Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Department of Diagnostic Pathology, Kyoto University Hospital, 54 Kawahara-cho Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
World J Surg Oncol. 2020 Dec 4;18(1):319. doi: 10.1186/s12957-020-02099-w.
Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a primary liver carcinoma with both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) components. We examined the clinicopathological characteristics and recurrence patterns of cHCC-CCA. Because of the rarity of cHCC-CCA, its etiology, clinicopathological features, and prognosis in comparison with other primary liver carcinoma remain unknown. Its recurrence pattern and sites in particular also need to be elucidated.
All patients who underwent hepatectomy for primary liver malignancies between 2005 and 2015 were retrospectively included in this study.
Eight hundred and ninety-four hepatectomies were performed. Nineteen cases of cHCC-CCA (2.1%) in 16 patients were enrolled. Three patients underwent re-hepatectomy. The background of hepatitis viruses and tumor marker patterns of cHCC-CCA were similar to those of HCC and dissimilar to those of intrahepatic CCA (iCCA). Biliary invasion was common in cHCC-CCA and iCCA. The 5-year overall survival values of the cHCC-CCA, HCC, and iCCA patients were 44.7%, 56.6%, and 38.5%, respectively. The 5-year recurrence-free survival values of the cHCC-CCA, HCC, and iCCA patients were 12.2%, 28.7%, and 32.9%, respectively. The liver was the most common recurrence site. Unlike HCC, however, the lymph node was the second-most common recurrence site in both cHCC-CCA and iCCA. Pathological samples of the recurrent lesions were obtained in six patients, and four had cHCC-CCA recurrence pathologically.
cHCC-CCA had a mixture of characteristics of HCC and iCCA. Many cases of cHCC-CCA remained cHCC-CCA pathologically even after recurrence.
混合型肝细胞癌-胆管细胞癌（cHCC-CCA）是一种原发性肝癌，具有肝细胞癌（HCC）和胆管细胞癌（CCA）两种成分。我们研究了 cHCC-CCA 的临床病理特征和复发模式。由于 cHCC-CCA 较为罕见，其病因、临床病理特征以及与其他原发性肝癌的预后尚不清楚。特别是其复发模式和部位也需要阐明。
回顾性纳入 2005 年至 2015 年间行肝切除术治疗的所有原发性肝癌患者。
共进行了 894 例肝切除术。纳入了 16 名患者中的 19 例 cHCC-CCA（2.1%）。3 名患者接受了再次肝切除术。cHCC-CCA 的肝炎病毒背景和肿瘤标志物模式与 HCC 相似，与肝内胆管癌（iCCA）不同。胆管侵犯在 cHCC-CCA 和 iCCA 中很常见。cHCC-CCA、HCC 和 iCCA 患者的 5 年总生存率分别为 44.7%、56.6%和 38.5%。cHCC-CCA、HCC 和 iCCA 患者的 5 年无复发生存率分别为 12.2%、28.7%和 32.9%。肝脏是最常见的复发部位。但与 HCC 不同，淋巴结是 cHCC-CCA 和 iCCA 患者的第二常见复发部位。6 名患者获得了复发病灶的病理样本，其中 4 例病理上为 cHCC-CCA 复发。
cHCC-CCA 具有 HCC 和 iCCA 的混合特征。许多 cHCC-CCA 病例即使在复发后仍保持 cHCC-CCA 的病理特征。
