General and Digestive Surgery, 12857Kanazawa Medical University, Kahoku, Ishikawa, Japan.
Gastroenterologic Surgery, 12858Kanazawa University, Kanazawa, Ishikawa, Japan.
Technol Cancer Res Treat. 2020 Jan-Dec;19:1533033820948141. doi: 10.1177/1533033820948141.
Although cholangiolocellular carcinoma is considered a combined hepatocellular and cholangiocarcinoma, we feel that this classification is not appropriate. Therefore, we compared the diagnostic imaging findings, surgical prognosis, and pathological features of cholangiolocellular carcinoma with those of other combined hepatocellular and cholangiocarcinoma subtypes, hepatocellular carcinoma, and cholangiocarcinoma.
The study patients included 7 with classical type combined hepatocellular and cholangiocarcinoma; 8 with stem cell feature, intermediate type combined hepatocellular and cholangiocarcinoma; 13 with cholangiolocellular carcinoma; 58 with cholangiocarcinoma; and 359 with hepatocellular carcinoma. All patients underwent hepatectomy or living-related donor liver transplantation from 2001 to 2014.
cholangiolocellular carcinoma could be distinguished from hepatocellular carcinom, other combined hepatocellular and cholangiocarcinoma subtypes, and cholangiocarcinoma by the presence of intratumoral Glisson's pedicle, hepatic vein penetration, and tumor-staining pattern on angiography-assisted CT. Cholangiolocellular carcinoma was associated with a significantly lower SUV-max than that of cholangiocarcinoma on FDG-PET. Hepatocellular carcinoma, classical type, and cholangiolocellular carcinoma had significantly better prognoses than stem cell feature, intermediate type and cholangiocarcinoma. A cholangiocarcinoma component was detected in cholangiolocellular carcinoma that progressed to the hepatic hilum, and the cholangiocarcinoma component was found in perineural invasion and lymph node metastases.
From the viewpoint of surgeon, cholangiolocellular carcinoma should be classified as a good-prognosis subtype of biliary tract carcinoma because of its tendency to differentiate into cholangiocarcinoma during its progression, and its distinctive imaging and few recurrence rates different from other combined hepatocellular and cholangiocarcinoma subtypes.
尽管胆毛细胆管细胞癌被认为是一种混合性肝细胞癌和胆管癌，但我们认为这种分类并不合适。因此，我们比较了胆毛细胆管细胞癌与其他混合性肝细胞癌和胆管癌亚型、肝细胞癌和胆管癌的诊断影像学表现、手术预后和病理特征。
本研究患者包括 7 例经典型混合性肝细胞癌和胆管癌；8 例干细胞特征、中间型混合性肝细胞癌和胆管癌；13 例胆毛细胆管细胞癌；58 例胆管癌；359 例肝细胞癌。所有患者均于 2001 年至 2014 年间接受了肝切除术或活体供肝移植。
胆毛细胆管细胞癌可通过肿瘤内 Glisson 蒂、肝静脉浸润和血管造影辅助 CT 上的肿瘤染色模式与肝细胞癌、其他混合性肝细胞癌和胆管癌亚型以及胆管癌相区别。在 FDG-PET 上，胆毛细胆管细胞癌的 SUV-max 明显低于胆管癌。肝细胞癌、经典型和胆毛细胆管细胞癌的预后明显优于干细胞特征、中间型和胆管癌。在进展至肝门部的胆毛细胆管细胞癌中检测到胆管癌成分，并且在神经周围侵犯和淋巴结转移中发现胆管癌成分。
从外科医生的角度来看，由于胆毛细胆管细胞癌在进展过程中倾向于分化为胆管癌，并且其影像学特征和复发率与其他混合性肝细胞癌和胆管癌亚型不同，因此应将其归类为预后良好的胆道癌亚型。
