Chen Jun, He Jian, Deng Min, Wu Hong-Yan, Shi Jiong, Mao Liang, Sun Qi, Tang Min, Fan Xiang-Shan, Qiu Yu-Dong, Huang Qin
Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu Province, China.
Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu Province, China.
Hum Pathol. 2017 Jun;64:118-127. doi: 10.1016/j.humpath.2017.01.016. Epub 2017 Apr 18.
Cholangiolocellular carcinoma is a type of intrahepatic cholangiocarcinoma (ICC). According to the 2010 World Health Organization classification, this carcinoma is a combined hepatocellular-cholangiocarcinoma with stem cell features, cholangiolocellular type (CHC-SC-CLC). The aim of this study was to compare the clinicopathological characteristics of CHC-SC-CLC and conventional ICC. Based on the gross and histologic characteristics, we divided consecutive ICC tumors into CHC-SC-CLC (n = 23), mass-forming (MF; n = 57), and non-MF (n = 22) groups. Compared with MF and non-MF groups, the CHC-SC-CLC group featured history of hepatolithiasis or bile duct operation in significantly fewer patients (4.3% versus 14.8% and 86.4%, respectively; P < .001) and was more common in the right lobe (70% versus 47% and 27%; P = .033) but lower frequency of invasive growth or peritumoral Glisson sheath invasion (61% and 22% versus 77% and 33% and 100% and 86%, respectively; P = .002 and P < .001) and absence of mucous production (0 versus 77% and 96%; P < .001). In CHC-SC-CLCs, the mutation rate of isocitrate dehydrogenase 1 (IDH1) or IDH2 was significantly higher (35%) than in MF (4%) or non-MF (0) ICCs (P < .001). The 1-, 3-, and 5-year postresection survival rates were also significantly better with CHC-SC-CLCs (93%, 79%, and 52%, respectively) than with MF (72%, 46%, and 40%) or non-MF (61%, 18%, and 0) ICCs (P = .041). Thus, CHC-SC-CLC tumors demonstrated an indolent growth pattern, more frequent IDH1/2 gene mutations, and better prognosis than did MF or non-MF ICC tumors.
细胆管细胞癌是肝内胆管癌（ICC）的一种类型。根据2010年世界卫生组织分类，这种癌是一种具有干细胞特征的肝细胞-胆管癌，细胆管细胞型（CHC-SC-CLC）。本研究的目的是比较CHC-SC-CLC与传统ICC的临床病理特征。基于大体和组织学特征，我们将连续的ICC肿瘤分为CHC-SC-CLC组（n = 23）、肿块形成型（MF；n = 57）和非肿块形成型（n = 22）组。与MF组和非MF组相比，CHC-SC-CLC组有肝内胆管结石或胆管手术史的患者明显较少（分别为4.3%、14.8%和86.4%；P <.001），在右叶更常见（分别为70%、47%和27%；P =.033），但侵袭性生长或肿瘤周围Glisson鞘侵犯的频率较低（分别为61%和22%、77%和33%、100%和86%；P =.002和P <.001），且无黏液产生（分别为0、77%和96%；P <.001）。在CHC-SC-CLC中，异柠檬酸脱氢酶1（IDH1）或IDH2的突变率显著高于MF（4%）或非MF（0）的ICC（35%；P <.001）。CHC-SC-CLC切除术后1年、3年和5年生存率也明显优于MF（分别为72%、46%和40%）或非MF（分别为61%、18%和0）的ICC（93%、79%和52%；P =.041）。因此，与MF或非MF的ICC肿瘤相比，CHC-SC-CLC肿瘤表现出生长缓慢的模式、更频繁的IDH1/2基因突变以及更好的预后。
