General Surgical Department, Ruijin Hospital Affiliated to Shanghai Jiaotong University, 197 Ruijin Er Road, Shanghai 200025, China.
J Hepatobiliary Pancreat Sci. 2012 Jul;19(4):361-9. doi: 10.1007/s00534-011-0417-2.
Our purpose was to assess the clinicopathological features and surgical outcomes of combined hepatocellular-cholangiocarcinoma (HCC-CC) in an Asian center.
Between 1998 and 2009, 27 patients were diagnosed with combined HCC-CC at our hospital. Their medical records were reviewed and clinicopathological data retrospectively analyzed.
The 27 patients included 24 (88.9%) males and 3 (11.1%) females with a mean age of 58.26 ± 11.18 years. Cirrhosis was present in 10 patients (37.0%), and 12 patients had hepatitis C or hepatitis B virus infection. Serum alpha fetoprotein was >20 ng/ml in 7 of the 19 patients in whom it was measured (36.8%). Twenty-five patients underwent hepatic resections and 2 received liver transplantations. Five (18.5%) patients had separate HCC and CC within the same liver (type I), 21 (77.8%) had tumors with mixed components (type II), and 1 patient had a type III tumor (3.7%). Of 22 patients with immunohistochemical data, 19 (86.4%) were cytokeratin (CK) 7-positive, 20 (90.9%) were CK19-positive, and 4 (18.2%) were CK20-positive. Mean follow-up was 25.8 months. The 1- and 2-year survival rates were 72.5 and 49.4%, respectively. The 1- and 2-year disease-free survival rates were 54.2 and 41.3%, respectively. Symptoms at the time of diagnosis, and regional lymph node metastases, were associated with higher mortality and recurrence.
Lymph node metastasis and positive resection margins are important factors affecting HCC-CC surgical outcomes.
本研究旨在评估亚洲中心的肝细胞癌-胆管细胞癌（HCC-CC）的临床病理特征和手术结果。
1998 年至 2009 年间，我院共诊断 27 例 HCC-CC 患者。回顾性分析其病历资料及临床病理数据。
27 例患者中，男 24 例（88.9%），女 3 例（11.1%），平均年龄 58.26 ± 11.18 岁。10 例（37.0%）患者存在肝硬化，12 例患者有丙型或乙型肝炎病毒感染。19 例患者中有 7 例（36.8%）检测到血清甲胎蛋白＞20ng/ml。25 例行肝切除术，2 例行肝移植术。5 例（18.5%）患者同一肝脏内存在单独 HCC 和 CC（I 型），21 例（77.8%）患者肿瘤为混合成分（II 型），1 例患者为 III 型肿瘤（3.7%）。22 例患者免疫组化结果显示，19 例（86.4%）CK7 阳性，20 例（90.9%）CK19 阳性，4 例（18.2%）CK20 阳性。中位随访时间为 25.8 个月。1 年和 2 年生存率分别为 72.5%和 49.4%，1 年和 2 年无病生存率分别为 54.2%和 41.3%。诊断时的症状和区域淋巴结转移与较高的死亡率和复发率相关。
淋巴结转移和阳性切缘是影响 HCC-CC 手术结果的重要因素。
