第115回日本外科学会定期学術集会 My Schedule

Purpose: To clarify the clinicopathological characteristics of hypervascular intrahepatic cholangiocarcinoma (ICC).Methods: Seventy patients with mass-forming ICC underwent hepatectomy between 2003 and 2013. These patients were divided into two groups based on the arterial phase CT findings; hypervascular ICC (mean CT value of the tumor > that of the non-tumorous liver parenchyma, n=21) and hypovascular ICC (n=49). Overall survival and clinicopathological factors were compared.Results: Overall survival of the hypervascular group was significantly better than that of the hypovascular group (5-year survival rate: 62.5% vs. 35.2%, respectively, p=0.046). Carbohydrate antigen 19-9 value of the hypervascular group was significantly lower than that of the hypovascular group (42+35 vs. 5233+28094, p=0.007). Pathological examination showed significantly lower frequency of lymph node metastasis (0% vs. 39%, p=0.001), lymphatic invasion (14% vs. 57%, p=0001), tumor necrosis (24% vs. 57%, p=0.010), and macroscopic periductal infiltrating combination (0% vs. 27%, p=0.009) of the hypervascular group compared with the hypovascular group. Microscopic bile ductular feature was more frequently found in the hypervascular group (57% vs. 29%, p=0.023). Immunohistochemical examination showed higher frequency of reactivity for neural cell adhesion molecule (a hepatic progenitor cells marker, 71% vs. 37%, p=0.008) and lower frequency of that for S100P (a large bile duct marker, 33% vs. 73%, p=0.002) of the hypervascular group. Conclusions: Prognosis after resection of hypervascular ICC is significantly better than the hypovascular ICC. Most of the hypervascular ICC are less invasive, and may originate from hepatic progenitor cells.

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