Intracholecystic papillary neoplasm（ICPN）由来胆嚢癌の後方視的解析から見る，術前診断の可能性と至適術式の検討

池永 直樹; 島田 有貴; 藤本 崇聡; 田村 公二; 渡邉 雄介; 阿部 俊也; 井手野 昇; 藤森 尚; 仲田 興平; 小田 義直; 相島 慎一; 中村 雅史

doi:10.11210/tando.39.735

Original Articles

Intracholecystic Papillary Neoplasm (ICPN) Derived Gallbladder Carcinoma: Preoperative Diagnosis and Optimal Surgical Procedure

Naoki Ikenaga, Yuki Shimada, Takaaki Fujimoto, Koji Tamura, Yusuke Watanabe, Toshiya Abe, Noboru Ideno, Nao Fujimori, Kohei Nakata, Yoshinao Oda, Shinichi Aishima, Masafumi Nakamura

Author information

Naoki Ikenaga
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Yuki Shimada
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University
Takaaki Fujimoto
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Koji Tamura
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Yusuke Watanabe
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Toshiya Abe
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Noboru Ideno
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Nao Fujimori
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University
Kohei Nakata
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
Yoshinao Oda
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University
Shinichi Aishima
Department of Scientific Pathology, Graduate School of Medical Sciences, Kyushu University
Masafumi Nakamura
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University

Keywords: intracholecystic papillary neoplasm, gallbladder carcinoma, surgical resection, cholecystectomy

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2025 Volume 39 Issue 5 Pages 735-743

DOI https://doi.org/10.11210/tando.39.735

Details

Abstract

Intracholecystic papillary neoplasm (ICPN) is a precancerous lesion of gallbladder carcinoma newly defined in the 2010 WHO classification. However, its preoperative diagnosis and optimal treatment remain unclear. This study retrospectively analyzed 47 cases of gallbladder carcinoma that underwent curative resection at our department from 2010 to 2023, including eight cases (17%) of ICPN-derived carcinoma. These were classified into gastric (3 cases), intestinal (1 case), and pancreatobiliary (4 cases) types. Compared to conventional gallbladder carcinoma, there were no significant differences in clinicopathological features or disease-free survival rates. Malignant cells were detected in 2 of 6 cytology cases, but no cases were preoperatively diagnosed as ICPN. Although preoperative diagnosis is challenging, ICPN-derived gallbladder carcinoma shows a prognosis similar to conventional cases, and a surgical approach similar to that for conventional gallbladder carcinoma is desirable.

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