Division of General Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
J Gastroenterol Hepatol. 2013 Jan;28(1):122-7. doi: 10.1111/j.1440-1746.2012.07289.x.
Combined hepatocellular-cholangiocarcinoma (CHC) is a rare liver malignancy. In this study, we compared patient characteristics and outcomes for primary CHC, intrahepatic cholangiocarcinoma (ICC), and hepatocellular carcinoma (HCC).
Medical records of patients with tissue-proven CHC (65 cases) treated at the Chang Gung Memorial Hospital between 1991 and 2005 were retrospectively reviewed. These records were compared to records of patients diagnosed with tissue-proven HCC (1985 cases) and ICC (127 cases) during the same period.
Hepatitis B and C are major causes of CHC. CHC patients exhibited greater similarity to HCC than to ICC patients with respect to cirrhotic changes, age, and positive serology for hepatitis B surface antigen and anti-hepatitis C antibody. Survival was related to tumor characteristics and intervention therapies, but not to etiologies.
The clinical characteristics of CHC are similar to those of HCC, but overall survival is more similar to that of ICC; survival may be related to tumor biology rather than the cause. Multimodal treatment with an initial aggressive therapeutic approach can improve survival.
混合型肝细胞肝癌（CHC）是一种罕见的肝脏恶性肿瘤。本研究旨在比较原发性 CHC、肝内胆管细胞癌（ICC）和肝细胞癌（HCC）患者的特征和结局。
回顾性分析 1991 年至 2005 年间在长庚纪念医院经组织学证实的 CHC（65 例）患者的病历资料，并与同期经组织学证实的 HCC（1985 例）和 ICC（127 例）患者的病历资料进行比较。
乙型肝炎和丙型肝炎是 CHC 的主要病因。CHC 患者与 HCC 患者在肝硬化改变、年龄、乙型肝炎表面抗原和丙型肝炎抗体阳性率方面具有更高的相似性，而与 ICC 患者的相似性较低。生存与肿瘤特征和干预治疗有关，与病因无关。
CHC 的临床特征与 HCC 相似，但总体生存率更类似于 ICC；生存可能与肿瘤生物学有关，而与病因无关。初始积极治疗的多模式治疗可改善生存。
