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Tumorigenesis and phenotypic characteristics of mucin‐producing bile duct tumors: an immunohistochemical approach
Author(s) -
Nakanuma Yasuni,
Zen Yoh,
Harada Kenichi,
Ikeda Hiroko,
Sato Yasunori,
Uehara Takeshi,
Sasaki Motoko
Publication year - 2010
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-009-0158-7
Subject(s) - mucin , bile duct , mucin 2 , pancreas , immunohistochemistry , carcinogenesis , pathology , intestinal metaplasia , adenocarcinoma , cdx2 , intraductal papillary mucinous neoplasm , medicine , muc1 , pancreatic duct , gastroenterology , cancer research , biology , cancer , dysplasia , transcription factor , gene expression , gene , biochemistry , homeobox
Intraductal papillary neoplasm of the bile duct (IPNB) is characterized by exophytic proliferation of neoplastic epithelial cells with fibrovascular stalks in bile duct lumen, mucin hypersecretion, and considerable dilatation or multilocular changes of the affected bile ducts. A mucin‐producing bile duct tumor is an IPNB with excessive mucin production and clinical symptoms. Herein, the phenotypes as well as the tumorigenesis and progression of IPNB are reviewed with immunohistochemical assistance. The tumors are subdivided into three phenotypes: pancreatobiliary, intestinal, and gastric. About half of IPNB cases are of the pancreatobiliary type, and the remaining half are of the intestinal type. Aberrant expression of CDX2 with MUC2 and CK20 is related to the development of intestinal metaplasia. Inactivation of P16INK4a and nuclear expression of β ‐catenin are related to the development of IPNB. Decreased expression of membranous β ‐catenin and E‐cadherin and aberrant expression of MMP‐7 and −9 and of MUC1 are related to invasion of IPNB with tubular adenocarcinoma, whereas MUC2 is involved in the invasion of IPNB with mucinous carcinoma. IPNB can be regarded as a counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas, particularly the main duct type. More comparative studies between IPNB and pancreatic IPMN are recommended for further analysis of these papillary neoplasms.