Abstract
We propose that diagnostic T Staging (dT Stage) based on the fifth edition of the carcinoma of the biliary tract handling rule (2003). The definition to the diagnosis standard is that, distinction of T 1 and T 2 are “Scanty invasion to perimuscular connective tissue” and “massive invasion to perimuscular connective tissue”, and of T 2 and T 3 are “infiltrated” and “not infiltrated” to the organs (Panc/Hinf), and of T 3 and T 4 are “infiltrated” and "not infiltrated" to the vascular factors (A/PV).
In 58 surgical excision examples, the results were 1) Even if the diagnosis of S invasion, Panc/Hinf 1, and A/PV 1 used IDUS and EUS that are high spatial resolution, the accuracy rate was low, and 2) The significant prognostic factor were arterial invasion, lymph node metastasis and hepatic infiltration. It is necessary for diagnostic algorithm that minimum diagnosis for surgical excision and consideration of prognosis are arterial invasion, lymph node metastasis and the horizontal cancer extension.
