Zhang Yu-Zhu, Liu Yu-Chen, Su Tong, Shi Jiang-Nan, Huang Yi, Liang Bo
Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang, Jiangxi, P. R. China.
The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang, Jiangxi, P. R. China.
Gastroenterol Rep (Oxf). 2024 Apr 15;12:goae031. doi: 10.1093/gastro/goae031. eCollection 2024.
The low incidence of combined hepatocellular cholangiocarcinoma (cHCC-CCA) is an important factor limiting research progression. Our study extensively included nearly three decades of relevant literature and assembled the most comprehensive database comprising 5,742 patients with cHCC-CCA. We summarized the characteristics, tumor markers, and clinical features of these patients. Additionally, we present the evolution of cHCC-CCA classification and explain the underlying rationale for these classification standards. We reviewed cHCC-CCA diagnostic advances using imaging features, tumor markers, and postoperative pathology, as well as treatment options such as surgical, adjuvant, and immune-targeted therapies. In addition, recent advances in more effective chemotherapeutic regimens and immune-targeted therapies were explored. Furthermore, we described the molecular mutation features and potential specific markers of cHCC-CCA. The prognostic value of Nestin has been proven, and we speculate that Nestin will also play a role in classification and diagnosis. However, further research is needed. Moreover, we believe that the possibility of using machine learning liquid biopsy for preoperative diagnosis and establishing a scoring system are directions for future research.
肝内胆管癌合并肝细胞癌（cHCC-CCA）的低发病率是限制研究进展的一个重要因素。我们的研究广泛纳入了近三十年的相关文献，并汇集了包含5742例cHCC-CCA患者的最全面数据库。我们总结了这些患者的特征、肿瘤标志物和临床特征。此外，我们展示了cHCC-CCA分类的演变，并解释了这些分类标准的基本原理。我们回顾了利用影像学特征、肿瘤标志物和术后病理进行的cHCC-CCA诊断进展，以及手术、辅助和免疫靶向治疗等治疗选择。此外，还探讨了更有效的化疗方案和免疫靶向治疗的最新进展。此外，我们描述了cHCC-CCA的分子突变特征和潜在的特异性标志物。巢蛋白（Nestin）的预后价值已得到证实，我们推测巢蛋白也将在分类和诊断中发挥作用。然而，还需要进一步研究。此外，我们认为使用机器学习液体活检进行术前诊断并建立评分系统的可能性是未来研究的方向。
