Department of Pathology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Department of Pathology and Institute of Oncology, The School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian, China.
Expert Rev Mol Diagn. 2023 May;23(5):445-456. doi: 10.1080/14737159.2023.2205588. Epub 2023 Apr 23.
Intrahepatic cholangiocarcinoma (ICC) can be divided into two morphological subtypes: large duct type and small duct type ICC. This study aims to verify the feasibility of the classification criteria and clinicopathological characteristics of ICC.
ICC patients were divided into the large and small type ICC by morphological and immunohistochemical patterns. Subsequently, clinicopathological data of the two groups was compared and the multivariate COX regression was used to verify the clinical significance of ICC subtypes. In addition, IDH1/2 mutation, KRAS mutation and FGFR2 translocation was also evaluated.
Totally, 32, 61 and 13 tumors were defined as large, small and the indeterminate-duct type ICC respectively. Clinicopathologically, the large and small duct type ICC showed distinct morphological features. Compared with the small duct type ICC, the large duct type ICC had higher levels of serum tumor markers, vascular invasion, lymph node metastasis, and postoperative recurrence. Furthermore, positive FGFR2 rearrangement occurred only in small duct type ICC and IDH1/2 was mutated mainly in small duct type ICC.
The subclassification system was applicable and the ICC subtypes had distinct clinicopathological characteristics, prognostic outcome, and IDH1/2 mutation pattern.
肝内胆管癌（ICC）可分为两种形态亚型：大导管型和小导管型 ICC。本研究旨在验证 ICC 的分类标准和临床病理特征的可行性。
通过形态学和免疫组织化学模式将 ICC 患者分为大、小 ICC 型。然后，比较两组的临床病理数据，并使用多变量 COX 回归验证 ICC 亚型的临床意义。此外，还评估了 IDH1/2 突变、KRAS 突变和 FGFR2 易位。
总共将 32、61 和 13 个肿瘤分别定义为大、小和不确定导管型 ICC。临床病理上，大、小胆管型 ICC 具有明显的形态学特征。与小胆管型 ICC 相比，大胆管型 ICC 的血清肿瘤标志物水平更高，血管侵犯、淋巴结转移和术后复发的发生率更高。此外，FGFR2 重排仅发生在小胆管型 ICC 中，IDH1/2 突变主要发生在小胆管型 ICC 中。
该分类系统适用，ICC 亚型具有明显的临床病理特征、预后和 IDH1/2 突变模式。
