Department of Surgery, Tokushima University, Tokushima, 770-8503, Japan.
Department of Pathology and Laboratory Medicine, Tokushima University, Tokushima, 770-8503, Japan.
World J Surg Oncol. 2021 May 7;19(1):142. doi: 10.1186/s12957-021-02216-3.
No universal classification method for intrahepatic cholangiocarcinoma (IHCC) has been reported based on the embryological origin of biliary epithelial cells. The aim of this study was to classify IHCC according to protein expression levels of somatostatin receptor 2 (SSTR2) and b-cell leukemia/lymphoma 2 (Bcl2) and to elucidate the clinicopathological features of each group.
Fifty-two IHCC patients who underwent hepatic resection were enrolled in this study. Protein expression levels of SSTR2 and Bcl2 were examined using immunohistochemistry. Clinicopathological factors were compared between the three groups and prognostic factors were investigated.
The patients were divided into three groups: SSTR2 positive and Bcl2 negative (p-Group H, n = 21), SSTR2 negative and Bcl2 positive (p-Group P, n = 14), and the indeterminate group (p-Group U, n = 17) for cases where SSTR2 and Bcl2 were both positive or both negative. All p-Group P cases displayed curability A or B. The 5-year survival rates of p-Group H and U patients were worse than those in p-Group P. p-Group H had higher T-factor, clinical stage, and incidence of periductal infiltration than p-Group P.
This method could be used to classify IHCC into peripheral and perihilar type by embryological expression patterns of SSTR2 and Bcl2.
目前尚无基于胆管上皮细胞胚胎起源的肝内胆管癌（IHCC）通用分类方法。本研究旨在根据生长抑素受体 2（SSTR2）和 B 细胞白血病/淋巴瘤 2（Bcl2）的蛋白表达水平对 IHCC 进行分类，并阐明各分组的临床病理特征。
本研究纳入了 52 例行肝切除术的 IHCC 患者。采用免疫组织化学法检测 SSTR2 和 Bcl2 的蛋白表达水平。比较三组间的临床病理因素，并探讨预后因素。
患者被分为三组：SSTR2 阳性和 Bcl2 阴性（p-组 H，n = 21）、SSTR2 阴性和 Bcl2 阳性（p-组 P，n = 14）以及 SSTR2 和 Bcl2 均为阳性或均为阴性的不确定组（p-组 U，n = 17）。所有 p-组 P 病例均为可治愈 A 或 B 期。p-组 H 和 U 患者的 5 年生存率均差于 p-组 P。p-组 H 的 T 分期、临床分期和胆管周围浸润发生率均高于 p-组 P。
本方法可根据 SSTR2 和 Bcl2 的胚胎表达模式将 IHCC 分为周围型和肝门型。
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