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Cellular senescence in biliary pathology. Special emphasis on expression of a polycomb group protein EZH2 and a senescent marker p16INK4a in bile ductular tumors and lesions.
[cholangiocarcinoma]
A
subgroup
of
intrahepatic
cholangiocarcinoma
and
combined
hepatocellular-
cholangiocarcinoma
contain
a
component
of
cholangiolocellular
carcinoma
,
which
is
composed
of
small
bile
ductular
cells
.
Ductular
reaction
,
a
reactive
lesion
at
the
portal
tract
interface
comprising
increased
bile
ductules
,
is
frequently
seen
in
chronic
advanced
liver
diseases
.
Bile
duct
adenoma
,
a
benign
tumor
/
tumorous
lesion
is
also
composed
of
bile
ductular
cells
.
Differential
diagnosis
among
these
bile
ductular
tumors
/
lesions
is
sometimes
difficult
.
Given
overexpression
of
a
polycomb
group
protein
EZH
2
in
intrahepatic
cholangiocarcinoma
and
high
expression
of
senescence-associated
p
16
INK
4
a
in
ductular
reactions
,
we
plan
to
apply
immunostaining
for
EZH
2
and
p
16
INK
4
a
for
differential
diagnosis
of
these
bile
ductular
tumors
/
lesions
.
The
expression
of
EZH
2
was
seen
in
all
cases
of
cholangiolocellular
carcinomas
,
while
it
was
not
observed
in
bile
duct
adenomas
or
ductular
reactions
.
In
contrast
,
the
expression
of
p
16
INK
4
a
was
seen
in
most
bile
duct
adenomas
and
all
ductular
reactions
,
whereas
it
was
barely
seen
in
cholangiolocellular
carcinomas
.
A
borderline
between
cholangiolocellular
carcinoma
and
the
surrounding
ductular
reaction
was
clearly
highlighted
by
the
reverse
expression
pattern
of
EZH
2
and
p
16
INK
4
a
.
In
conclusion
,
immunostaining
for
EZH
2
and
p
16
INK
4
a
may
be
useful
for
differential
diagnosis
for
bile
ductular
tumors
/
lesions
.