Anastomotic Recurrence and Expressions of Carbohydrate Antigens in Hepatic Surgical Margin in Hilar Bile Duct Cancer

Keiichiro Uchikura, Sonshin Takao, Suguru Yonezawa^*, Hiroshi Imamura, Masaaki Kubo, Hiroyuki Shinchi and Takashi Aikou

First Dept. of Surgery, and 2nd Dept. of Pathology^*, Kagoshima University School of Medicine

Thirty-one patients with bile duct carcinoma were studied. The specimens of carcinoma and of the hepatic surgical margin of bile duct carcinoma were stained with hematoxylin-eosin and examined Immunohistochemically using carbohydrate antigens (MUC1, MUC2, STn, SLx, SLa). The relationships between recurrence patterns and carbohydrate antigen expression were investigated. The rates of expression of MUC1, STn, and SLx in cancer were significantly higher than those in non-cancerous epithelium. Of 31 patients with hilar bile duct carcinoma, 19 had a negative hepatic surgical margin (hm0), 6 were positive at a distance of 5mm from the hepatic surgical margin (hm1), and 6 had a positive hepatic surgical margin (hm2). MUC1 expression rates of hm0, hm1, and hm2 were 32% (6/19), 33% (2/6), and 67% (4/6), respectively. These 12 MUC1-positive margins histologically involved 4 carcinomas, and 4 dysplastic, 1 hyperplastic, and 3 normal epithelia. Local recurrences were observed at choledochojejunostomy in 4 (33%) of 12 patients with MUC1-positive margins, but in 0 (0%) of 19 patients with MUC1-negative margins. Therefore, expression of MUC1 may be useful for histological examination of the hepatic surgical margin of bile duct carcinoma.

Key words
bile duct cancer, carbohydrate antigens, MUC1, hepatic surgical margin, recurrent types

Reprint requests
Keiichirou Uchikura First Department of Surgery, Kagoshima University School of Medicine 8-35-1 Sakuragaoka, Kagoshima-city, 890-0075 JAPAN

Accepted
November 13, 1998

To read the PDF file you will need Abobe Reader installed on your computer.