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Carcinoma of the gallbladder. A clinicopathology of 103 patients and a newly proposed staging.

Abstract
Tissue samples from 103 patients with gallbladder carcinoma were examined, using 5-mm stepwise tissue sections. Three pathologic stages were used: Stage I; carcinoma invading not further than the muscle coat of the gallbladder, with or without extension along Rokitansky-Aschoff sinuses in the subserosa (11 cases); Stage II, carcinoma extending to the subserosal fibroadipose tissue of the gallbladder (73 cases); and Stage III: carcinoma invading the adjacent organs such as the duodenum, liver, and colon (19 cases). In the 11 patients with Stage I carcinoma, there was no apparent lymph node metastasis and all remained well for 3 months to 14 years after the initial operation. The cumulative 3-year survival rate of Stage I (100%) was significantly higher than of Stage II (40%) and Stage III (10%) (P less than 0.01, P less than 0.001). The Stage I tumors, therefore, can be defined as early carcinoma of the gallbladder. Dysplastic epithelium was seen in the mucosa adjacent to the malignant lesion in 57% of those with gallbladder carcinoma: 73% in Stage I, 59% in Stage II, and 42% in Stage III. Nine gallbladders had multiple foci of adenocarcinoma in a background of a diffuse dysplasia. Immunohistochemical study for carcinoembryonic antigen and carbohydrate antigen 19-9 resulted in positive staining of the dysplastic epithelial element adjacent to the invasive carcinoma and, in a similar fashion, in the carcinoma itself, thereby indicating a close relation between the epithelial dysplasia and adenocarcinoma of the gallbladder.
AuthorsK Yamaguchi, M Enjoji
JournalCancer (Cancer) Vol. 62 Issue 7 Pg. 1425-32 (Oct 01 1988) ISSN: 0008-543X [Print] United States
PMID3166397 (Publication Type: Journal Article)
Chemical References
  • Antigens, Neoplasm
  • Antigens, Tumor-Associated, Carbohydrate
  • Carcinoembryonic Antigen
Topics
  • Adenocarcinoma (immunology, pathology, surgery)
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Neoplasm (analysis)
  • Antigens, Tumor-Associated, Carbohydrate
  • Carcinoembryonic Antigen (analysis)
  • Epithelium (immunology)
  • Female
  • Follow-Up Studies
  • Gallbladder Neoplasms (immunology, pathology, surgery)
  • Humans
  • Immunohistochemistry
  • Japan
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging

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