factors and prognosis after hepatic resection. Acta Med Nagasaki 48:23-7
  19. Khan SA, Thomas HC, Davidson BR, et al. (2005) Cholangiocarcinoma. Lancet 366:1303-314 CrossRef
  20. Lazaridis KN, Gores GJ (2005) Cholangiocarcinoma. Gastroenterology 128:1655-667 CrossRef
  21. Fukukura Y, Hamanoue M, Fujiyoshi F, et al. (2000) Cholangiolocellular carcinoma of the liver: CT and MR findings. J Comput Assist Tomogr 24:809-12 CrossRef
  22. Jung AY, Lee JM, Choi SH, et al. (2006) CT features of an intraductal polypoid mass: differentiation between hepatocellular carcinoma with bile duct tumor invasion and intraductal papillary cholangiocarcinoma. J Comput Assist Tomogr 30:173-81 CrossRef
  23. Song SJ, Lee JM, Kim YJ, et al. (2007) Differentiation of intraductal papillary mucinous neoplasms from other pancreatic cystic masses: comparison of multirow-detector CT and MR imaging using ROC analysis. J Magn Reson Imaging 26:86-3 CrossRef
  24. Nakanuma Y, Xu J, Harada K, et al. (2011) Pathological spectrum of intrahepatic cholangiocarcinoma arising in non-biliary chronic advanced liver diseases. Pathol Int 61:298-05 CrossRef
  25. Xu J, Igarashi S, Sasaki M, et al. (2012) Intrahepatic cholangiocarcinomas in cirrhosis are hypervascular in comparison with those in normal livers. Liver Int 32:1156-164 CrossRef
  26. Xu J, Sasaki M, Harada K, et al. (2011) Intrahepatic cholangiocarcinoma arising in chronic advanced liver disease and the cholangiocarcinomatous component of hepatocellular?cholangiocarcinoma?share common phenotypes and cholangiocarcinogenesis. Histopathology 59:1090-099 CrossRef
  27. Jung EM, Ross CJ, Rennert J, et al. (2010) Characterization of microvascularization of liver tumor lesions with?high?resolution?linear ultrasound and contrast enhanced ultrasound (CEUS) during surgery: first results. Clin Hemorheol Microcirc 46:89-9
  28. Nanashima A, Yamaguchi H, Shibasaki S, et al. (2006) Relationship between CT volumetry and functional liver volume using technetium-99?m galactosyl serum albumin scintigraphy in patients undergoing preoperative portal vein embolization before major hepatectomy: a preliminary study. Dig Dis Sci 51:1190-195 CrossRef
  29. Liver Cancer Study group of Japan (2003). In: Makuuchi M, (ed). / The general rules for the clinical and pathological study of primary liver cancer, 2nd English edition. Tokyo: Kanehara Co., pp 6-8.
  30. Park HS, Lee JM, Choi JY, et al. (2008) Preoperative evaluation of bile duct cancer: MRI combined with MR cholangiopancreatography versus MDCT with direct cholangiography. AJR Am J Roentgenol 190:396-05 CrossRef
  31. Chamberlain RS, Blumgart LH (1999) Hilar cholangiocarcinoma: a review and commentary. Ann Surg Oncol 7:55-6 CrossRef
  32. Valls C, Gumà A, Puig I, et al. (2000) Intrahepatic peripheral cholangiocarcinoma: CT evaluation. Abdom Imaging 25:490-96 CrossRef
  33. Sano T, Kamiya J, Nagino M, et al. (1999) Macroscopic classification and preoperative diagnosis of intrahepatic cholangiocarcinoma in Japan. J Hepatobiliary Pancreat Surg 6:101-07 CrossRef
  34. Sanada Y, Yoshida K, Itoh H (2007) Comparison of CT enhancement patterns and histologic features in hepatocellular carcinoma up to 2?cm: assessment of malignant potential with claudin-10 immunohistochemistry. Oncol Rep 17:1177-182
  35. Kim NR, Lee JM, Kim SH, et al. (2008) Enhancement characteristics of cholangiocarcinomas on mutiphasic helical CT: emphasis on morphologic subtypes. Clin Imaging 32:114-20 CrossRef
  36. Kim SJ, Lee JM, Han JK, et al. (2007) Peripheral mass-forming cholangiocarcinoma in cirrhotic liver. AJR Am J Roentgenol 189:1428-434 CrossRef
  37. Hai S, Kubo S, Yamamoto S, et al. (2005) Clinicopathologic characteristics of hepatitis C virus-associated intrahepatic cholangiocarcinoma. Dig Surg 22:432-39 CrossRef
  38. Polizos A, Kelekis N, Sinani C, et al. (2003) Advanced intrahepatic cholangiocarcinoma in hepatitis C virus-related decompensated cirrhosis: case report and review of the literature. Eur J Gastroenterol Hepatol 15:331-34 CrossRef
  39. Perumal V, Wang J, Thuluvath P, et al. (2006) Hepatitis C and hepatitis B nucleic acids are present in intrahepatic cholangiocarcinomas from the United States. Hum Pathol 37:1211-216 CrossRef
  40. Alison MR (2005) Liver stem cells: implications for hepatocarcinogenesis. Stem Cell Rev 1:253-60 CrossRef
  41. Acalovschi M (2004) Cholangiocarcinoma: risk factors, diagnosis and management. Rom J Intern Med 42:41-8
  42. Yamamoto M, Ariizumi S, Otsubo T, et al. (2004) Intrahepatic cholangiocarcinoma diagnosed preoperatively as hepatocellular carcinoma. J Surg Oncol 87:80-3 CrossRef
  43. Asayama Y, Yoshimitsu K, Irie H, et al. (2006) Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. Radiology 238:150-55 CrossRef
  44. Shirabe K, Shimada M, Tsujita E, et al. (2004) Prognostic factors in node-negative intrahepatic cholangiocarcinoma with special reference to angiogenesis. Am J Surg 187:538-42 CrossRef
  45. Leelawat K, Leelawat S, Ratanachu-Ek T, et al. (2006) Circulating hTERT mRNA as a tumor marker in?cholangiocarcinoma patients. World J Gastroenterol 12:4195-198
  
• 作者单位：Atsushi Nanashima (1)
  Takafumi Abo (1)
  Goushi Murakami (1)
  Aya Matsumoto (1)
  Kazuo Tou (1)
  Hiroaki Takeshita (1)
  Masaki Kunizaki (1)
  Shigekazu Hidaka (1)
  Ichiro Sakamoto (2)
  Hideyuki Hayashi (2)
  Toru Fukuda (3)
  Takashi Kudo (2) (4)
  Takeshi Nagayasu (1)
  
  1. Division of Surgical Oncology and Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
  2. Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  3. Section of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
  4. Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, 12-4 Sakamoto, Nagasaki, 852-8102, Japan
  

文摘

Purpose Arterial enhancement of intrahepatic cholangiocarcinoma (ICC) has been noted. To precisely identify the characteristics of tumor enhancement patterns, we examined the relationship between CT attenuation in the tumor and clinicopathological parameters or prognosis. Methods Subjects were 42 ICC patients who had undergone hepatectomy. microvessel density (MVD) determined by CD34 staining was compared with imaging. Attenuation was calculated in images from multidetector CT of tumor and non-tumorous regions. Enhancement patterns were divided into two groups: arterial enhancement with higher attenuation (>16?HU; Hyper group, n?=?12); and arterial enhancement with lower attenuation (Hypo group, n?=?30). Results Univariate analysis identified high tumor marker level, increased size, less-differentiation, incomplete resection, increased bleeding, and lower MVD as significantly associated with poor survival (p?<?0.05). Increased attenuation throughout the whole ICC correlated significantly with radiological findings and MVD. Concomitant hepatitis, well-differentiation, and smaller tumor were more significantly frequent in the Hyper group than in the Hypo group (p?<?0.05). Postoperative early recurrence was significantly less frequent in the Hyper group, and overall survival was significantly better in the Hyper group (p?<?0.05). Conclusions Increased CT attenuation correlated with ICC tumor vascularity. Increased tumor enhancement in the arterial phase was associated with chronic hepatitis, lower malignancy, and better survival.