ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 inflammation (71%) and no fibrosis in 29%. Fibrosis was staged as F1 22%, F2 12%, F3 10% or F4 27%. Conclusion: Central histopathology review according to WHO 2019 and TNM 2017 modifies histological grading and staging in about 1/2 and 1/4 of resected HCCs, respectively, with clinical implications. One third of HCCs are re-classified into new histo- logical subtypes, some with known molecular background, prog- nostic and/or predictive impact, important for patient management. PS-13-004 The site of metastatic lymph node has prognostic significance in pancreatic ductal adenocarcinoma S. Cagaptay*, A.A. Ağalar, C. Agalar, T. Egeli, M. Ozbilgin, T. Unek, T. Unek, Ö. Sağol *Dokuz Eylül University Faculty of Medicine, Turkey Background & objectives: Pancreatic ductal adenocarcinomas (PDAC) have poor survival rates and prognosis. Important prognostic parameters are; tumour size/stage, metastatic lymph nodes count and vascular invasion. In the current AJCC staging system, there is no rec- ommendation to specify metastatic regional lymph node localization. Methods: Metastatic sites of 82 patients with regional lymph node metastases out of 101 patients with PDAC who underwent pancreaticoduodenectomy were classified as peripancreatic, perigastric, hepatico-communis, hepatic pedicle and other regions. Each region’s number of metastatic lymph nodes was determined. The associations between the presence of metastases in each lymph node region and overall survival and disease-free survival were determined statistically. Results: Eighty cases (79.2%) had peripancreatic, 7 cases (6.9%) had perigastric, 6 cases (5.9%) had hepatico-communis, and 7 cases (6.9%) had hepatic pedicle lymph node metastasis. In survival analysis, the estimated overall and disease-free survival time were significantly shorter in patients with hepatic pedicle lymph node metastasis (35.5 vs 11.24 month; p= 0.001, 18.55 months/3.68 months; p <0.001, respectively). Although not sig- nificant, the estimated overall survival time was shorter in patients with hepaticocommunis lymph node metastasis (34.7 months/20.5 months; p= 0.32) Hepatic pedicle lymph node metastasis was an independent predic- tor of mortality (p=0.005) and recurrence (p=0.003) in multivari- ate analysis. Conclusion: The presence of hepatic pedicle lymph node metastasis is an independent poor prognostic factor for mortality and recurrence risk, according to our findings. Although not significant, patients with hepaticocommunis lymph node metastasis have 14-month shorter life expectancy than those without. With these findings, we conclude that the metastatic lymph node site may have an impact on the prognosis, and may be included in pathology reports. PS-13-005 Ground-glass change: think beyond chronic hepatitis B infection F. Pereira*, J. Gama, R. Oliveira, M.R. Silva, M.J. Andrade, M.A. Cipriano *Hospital Prof. Doutor Fernando Fonseca, Portugal Background & objectives: Ground-glass change (GGC) corresponds to hepatocytes with eosinophilic granular, glassy cytoplasm on light microscopy, induced by proliferated smooth endoplasmic reticulum. GGC has been classically associated with chronic hepatitis B (HBV) infection but can be induced by drugs. Methods: Analysed liver biopsies and surgical resections with GGC hepatocytes between January 2007 and December 2021, in “Centro Hospitalar e Universitário de Coimbra”. Sex, age, nature of the product and the GGC aetiology were collected. The quantity of GGC was divided into the following categories: mild (1-30%), moderate (30-70%) and severe (70-100%). Results: 79 patients with GG hepatocytes, 49 were male and 30 female. The average patient age was 39 years. Seventy of the sam- ples came from native livers (88.6%) and remaining 9 from allo- graft livers (11.4%). The main cause identified was HBV infec- tion (74.7%). The remainder were due to drug-induced liver injury (12.7%), hepatocellular carcinoma (2.5%), and autoimmune hepa- titis (2.5%). In 4 cases the exact aetiology could not be identified (5.1%), and 2 are still under investigation (2.5%). The GGC ranged from mild (48.1%), moderate (34.2 %) to severe (17.7%). Mild GGC was more frequent in non-viral aetiologies and moderate/ severe was more frequent in HBV infection, but without statistical significance (p=0.324). Conclusion: GGC mimicking the appearance of HBV infection may be seen in other conditions and are the result of cytoplasmic accumulation of glycogen, fibrinogen or cellular organelles. GGC are distinguished from HBV infection based on clinical information as well as lack of immunopositivity for hepatitis B surface antigen. Despite not statistically significant in our study, mild GGC should arise suspicion for non-HBV related causes. PS-13-006 The influence of pancreatic regression characteristics on out- come of neoadjuvant treated pancreatic cancer in two Austrian university centres B. Neumayer*, D. Neureiter, E. Klieser, F. Huemer, L. Weiss, R. Greil, A. Djanani, G. Oberhuber, K. Schlick *Institute of Pathology, Paracelsus Medical University/ Univer- sitätsklinik Salzburg SALK, Austria Background & objectives: Neoadjuvant treatment strategies for extended pancreatic cancer could improve the outcome of this dismal disease entity now and in the future. Our histopathological knowledge of pancreatic regression phenomena are thereby sparse. Methods: We investigated retrospectively the pathological regression grading of neoadjuvant treated pancreatic cancer of two university clinical centres of Austria using all known grading systems. Furthermore, extensive clinic-pathological data as well as different histomorphological and immunohistochemical (e.g. different markers of proliferation, tumour associated inflammation and chemoresistance) findings were collected and correlated to clinical and pathological endpoints. Results: Overall, 22 patients (female/male: 16 (72.7%)/ 6 (27.3%) with a mean age of 64.6±8.9 years) with pancreatic cancer were enrolled in this study until now. The pretreated pancreatic cancer revealed more low grading (G1-G2: n=16 (72.7%)) and more high T-stages (T3-T4: n=17 (77.3%) as well as more high regression grade (CAP 0-2: n=13 (59%) according the 4-tired CAP regres- sion grading system). Looking in detail, the statistical analysis indicated that some clinic-pathological, histomorphological and immunohistochemical parameters were statistically associated to endpoints (survival, recurrence, metastasis and regression grading) and could predict therapeutic response, overall. Conclusion: We demonstrated that the classical and deep inves- tigation of such neoadjuvant treated pancreatic cancer specimen could be helpfully for stratify the therapeutic success. In the future, the definitive predictive and prognostic role of the regression S135