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肝移植患者中偶然发现的肝细胞-胆管细胞癌合并症:其预后是否更差?

Incidental combined hepatocellular-cholangiocarcinoma in liver transplant patients: Does it have a worse prognosis?

作者信息

Anilir Ender, Oral Alihan, Sahin Tolga, Turker Fatih, Yuzer Yildiray, Tokat Yaman

机构信息

Istanbul Aydin University, Medikalpark Florya Hospital, Organ Transplantation Center, Istanbul, Turkiye.

Biruni University Faculty of Medicine, Internal Medicine Center, Istanbul, Turkiye.

出版信息

Hepatol Forum. 2023 Sep 20;4(3):97-102. doi: 10.14744/hf.2022.2022.0037. eCollection 2023.

DOI:10.14744/hf.2022.2022.0037
PMID:37822306
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10564256/
Abstract

BACKGROUND AND AIM

Combined hepatocellular-cholangiocarcinoma (CHC) requires attention clinically and pathologically after liver transplantation (LT) because of its unique biology, difficulties in diagnosis, and being rare. We aimed to present our single-center experience for this incidental combined tumor. It is aimed to present our single-center experience for this incidental combined tumor.

MATERIALS AND METHODS

Seventeen patients with CHC were included in the study. There were 260 hepatocellular carcinoma (HCC) patients determined as the control group. Patients were evaluated for demographic, etiological, pathological features, and survival.

RESULTS

Macrovascular and microvascular invasion levels were significantly higher in the CHC group (p<0.05). P53, CK19, and CK7 levels were significantly higher in the CHC group (p<0.05). Hepatocyte-specific antigen level was significantly higher in the HCC group. The mean overall survival was significantly higher in the HCC group (p<0.05).

CONCLUSION

Even though CHC is a rare liver tumor, it has features that need to be clarified regarding both survival and tumor biology. İnvestigating prognostic factors, especially in terms of survival and recurrence, will be very beneficial to identify candidates who will benefit from LT and be included in the indications for LT for CHC. This study evaluated the outcomes of patients showing combined HCC-intrahepatic cholangiocarcinoma in explant pathology.

摘要

背景与目的

肝移植(LT)后,肝细胞胆管癌(CHC)因其独特的生物学特性、诊断困难及罕见性,在临床和病理方面都需要引起关注。我们旨在介绍我们单中心对于这种偶然发现的联合肿瘤的经验。目的是展现我们单中心对于这种偶然发现的联合肿瘤的经验。

材料与方法

本研究纳入了17例CHC患者。确定260例肝细胞癌(HCC)患者作为对照组。对患者进行人口统计学、病因学、病理特征及生存情况评估。

结果

CHC组的大血管和微血管侵犯水平显著更高(p<0.05)。CHC组的P53、CK19和CK7水平显著更高(p<0.05)。HCC组的肝细胞特异性抗原水平显著更高。HCC组的平均总生存期显著更长(p<0.05)。

结论

尽管CHC是一种罕见的肝脏肿瘤,但在生存和肿瘤生物学方面都有需要阐明的特征。研究预后因素,尤其是在生存和复发方面,对于确定能从LT中获益并被纳入CHC的LT适应证的患者非常有益。本研究评估了在外植病理中显示为HCC合并肝内胆管癌患者的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/316c/10564256/8ec61399903a/hf-4-097-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/316c/10564256/8ec61399903a/hf-4-097-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/316c/10564256/8ec61399903a/hf-4-097-g001.jpg

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Jpn J Radiol. 2020 Aug;38(8):697-718. doi: 10.1007/s11604-020-00961-1. Epub 2020 Apr 3.
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Liver Transplantation for Cholangiocarcinoma and Mixed Hepatocellular Cholangiocarcinoma: Working Group Report From the ILTS Transplant Oncology Consensus Conference.肝移植治疗胆管细胞癌和混合型肝细胞胆管细胞癌:ILTS 移植肿瘤学共识会议工作组报告。
Transplantation. 2020 Jun;104(6):1125-1130. doi: 10.1097/TP.0000000000003212.
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A Review on the Update of Combined Hepatocellular Cholangiocarcinoma.
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Medicine (Baltimore). 2019 Sep;98(38):e17102. doi: 10.1097/MD.0000000000017102.
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Competing risk analyses of overall survival and cancer-specific survival in patients with combined hepatocellular cholangiocarcinoma after surgery.手术治疗后合并肝细胞癌-胆管细胞癌患者的总生存和癌症特异性生存的竞争风险分析。
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