Ariizumi Shun-Ichi, Kotera Yoshihito, Katagiri Satoshi, Nakano Masayuki, Nakanuma Yasuni, Saito Akiko, Yamamoto Masakazu
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Kawada 8-1, Shinjuku-ku, Tokyo, 162-8666, Japan.
Ann Surg Oncol. 2014 Jun;21 Suppl 3(Suppl 3):S451-8. doi: 10.1245/s10434-014-3582-0. Epub 2014 Mar 17.
Cholangiolocellular carcinoma (CoCC) has distinct pathological characteristics, and CoCC is considered to originate from hepatic progenitor or stem cells. However, the surgical outcome of CoCC has not been clarified in detail.
We retrospectively studied 275 patients with intrahepatic cholangiocarcinoma (ICC) who underwent hepatectomy between 1990 and 2011. Surgical outcomes were compared between 29 patients with CoCC and 130 patients with mass-forming (MF) type ICC since all patients with CoCC showed MF type on macroscopic findings.
The number of patients with chronic liver disease was significantly higher in the CoCC group than in the ICC group. The number of patients with abnormal levels of CA19-9 was significantly lower in the CoCC group than in the ICC group. Portal vein invasion and intrahepatic metastasis were significantly lower in patients with CoCC group than in the ICC group. In the CoCC group, 15 of 28 patients survived for more than 5 years after curative surgery whereas 15 of 102 patients with ICC survived for more than 5 years after curative surgery. The 5-year survival rate was significantly higher in patients with CoCC (75 %) than in patients with ICC (33 %, p = 0.0005). Multivariate analysis showed CoCC, absence of portal vein invasion or hepatic vein invasion, and absence of intrahepatic metastasis to be significant independent prognostic factors for overall survival in patients with MF-type ICC and CoCC.
CoCC is rare, but patients with CoCC had special characteristics with favorable long-term survival due to its less invasive histopathologic characteristics.
胆管细胞癌（CoCC）具有独特的病理特征，被认为起源于肝祖细胞或干细胞。然而，CoCC的手术结果尚未得到详细阐明。
我们回顾性研究了1990年至2011年间接受肝切除术的275例肝内胆管癌（ICC）患者。由于所有CoCC患者在宏观检查中均表现为肿块形成（MF）型，因此对29例CoCC患者和130例MF型ICC患者的手术结果进行了比较。
CoCC组慢性肝病患者数量显著高于ICC组。CoCC组CA19-9水平异常的患者数量显著低于ICC组。CoCC组患者的门静脉侵犯和肝内转移显著低于ICC组。在CoCC组中，28例患者中有15例在根治性手术后存活超过5年，而102例ICC患者中有15例在根治性手术后存活超过5年。CoCC患者的5年生存率（75%）显著高于ICC患者（33%，p = 0.0005）。多变量分析显示，CoCC、无门静脉侵犯或肝静脉侵犯以及无肝内转移是MF型ICC和CoCC患者总生存的重要独立预后因素。
CoCC罕见，但由于其侵袭性较小的组织病理学特征，CoCC患者具有特殊特征，长期生存率良好。
