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Comparison of the Malignant Predictors in Intrahepatic and Extrahepatic Intraductal Papillary Neoplasm of the Bile Duct

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Author(s)
Sung Yong HanDong Uk KimHyeong Seok NamDae Hwan KangSung Ill JangDong Ki LeeDong Woo ShinKwang Bum ChoMin Jae YangJae Chul HwangJin Hong KimHoonsub SoSung Jo BangMin Je SungChang-Il KwonDong Wook LeeChang-Min ChoJae Hee Cho
Keimyung Author(s)
Cho, Kwang Bum
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Clin Med
Issued Date
2022
Volume
11
Issue
7
Keyword
intraductal papillary neoplasm of the bile ductprognosisnatural coursecholangiocarcinomapredictor
Abstract
Background:
Intraductal papillary neoplasm of the bile duct (IPNB) is a precancerous lesion of cholangiocarcinoma, for which surgical resection is the most effective treatment. We evaluated the predictors of malignancy in IPNB according to anatomical location and the prognosis without surgery.

Methods:
A total of 196 IPNB patients who underwent pathologic confirmation by surgical resection or endoscopic retrograde cholangiography or percutaneous transhepatic cholangioscopic biopsy were included. Clinicopathological findings of IPNB with invasive carcinoma or mucosal dysplasia were analyzed according to anatomical location.

Results:
Of the 116 patients with intrahepatic IPNB (I-IPNB) and 80 patients with extrahepatic IPNB (E-IPNB), 62 (53.4%) and 61 (76.3%) were diagnosed with invasive carcinoma, respectively. Multivariate analysis revealed that mural nodule > 12 mm (p = 0.043) in I-IPNB and enhancement of mural nodule (p = 0.044) in E-IPNB were predictive factors for malignancy. For pathologic discrepancy before and after surgery, IPNB has a 71.2% sensitivity and 82.3% specificity. In the non-surgical IPNB group, composed of nine I-IPNB and seven E-IPNB patients, 43.7% progressed to IPNB with invasive carcinoma within 876 days.

Conclusions:
E-IPNB has a higher rate of malignancy than I-IPNB. The predictive factor for malignancy is mural nodule > 12 mm in I-IPNB and mural nodule enhancement in E-IPNB.
Keimyung Author(s)(Kor)
조광범
Publisher
School of Medicine (의과대학)
Citation
Sung Yong Han et al. (2022). Comparison of the Malignant Predictors in Intrahepatic and Extrahepatic Intraductal Papillary Neoplasm of the Bile Duct. J Clin Med, 11(7), 1985. doi: 10.3390/jcm11071985
Type
Article
ISSN
2077-0383
Source
https://www.mdpi.com/2077-0383/11/7/1985
DOI
10.3390/jcm11071985
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44324
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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