Intraductal papillary neoplasms and mucinous cystic neoplasms of the hepatobiliary system: demographic differences between Asian and Western populations, and comparison with pancreatic counterparts.
OBJECTIVE
To improve the characterization of intraductal papillary neoplasm of the bile duct (IPNB) and mucinous cystic neoplasm of the liver (MCN-L).


RESULTS
A retrospective review of pathology archives (1999-2011) in our three institutions identified cases of IPNB (n = 138) and MCN-L (n = 54). The IPNB/MCN-L ratio was 5.7:1 at Samsung Medical Centre in Seoul, which was significantly higher than those at the University of Washington Medical Center in Seattle (1:3.0) and King's College Hospital in London (1:6.3). This difference was mainly attributable to the considerably larger number of patients with IPNB in Seoul (n = 131) than in Seattle and London (n = 7). Western patients with IPNB were all non-Asian in ancestry. IPNB differed from pancreatic intraductal papillary neoplasm in its higher histological grade, more advanced stage of an associated invasive cancer, and worse prognosis. In contrast, MCN-L showed significantly lower histological grade than its pancreatic counterpart (P = 0.022). Unlike in pancreatic mucinous cystic neoplasm, malignant transformation was very rare in MCN-L (10% versus 2%).


CONCLUSIONS
This study demonstrated demographic differences in IPNB and MCN-L among regions. IPNB and MCN-L differ from their pancreatic counterparts in the risk of malignant transformation and patients' prognosis.
Histopathology Section, Institute of Liver Studies, King's College Hospital, London, UK.
Yoh
Y
Zen
Kee-Taek
KT
Jang
Soomin
S
Ahn
Dong Hun
DH
Kim
Dong Wook
DW
Choi
Seong Ho
SH
Choi
Jin Seok
JS
Heo
Matthew M
MM
Yeh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001650:Bile Duct Neoplasms / Q000453:epidemiology* / Q000473:pathology; D044584:Carcinoma, Ductal / Q000453:epidemiology*; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000473:pathology; D002291:Carcinoma, Papillary / Q000453:epidemiology* / Q000473:pathology; D018282:Cystadenocarcinoma, Mucinous / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies
cystadenoma; incidence; intraductal papillary mucinous neoplasm; liver; pancreas