Extent of Suitable Resection for Bile Duct Carcinoma -From the Mode of Spreading and Biological Behavior-

Atsushi Takimoto, Itaru Endo, Shinji Togo, Hitoshi Sekido, Yasushi Ichikawa, Takashi Ishikawa, Akira Nakano, Hiroshi Shimada

Second Department of Surgery, Yokohama City University

Macroscopically, hepatic bile duct carcinoma was divided into 3 types, papillary (P), nodular (N) and diffuse (D). P-type expressed cadherin and catenin more strongly than N-and D-types. Expression of both cadherin and catenin was stronger in pap and tubl than tub2. The nuclear area of the cancer cell, which correlated with both the labeling index of Ki-67 and aberrant accumulation of p53, was significantly larger in the subserosal layer than in the mucosal layer. These findings may explain the differences in biological behavior between P- and N, D-types. P-type grows within the mucosal layer, while N- and D-types are more invasive, extending into the subserosal layer. In reality, the poor for N-, D-type of hepatic bile duct carcinoma after surgery is clinically observed. Therefore, for the treatment of N, D-type bile duct carcinoma, more extensive surgical intervention including resection of the liver and vessels is required.

Key words
extra-hepatic bile duct carcinoma, biological behevior, extent of suitable resection towerd liver

Reprint requests
Atsushi Takimoto Second Department of Surgery, Yokohama City University
3-9 Fukura, Kanazawa-ku, Yokohama, 236 JAPAN

Accepted
July 2, 1997

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