Ahn Keun Soo, Kang Koo Jeong
Department of Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, South Korea.
World J Hepatol. 2020 Dec 27;12(12):1148-1157. doi: 10.4254/wjh.v12.i12.1148.
Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous primary liver cancer, and currently there exist only a few options of targeted therapy. Histopathologically, iCCA is sub-classified according to morphology (mass forming type, periductal infiltrating type, and intraductal growing type) and histology (small duct type and large duct type). According to different histopathological types, clinical features such as risk factors and prognosis vary. Recent developments in genomic profiling have revealed several molecular markers for poor prognosis and activation of oncogenic pathways. Exploration of molecular characteristics of iCCA in each patient is a major challenge in a clinical setting, and there is no effective molecular-based targeted therapy. However, several recent studies suggested molecular-based subtypes with corresponding clinical and pathological features. Even though the subtypes have not yet been validated, it is possible that molecular features can be predicted based on clinicopathological characteristics and that this could be used for a more rational approach to integrative clinical and molecular subclassification and targeted therapy. In this review, we explored the genomic landscape of iCCA and attempted to find relevance between clinicopathologic and molecular features in molecular subtypes in several published studies. The results reveal future directions that may lead to a rational approach to the targeted therapy.
肝内胆管癌（iCCA）是一种异质性原发性肝癌，目前靶向治疗选择有限。在组织病理学上，iCCA根据形态学（肿块形成型、导管周围浸润型和导管内生长型）和组织学（小导管型和大导管型）进行亚分类。根据不同的组织病理学类型，危险因素和预后等临床特征各不相同。基因组分析的最新进展揭示了几种预后不良和致癌途径激活的分子标志物。在临床环境中，探索每位iCCA患者的分子特征是一项重大挑战，并且尚无有效的基于分子的靶向治疗方法。然而，最近的几项研究提出了具有相应临床和病理特征的分子亚型。尽管这些亚型尚未得到验证，但基于临床病理特征预测分子特征并将其用于更合理的综合临床和分子亚分类及靶向治疗方法是有可能的。在本综述中，我们探讨了iCCA的基因组格局，并试图在几项已发表的研究中找出分子亚型的临床病理特征与分子特征之间的相关性。结果揭示了可能通向合理靶向治疗方法的未来方向。
