title: Intraductal papillary neoplasm of the bile duct.
abstract: Intraductal papillary neoplasm of the bile duct (IPNB) is a variant of bile duct carcinoma that is characterized by intraductal growth and better outcomes compared with common cholangiocarcinoma. IPNBs are mainly found in patients from Far Eastern areas, where hepatolithiasis and clonorchiasis are endemic. According to the immunohistochemical profiles of the mucin core proteins, IPNBs are classified into four types: pancreaticobiliary, intestinal, gastric, and oncocytic. Approximately 40%-80% of IPNBs contain a component of invasive carcinoma or tubular or mucinous adenocarcinoma, suggesting that IPNB is a disease with high potential for malignancy. It is difficult to make an accurate preoperative diagnosis because of IPNB's low incidence and the lack of specificity in its clinical manifestation. The most common abnormal preoperative imaging findings of IPNB are intraductal masses and the involvement of bile duct dilation. Simultaneous proximal and distal bile duct dilation can be detected in some cases, which has diagnostic significance. Cholangiography and cholangioscopy are needed to confirm the pathology and demonstrate the extent of the lesions. However, pathologic diagnosis by biopsy cannot reflect the actual stage in many cases because different foci may be of different stages and because mixed pathologic findings may exist in the same lesion. Surgical resection is the major treatment. Systematic cholangioscopy with staged biopsies and frozen sections is recommended during resection to ensure that no minor tumors are left and that curative resection is achieved. Staging, histologic subtype, curative resection and lymph node metastasis are factors affecting long-term survival.
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Xue-Shuai
authors.initials: XS
authors.lastname: Wan
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Yi-Yao
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Jun-Yan
authors.initials: JY
authors.lastname: Qian
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Xiao-Bo
authors.initials: XB
authors.lastname: Yang
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: An-Qiang
authors.initials: AQ
authors.lastname: Wang
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Lian
authors.initials: L
authors.lastname: He
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Zhao
authors.affiliation: Xue-Shuai Wan, Yi-Yao Xu, Jun-Yan Qian, Xiao-Bo Yang, An-Qiang Wang, Lian He, Hai-Tao Zhao, Xin-Ting Sang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Xin-Ting
authors.initials: XT
authors.lastname: Sang
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D001650:Bile Duct Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D001652:Bile Ducts / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D001662:Biliary Tract Surgical Procedures; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D002291:Carcinoma, Papillary / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D004108:Dilatation, Pathologic; D016145:Endoscopy, Digestive System; D006801:Humans; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010212:Papilloma / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Biliary papillomatosis; Intraductal neoplasm; Mucinous; Papillary cholangiocarcinoma; Prognosis