Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
Pathol Int. 2011 May;61(5):298-305. doi: 10.1111/j.1440-1827.2011.02665.x.
Intrahepatic cholangiocarcinoma (ICC) is reported to develop in non-biliary chronic advanced liver diseases (CALD). Herein, we characterize the pathological features of ICC arising in CALD in comparison with those in non-CALD livers. Of 471 surgically resected cases of ICC in Kanazawa, Japan and Seoul, Korea, 53 were associated with CALD (group A), while the remaining 418 arose in otherwise normal livers (group B). When ICC were classified into bile duct type, bile ductular type, variants, and intraductal papillary neoplasm of the bile duct (IPNB), the whole spectrum of subtypes were found in group A; the majority of ICC belonged to the bile duct type in both groups. In group A, bile ductular type was rather frequent (22.6%) compared with group B (8.4%). IPNB was more frequent in group B (22.5%) than group A (3.8%), and in group B, frequent in Seoul cases (24.8%), but rare in Kanazawa cases (2.3%). Variants of ICC were rare in both groups. These results imply that cholangiocarcinogenesis itself is upregulated in group A in comparison with group B and that the bile ductular type is specifically related to group A. Some unique environmental factors in Seoul may be responsible for the frequent development of IPNB.
肝内胆管癌 (ICC) 据报道发生于非胆源性慢性进展性肝病 (CALD)。在此，我们比较了 CALD 相关 ICC 与非 CALD 肝脏 ICC 的病理特征。在日本金泽和韩国首尔的 471 例 ICC 手术切除病例中，53 例与 CALD 相关 (A 组)，而其余 418 例发生于正常肝脏 (B 组)。当 ICC 被分为胆管型、胆管细胞型、变异型和胆管内乳头状肿瘤 (IPNB) 时，A 组中发现了整个亚型谱；两组中大多数 ICC 均属于胆管型。在 A 组中，胆管细胞型相对常见 (22.6%)，而 B 组则相对较少 (8.4%)。B 组的 IPNB 更为常见 (22.5%)，而 A 组则相对较少 (3.8%)，B 组中首尔病例更为常见 (24.8%)，而金泽病例则相对较少 (2.3%)。ICC 的变异型在两组中均较为罕见。这些结果表明，与 B 组相比，A 组中胆管癌发生本身被上调，并且胆管细胞型与 A 组特别相关。首尔的一些独特环境因素可能导致 IPNB 的频繁发生。
