{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:55:59Z","timestamp":1761710159221,"version":"3.41.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec>\n<jats:title>Purpose<\/jats:title>\n<jats:p>We proposed a novel morphological classification for intraductal papillary neoplasm of the bile duct (IPNB) and evaluated its association with postoperative prognosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Forty-two IPNB patients who underwent surgical resection were classified morphologically into three types\u2014branched (n\u2009=\u200910), main duct (n\u2009=\u200926), and mixed (n\u2009=\u20096)\u2014based on preoperative imaging features indicating cystic and\/or bile duct involvement. Among them, 32 patients with evaluable specimens were further categorized pathologically into Type 1 (n\u2009=\u200910) and Type 2 (n\u2009=\u200922). Patient characteristics and postoperative outcomes were analyzed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Intraepithelial neoplasia was more frequently observed in the branched type, whereas invasive carcinoma predominated in the main duct type. In the mixed type, a half of patients involved both intra- and extrahepatic bile ducts, and this type also showed the highest incidence of residual tumor. The mixed type had the poorest 5-year postoperative survival rate (50%), compared to 90% in the main duct type and 100% in the branched type. It also exhibited the highest 5-year recurrence rate (62%). Among IPNB patients with associated invasive carcinoma, tumor infiltration beyond the bile duct wall (p\u2009&lt;\u20090.001) and lymph node metastasis (p\u2009=\u20090.021) were significantly associated with poor prognosis, whereas the anatomical extent of the lesion (intrahepatic, extrahepatic, or both) was not. Morphological classification was significantly correlated with pathological subtypes: the branched type was predominant in Type 1 (60%), while the main duct type predominated in Type 2 (64%) (p\u2009=\u20090.039).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our novel morphological classification of IPNB correlates with postoperative prognosis and may assist in preoperative planning of surgical strategies for IPNB patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0325081","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T17:29:18Z","timestamp":1748453358000},"page":"e0325081","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["A recent update on the morphological classification of intraductal papillary neoplasm of the bile duct: Correlation with postoperative prognosis and pathological features"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1980-9224","authenticated-orcid":true,"given":"Daisuke","family":"Noguchi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-0500","authenticated-orcid":true,"given":"Naohisa","family":"Kuriyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Kozuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruna","family":"Komatubara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1876-3052","authenticated-orcid":true,"given":"Takahiro","family":"Ito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aoi","family":"Hayasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Iizawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiro","family":"Fujii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Tanemura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Murata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Kishiwada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2253-544X","authenticated-orcid":true,"given":"Shugo","family":"Mizuno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"pone.0325081.ref001","article-title":"Tumors of the gallbladder and extrahepatic bile ducts.","volume-title":"WHO classification of Tumors editorial board. 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