Tanaka K, Honna T, Kitano Y, Kuroda T, Tanaka K, Morikawa N, Matsuda H, Kawashima N, Matsuoka K, Miyauchi J
Department of Surgery, National Centre for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.
J Clin Pathol. 2005 Aug;58(8):884-7. doi: 10.1136/jcp.2004.021956.
Fibrolamellar carcinoma (FLC), a variant of hepatocellular carcinoma (HCC), very rarely occurs in association with cholangiocarcinoma (CC). This report describes the first case of FLC coexisting with CC (FLC-CC) from Japan. Although the major part of the tumour located in the right lobe of the liver showed the typical features of FLC, CC was admixed with the FLC, not only in the primary hepatic tumour, but also in the lymph node metastases. Immunohistochemical analysis revealed that, although carcinoembryonic antigen (CEA), which can be detected with monoclonal antibodies in the cytoplasm and the cell surface of CC cells but not HCC cells, was expressed in only the CC cells in the primary tumour, it was expressed extensively in the cytoplasm of both CC and FLC cells in the metastatic and recurrent tumours. Furthermore, Hep Par 1, a hepatocyte specific antigen, was also expressed in both the FLC and CC cells. These findings suggest that, in this case, both FLC and CC were possibly derived from the same cancer stem cell with the capacity to differentiate into both hepatocytes and bile duct epithelium, and that both the cellular components, therefore, exhibited biphenotypic antigen expression.
纤维板层癌（FLC）是肝细胞癌（HCC）的一种变异型，极少与胆管癌（CC）同时发生。本报告描述了日本首例FLC与CC并存（FLC-CC）的病例。尽管位于肝右叶的肿瘤主要部分表现出FLC的典型特征，但CC不仅在原发性肝肿瘤中，而且在淋巴结转移灶中都与FLC混合存在。免疫组化分析显示，癌胚抗原（CEA）可在CC细胞的细胞质和细胞表面用单克隆抗体检测到，但在HCC细胞中检测不到，虽然它仅在原发性肿瘤的CC细胞中表达，但在转移性和复发性肿瘤的CC和FLC细胞的细胞质中均广泛表达。此外，肝细胞特异性抗原Hep Par 1在FLC和CC细胞中也均有表达。这些发现表明，在该病例中，FLC和CC可能均源自同一个具有分化为肝细胞和胆管上皮细胞能力的癌干细胞，因此两种细胞成分均表现出双表型抗原表达。
