Classification of Pancreatic Carcinoma
膵癌取扱い規約 英語版 第4版
―目次―
Abbreviations
Synopsis
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)