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. 1989 Feb;209(2):181–187. doi: 10.1097/00000658-198902000-00008

Clinicohistopathologic and immunohistochemical studies of intrapancreatic development of carcinoma of the head of the pancreas.

A Nakao 1, T Ichihara 1, T Nonami 1, A Harada 1, T Koshikawa 1, N Nakashima 1, H Nagura 1, H Takagi 1
PMCID: PMC1493910  PMID: 2464969

Abstract

Clinicohistopathologic and immunohistochemical studies of intrapancreatic development of duct cell carcinoma of the head of the pancreas to the body and tail were done in 34 cases in which total pancreatectomy accompanied by portal vein resection were performed from July 1981 to June 1987. In studies of hematoxylin and eosin (HE) staining, intrapancreatic development from the head to the body or tail was observed in 14 cases of 34 cases (41.1%). Multicentricity or skip development was observed in two of 14 cases. However, by using immunostaining of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and DUPAN2, small cancer nests surrounded by dense fibrous connective tissues could be easily and accurately diagnosed, and finally, in 25 of 34 cases (73.5%), intrapancreatic continuous development from the head to body or tail was observed. The intrapancreatic development correlated with portal invasion and perineural invasion of carcinoma, hardness of body and tail, obstruction of the main pancreatic duct, and irregular pancreaticogram. The intraoperative quick immunostaining on the cryostat sections, together with HE staining, is useful to determine the intrapancreatic development of the carcinoma. The indication of total pancreatectomy or pancreatoduodenectomy for carcinoma of the head of the pancreas can be determined by these results.

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Selected References

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  1. Ahnen D. J., Nakane P. K., Brown W. R. Ultrastructural localization of carcinoembryonic antigen in normal intestine and colon cancer: abnormal distribution of CEA on the surfaces of colon cancer cells. Cancer. 1982 May 15;49(10):2077–2090. doi: 10.1002/1097-0142(19820515)49:10<2077::aid-cncr2820491020>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  2. Collins J. J., Jr, Craighead J. E., Brooks J. R. Rationale for total pancreatectomy for carcinoma of the pancreatic head. N Engl J Med. 1966 Mar 17;274(11):599–602. doi: 10.1056/NEJM196603172741103. [DOI] [PubMed] [Google Scholar]
  3. Cooperman A. M., Herter F. P., Marboe C. A., Helmreich Z. V., Perzin K. H. Pancreatoduodenal resection and total pnacreatectomy--an institutional review. Surgery. 1981 Oct;90(4):707–712. [PubMed] [Google Scholar]
  4. Edis A. J., Kiernan P. D., Taylor W. F. Attempted curative resection of ductal carcinoma of the pancreas: review of Mayo Clinic experience, 1951-1975. Mayo Clin Proc. 1980 Sep;55(9):531–536. [PubMed] [Google Scholar]
  5. Fortner J. G., Kim D. K., Cubilla A., Turnbull A., Pahnke L. D., Shils M. E. Regional pancreatectomy: en bloc pancreatic, portal vein and lymph node resection. Ann Surg. 1977 Jul;186(1):42–50. doi: 10.1097/00000658-197707000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hamada Y., Yamamura M., Hioki K., Yamamoto M., Nagura H., Watanabe K. Immunohistochemical study of carcinoembryonic antigen in patients with colorectal cancer. Correlation with plasma carcinoembryonic antigen levels. Cancer. 1985 Jan 1;55(1):136–141. doi: 10.1002/1097-0142(19850101)55:1<136::aid-cncr2820550121>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  7. Ichihara T., Nagura H., Nakao A., Sakamoto J., Watanabe T., Takagi H. Immunohistochemical localization of CA 19-9 and CEA in pancreatic carcinoma and associated diseases. Cancer. 1988 Jan 15;61(2):324–333. doi: 10.1002/1097-0142(19880115)61:2<324::aid-cncr2820610223>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  8. Ihse I., Lilja P., Arnesjö B., Bengmark S. Total pancreatectomy for cancer. An appraisal of 65 cases. Ann Surg. 1977 Dec;186(6):675–680. doi: 10.1097/00000658-197712000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Klöppel G., Lohse T., Bosslet K., Rückert K. Ductal adenocarcinoma of the head of the pancreas: incidence of tumor involvement beyond the Whipple resection line. Histological and immunocytochemical analysis of 37 total pancreatectomy specimens. Pancreas. 1987;2(2):170–175. [PubMed] [Google Scholar]
  10. Koprowski H., Steplewski Z., Mitchell K., Herlyn M., Herlyn D., Fuhrer P. Colorectal carcinoma antigens detected by hybridoma antibodies. Somatic Cell Genet. 1979 Nov;5(6):957–971. doi: 10.1007/BF01542654. [DOI] [PubMed] [Google Scholar]
  11. Kozuka S., Sassa R., Taki T., Masamoto K., Nagasawa S., Saga S., Hasegawa K., Takeuchi M. Relation of pancreatic duct hyperplasia to carcinoma. Cancer. 1979 Apr;43(4):1418–1428. doi: 10.1002/1097-0142(197904)43:4<1418::aid-cncr2820430431>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  12. Matsui Y., Aoki Y., Ishikawa O., Iwanaga T., Wada A., Tateishi R., Kosaki G. Ductal carcinoma of the pancreas. Rationales for total pancreatectomy. Arch Surg. 1979 Jun;114(6):722–726. doi: 10.1001/archsurg.1979.01370300076013. [DOI] [PubMed] [Google Scholar]
  13. Metzgar R. S., Gaillard M. T., Levine S. J., Tuck F. L., Bossen E. H., Borowitz M. J. Antigens of human pancreatic adenocarcinoma cells defined by murine monoclonal antibodies. Cancer Res. 1982 Feb;42(2):601–608. [PubMed] [Google Scholar]
  14. Nagura H., Tsutsumi Y., Shioda Y., Watanabe K. Immunohistochemistry of gastric carcinomas and associated diseases: novel distribution of carcinoembryonic antigen and secretory component on the surface of gastric cancer cells. J Histochem Cytochem. 1983 Jan;31(1A):193–198. [PubMed] [Google Scholar]
  15. Piorkowski R. J., Blievernicht S. W., Lawrence W., Jr, Madariaga J., Horsley J. S., 3rd, Neifeld J. P., Terz J. J. Pancreatic and periampullary carcinoma. Experience with 200 patients over a 12 year period. Am J Surg. 1982 Feb;143(2):189–193. doi: 10.1016/0002-9610(82)90064-2. [DOI] [PubMed] [Google Scholar]
  16. Pliam M. B., ReMine W. H. Further evaluation of total pancreatectomy. Arch Surg. 1975 May;110(5):506–512. doi: 10.1001/archsurg.1975.01360110052010. [DOI] [PubMed] [Google Scholar]
  17. Suzuki Y., Ichihara T., Nakao A., Sakamoto J., Takagi H., Nagura H. High serum levels of DUPAN2 antigen and CA19-9 in pancreatic cancer: correlation with immunocytochemical localization of antigens in cancer cells. Hepatogastroenterology. 1988 Jun;35(3):128–135. [PubMed] [Google Scholar]
  18. Tryka A. F., Brooks J. R. Histopathology in the evaluation of total pancreatectomy for ductal carcinoma. Ann Surg. 1979 Sep;190(3):373–381. doi: 10.1097/00000658-197909000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Tsutsumi Y., Nagura H., Watanabe K. Immunohistochemical observations of carcinoembryonic antigen (CEA) and CEA-related substances in normal and neoplastic pancreas. Pitfalls and caveats in CEA immunohistochemistry. Am J Clin Pathol. 1984 Nov;82(5):535–542. doi: 10.1093/ajcp/82.5.535. [DOI] [PubMed] [Google Scholar]
  20. van Heerden J. A. Pancreatic resection for carcinoma of the pancreas: Whipple versus total pancreatectomy--an institutional perspective. World J Surg. 1984 Dec;8(6):880–888. doi: 10.1007/BF01656028. [DOI] [PubMed] [Google Scholar]

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