title: Adenosquamous carcinoma of the gallbladder.
abstract: OBJECTIVE
  Adenosquamous carcinoma of the gallbladder is relatively rare. Its biological behavior and optimal surgical procedure are still controversial.
  
  
  METHODS
  Clinicopathological factors and proliferating cell nuclear antigen expression were studied in four stage IV adenosquamous carcinoma patients who underwent curative surgery between June 1987 and April 2000, comparing those of 14 stage IV adenocarcinoma patients at the same period.
  
  
  RESULTS
  Preoperative radiological evaluation disclosed a mass invading to the adjacent organs in all cases (liver in 3 cases, and liver and stomach in one case). Three patients (case 1, 2 and 3: well-differentiated adenosquamous carcinomas) were all alive without recurrence in 10, 7, and 2 years after surgery. In contrast, the remaining patient (case 4: moderately differentiated adenosquamous carcinoma) with positive pathologic factors (lymph node metastasis, vascular invasion, etc) deceased one year after surgery due to peritoneal dissemination. When survival rate of adenosquamous carcinoma was compared, the prognosis of adenosquamous carcinoma was significantly better than that of adenocarcinoma (P = 0.0103). Comparison of pathological factors revealed that the frequency of lymph node metastasis was significantly higher in adenocarcinoma than in adenosquamous carcinoma (P = 0.004). Consistent with these findings, the positivity rate of proliferating cell nuclear antigen labeling was significantly lower in squamous carcinoma component, compared with adenosquamous component (P < 0.0001) or adenocarcinoma (P < 0.0001).
  
  
  CONCLUSIONS
  Even in patients with stage IV adenosquamous carcinoma of the gallbladder, a long-term survival may be obtained by curative surgery if the squamous component is predominant.
authors.affiliation: Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Motoi
authors.initials: M
authors.lastname: Kondo
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
authors.forename: Masato
authors.initials: M
authors.lastname: Sakon
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Wakasa
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism
chemical_list: D018809:Proliferating Cell Nuclear Antigen