Classification of Pancreatic Carcinoma (4th English Edition) (第4版)

Classification of Pancreatic Carcinoma (4th English Edition) (第4版)

膵癌取扱い規約 (英語版)


著者名:Japan Pancreas Society(日本膵臓学会)







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目次情報 内容紹介 推薦人


Dataset for histopathological reports for pancreatic cancer

I. Introduction (purpose and the main disease covered)

II. Principles of Recording Findings

III. Description of Findings
 1. Primary tumor
  1) Tumor location
  2) Size and number of the tumors
  3) Macroscopic type
  4) Grade of local invasion
   (1) T category
   (2) Diagnostic imaging guidance for T category
   (3) CT imaging evaluating T category (comparison with the microscopic view)
 2. Lymph node metastases
  1) Identification of the lymph nodes
   (1) Station numbers, names, and boundaries of lymph nodes related to the pancreas
   (2) Lymph node numbers related to the pancreas and diagnostic CT criteria for lymph node metastasis
  2) Regional lymph nodes
  3) Recording lymph node metastases
   (1) Degree of lymph node metastasis (N)
   (2) Ratio of lymph node metastasis
3. Distant metastases (M)
 1) Peritoneal metastasis (P)
 2) Hepatic metastasis (H)
4. Staging
 TNM Clinical Classification of the UICC TNM Classification, 8th edition (2016)
5. Resectability classification
 1) Resectability
 2) Examples of CT images for resectability classification

IV. Surgical Treatment
 1. Type of operative procedure
  1) Surgery with or without resection
  2) Method of operative approach
 2. Description of pancreatic resection
  1) Type of resection
  2) Combined resection
  3) Reconstructions
   (1) Reconstructions after PD, PPPD, or SSPPD
   (2) Type of pancreaticoenteric anastomosis
3. Classification of lymph node dissections (D)
4. Assessment of residual tumor (R)
 1) Pancreatic cut-end margin (PCM)
 2) Bile duct cut-end margin (BCM)
 3) Dissected peripancreatic tissue margin (DPM)

V. Results of Treatment
 1. Number of patients with pancreatic cancer
 2. Prognostic survey
 3. Cause of death
 4. Mode of recurrence
 5. Survival rate

VI. Handling of Resected Specimens
 1. Handling of resected pancreatic specimens
 2. Sectioning
  1) Pancreatoduodenectomy specimens
  2) Distal pancreatectomy specimens
  3) Total pancreatectomy specimens
 3. Method of performing peritoneal washing cytology

VII. Histological Findings of Pancreatic Neoplasms
 1. International Classification of Diseases for Oncology (ICD-O) code
  [1] Epithelial neoplasms
  2] Non-epithelial neoplasms
 2. Cancer-stroma relationship
 3. Growth patterns of neoplasms infiltrating surrounding tissue (INF)
 4. Lymphatic invasion (ly)
 5. Venous invasion (v)
 6. Nerve invasion (ne)
 7. Intraductal spread in MPD (mpd)
 8. Explanation of the histological classification
  [1] Epithelial neoplasms
  [2] Non-epithelial neoplasms
■Atlas of Pathology
Exocrine Neoplasms
Serous neoplasms
Mucinous cystic neoplasm
Intraductal neoplasms
Pancreatic intraepithelial neoplasia (PanIN)
Invasive ductal carcinomas
Acinar cell neoplasms
Neuroendocrine Neoplasms
Epithelial Neoplasms of Uncertain Differentiation

VIII. Biopsy/Cytology of Pancreatic Neoplasms
 1. Reporting of pancreatic biopsy/cytology
■Biopsy Histology
 2. Pancreatic cytology report
  1) Reporting format and diagnosis
  2) Classification of intraoperative peritoneal washing cytology (CY)
  3) Pancreatic neoplasms
■Cytological Atlas

IX. Histological Assessment of Preoperative Therapeutic Effects

Criteria for histological response to drug therapy/radiotherapy
Histological findings following drug therapy/radiotherapy
Example of histological assessment of preoperative therapeutic effects (Grade 2)