Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2011 Sep;52(5):753-60. doi: 10.3349/ymj.2011.52.5.753.
Combined hepatocellular-cholangiocarcinoma (CHCC) is an uncommon form of cancer, and its clinicopathological features have rarely been reported in detail. This study was undertaken to evaluate the clinicopathological characteristics and prognostic factors of CHCC.
The clinicopathological features of patients diagnosed with CHCC at Severance Hospital between January 1996 and December 2007 were retrospectively studied by comparing them with the features of patients with hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) who had undergone a hepatic resection during the same period.
Forty-three patients diagnosed with CHCC were included in this study (M : F=35 : 8, median age, 55 years). According to the parameters of the American Joint Committee on Cancer staging, there were 6 (14.0%), 9 (20.9%), 25 (58.1%), and 3 (7.0%) patients with stages I, II, III, and IV cancer, respectively. Thirty-two of the 43 patients underwent resection with curative intent. After resection, 27 patients (84.4%) had tumor recurrence during the follow-up period of 18 months (range: 6-106 months), and the median time to recurrence was 13 months. Overall median survival periods after hepatic resection of CHCC, HCC and CC were 34, 103 and 38.9 months, respectively (p<0.001). The median overall survival for all patients with CHCC was 21 months, and the 5-year survival rate was 18.1%. The presence of portal vein thrombosis and distant metastasis were independent prognostic factors of poor survival.
Even after curative hepatic resection, the presence of a cholangiocellular component appeared to be a poor prognostic indicator in patients with primary liver cancer.
肝细胞-胆管细胞癌（CHCC）是一种罕见的癌症形式，其临床病理特征鲜有详细报道。本研究旨在评估 CHCC 的临床病理特征和预后因素。
通过比较 1996 年 1 月至 2007 年 12 月期间在 Severance 医院接受肝切除术的肝细胞癌（HCC）或胆管细胞癌（CC）患者的特征，回顾性研究在同一时期被诊断为 CHCC 的患者的临床病理特征。
本研究纳入了 43 例 CHCC 患者（男：女=35：8，中位年龄 55 岁）。根据美国癌症联合委员会分期参数，分别有 6（14.0%）、9（20.9%）、25（58.1%）和 3（7.0%）例患者处于 I、II、III 和 IV 期癌症。43 例患者中的 32 例接受了根治性切除术。根治性切除后，27 例（84.4%）患者在 18 个月的随访期间（范围：6-106 个月）发生肿瘤复发，中位复发时间为 13 个月。CHCC、HCC 和 CC 患者肝切除术后的总中位生存时间分别为 34、103 和 38.9 个月（p<0.001）。所有 CHCC 患者的总中位生存时间为 21 个月，5 年生存率为 18.1%。门静脉血栓形成和远处转移的存在是生存不良的独立预后因素。
即使进行了根治性肝切除术，原发性肝癌中存在胆管细胞成分似乎也是预后不良的指标。
