PHÂN LOẠI MÔ BỆNH HỌC CỦA U BÓNG VATER THEO TỔ CHỨC Y TẾ THẾ GIỚI 2019

Abstract

Background: In the latest version of the World Health Organization 2019, there have been many changes in terminology, classification as well as diagnosis of ampullary tumor compared with previous versions. The histopathological classification helps to provide important prognostic information, providing appropriate and optimal treatment strategies for patients because there are differences in treatment orientation and prognosis for patients with different types of tumors in the ampulla of Vater. Objectives: Survey some characteristics of age, gender, histopathology, and classification of ampullary tumors according to the World Health Organization 2019. Methods: Case series report of 78 cases of ampullary tumors that were operated on at the  University Medical Center of Ho Chi Minh City from January 2019 to November 2022. Results: The group of malignant epithelial tumors accounted for the majority with a rate of 94.9%, mainly having 3 histological forms: intestinal type adenocarcinoma (35.9%), pancreatobiliary type adenocarcinoma (28.2%) and mixed type adenocarcinoma (26.9%); in addition, the rates of mucinous adenocarcinoma and poorly cohesive cell carcinoma were 1.3% and 2.6%, respectively. Benign epithelial tumors, precursors lesions, and neuroendocrine neoplasms accounted for only a small proportion of 3.8% and 1.3%, respectively. The mean age of the patient was 59 years old with a male: female ratio of 1:1.1. The average tumor size is 2.1 cm, common in the range of 1–<2cm (48.7%). The most common macroscopic appearance is an exophytic mass (52.6%). The degree of moderate differentiation accounted mainly for malignant tumors (86.5%). Some other histological features in the group of malignant tumors: the rate of vascular invasion, perineural invasion, tumor necrosis, and mucin in the stroma were 9.3%, 13.3%, 32%, and 17.3%, respectively. Conclusions: The study showed the characteristics of age, sex, histopathology, and their relationships. These results help in the correct diagnosis and accurate classification of the ampullary tumor; and help support clinical decisions in treatment and better prognosis of patients.