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Fetal gut-like differentiation in gallbladder cancer
Kei Koyama1, Daichi Maeda2, Daisuke Tamura3
1Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, 010-8543, Japan; Faculty of Medicine, Akita University, Akita, 010-8543, Japan.
Human Pathology
|October 4, 2017
Summary
Fetal gut-like adenocarcinoma, a rare gallbladder cancer subtype, is identified and characterized by SALL4 expression. This finding suggests a distinct histological classification for this specific cancer presentation.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Adenocarcinomas with fetal gut-like (enteroblastic) differentiation occur in various organs, often with elevated alpha-fetoprotein (AFP).
- Detailed investigation of fetal gut-like differentiation in gallbladder cancer is lacking.
Purpose of the Study:
- To investigate the presence and characteristics of fetal gut-like differentiation in gallbladder cancer.
- To assess the expression of embryonic stem cell marker SALL4 and oncofetal proteins (GPC3, AFP) in gallbladder cancer.
Main Methods:
- Morphological and immunohistochemical analyses were performed on 49 gallbladder cancer cases.
- Expression of SALL4, glypican-3 (GPC3), and alpha-fetoprotein (AFP) was evaluated.
Main Results:
- One case of fetal gut-like adenocarcinoma coexisting with conventional adenocarcinoma was identified, showing diffuse SALL4 and partial AFP positivity.
- Overall SALL4 and GPC3 positivity rates were 12.2% and 16.3%, respectively.
- SALL4 and GPC3 expression did not correlate with clinicopathological factors.
Conclusions:
- Fetal gut-like adenocarcinoma represents 2% of the studied gallbladder cancer cases.
- Fetal gut-like adenocarcinoma is proposed as a distinct histological subtype of gallbladder cancer.
- SALL4 expression is a key characteristic of this distinct gallbladder cancer subtype.
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