Relationship of Biliary Duct Invasion with Clinicopathologic Data in Colorectal Carcinoma Liver Metastases

Overview

Intrabiliary metastasis from colorectal carcinoma (CRC) is a relatively rare occurrence, characterized by the growth of cancer cells within or invasion of the bile ducts. This pattern is distinct from CRC with lymph vascular metastases due to its cholestatic appearance. Our objective was to investigate the clinicopathological characteristics of colorectal cancer cases that have metastasized to the liver and involve invasion of the biliary ducts (BDI). A retrospective evaluation was conducted on resection tissues from 133 patients of colorectal cancer (CRC) with liver metastases that were operated on between 2000 and 2011. The study analyzed the demographic information of patients, as well as the number and size of metastatic foci, method of resection, presence of bile duct injury (BDI), lymph vascular invasion (LVI), and tumor involvement in surgical margins. The pathological characteristics of the original tumor were assessed in 100 instances. Statistical analysis was conducted using nonparametric tests. The presence of BDI was seen in 14.3% of the cases (n=19) and was shown to be substantially higher in male patients (p=0.043). There was a single instance of exclusive intrabiliary metastases accompanied by significant bile duct injury. Although there were more incidences of BDI in individuals under 50 years old (16% vs. 14%) and a higher occurrence of multifocal metastases (19% vs. 12%), these differences were not statistically significant. Out of the instances involving BDI, 74% had a segmental resection, and in 63% of these cases, the resection margin was clear of a tumor. The main tumor exhibited a moderate level of differentiation, specifically adenocarcinoma, in 64% of cases. Furthermore, instances where lymph nodes were affected showed a tendency to have higher levels of BDI. In this series, it was observed that CRC metastases with BDI tended to occur more frequently in male patients under the age of 50, who had multiple metastatic foci, the existence of LVI in the liver, and primary tumor metastasis to the lymph nodes. When there is a significant bile duct injury (BDI), it is important to evaluate it as a possible diagnosis alongside intrahepatic cholangiocarcinoma and biliary intraductal neoplasms.

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1. Fatma Yildirim

Lokman Hekim University, Faculty of Medicine, Department of Pathology, Ankara, Turkiye
0000-0003-3887-702X
fatma_unal@hotmail.com

2. Asuman Argon

Health Sciences University, Izmir Faculty of Medicine, Department of Pathology, Izmir, Turkıye
0000-0001-7406-0610
asumanargon@gmail.com
3. Alper Uguz
Ege University, Faculty of Medicine, Department of Surgery, Izmir, Turkiye
0000-0001-8127-5644
dralperuguz@yahoo.com
4. Murat Sezak
Ege University, Faculty of Medicine, Department of Pathology, Izmir, Turkiye
0000-0002-0457-4832
drsezak@gmail.com

5. Basak Doganavsargil
Ege University, Faculty of Medicine, Department of Pathology, Izmir, Turkiye
0000-0002-4738-4350
bdoganavsargil@yahoo.com
6. Murat Zeytunlu
Ege University, Faculty of Medicine, Department of Pathology, Izmir, Turkiye
0000-0001-6911- 8953
zeytunlu@med.ege.edu.tr
7. Deniz Nart
Ege University, Faculty of Medicine, Department of Pathology, Izmir, Turkiye
0000-0002-8100-6978
deniznart@yahoo.com
8. Funda Yilmaz
Ege University, Faculty of Medicine, Department of Pathology, Izmir, Turkiye
0000-0003-1837-6498
fundayılmazbarbet@yahoo.fr

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