Zhu Zhu, Yang Chun, Zeng Mengsu, Zhou Changwu
Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, People's Republic of China.
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
J Hepatocell Carcinoma. 2024 Dec 18;11:2483-2492. doi: 10.2147/JHC.S491243. eCollection 2024.
To investigate the differences of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) patients with a cholangiocarcinoma (CCA) component ≥ 30% or < 30% versus intrahepatic cholangiocarcinoma (iCCA) patients in recurrence-free survival (RFS) and overall survival (OS) prognoses.
Patients with cHCC-CCA and iCCA after surgery were recruited. All cHCC-CCA patients were divided into two subgroups (CCA components ≥ 30% and < 30%). Then, Kaplan-Meier survival analysis and Cox regression analysis were used to investigate and compare the differences of cHCC-CCAs with a CCA component ≥ 30% or < 30% versus iCCAs in RFS and OS prognoses, respectively. The differences of MRI features between cHCC-CCAs with a CCA component ≥ 30% and < 30% were also compared.
One hundred sixty-four cHCC-CCAs and 146 iCCAs were enrolled. Compared with iCCAs, cHCC-CCAs with a CCA component < 30% had better OS prognosis (HR: 2.888, p = 0.045). However, Cox regression analysis revealed that cHCC-CCAs with a CCA component ≥ 30% had poorer RFS (HR: 0.503, p < 0.001) and OS (HR: 0.58, p = 0.033) prognoses than iCCAs. In addition, rim APHE (OR = 0.286, p < 0.001), targetoid diffusion restriction (OR = 0.316, p = 0.019), corona enhancement (OR = 0.481, p = 0.033), delayed enhancement (OR = 0.251, p = 0.001), and LR-M (OR = 1.586, p < 0.001) were significant factors associated with cHCC-CCAs with a CCA component ≥ 30%. Multivariable regression analyses showed that only LR-M (OR = 1.522, p = 0.042) was a significantly independent predictor for cHCC-CCAs with a CCA component ≥ 30%.
cHCC-CCAs with a CCA component ≥ 30% had worse prognoses than iCCAs. Therefore, we suggest that the postoperative treatment of cHCC-CCAs with a CCA component ≥ 30% can be based on the treatment strategy for iCCAs.
探讨胆管癌（CCA）成分≥30%或<30%的肝细胞癌-胆管癌混合型（cHCC-CCA）患者与肝内胆管癌（iCCA）患者在无复发生存期（RFS）和总生存期（OS）预后方面的差异。
招募手术后的cHCC-CCA和iCCA患者。所有cHCC-CCA患者分为两个亚组（CCA成分≥30%和<30%）。然后，分别采用Kaplan-Meier生存分析和Cox回归分析来研究和比较CCA成分≥30%或<30%的cHCC-CCA与iCCA在RFS和OS预后方面的差异。还比较了CCA成分≥30%和<30%的cHCC-CCA之间的MRI特征差异。
纳入164例cHCC-CCA和146例iCCA。与iCCA相比，CCA成分<30%的cHCC-CCA具有更好的OS预后（HR：2.888，p = 0.045）。然而，Cox回归分析显示，CCA成分≥30%的cHCC-CCA的RFS（HR：0.503，p < 0.001）和OS（HR：0.58，p = 0.033）预后比iCCA差。此外，边缘性动脉期高强化（OR = 0.286，p < 0.001）、靶征样扩散受限（OR = 0.316，p = 0.019）、晕环强化（OR = 0.481，p = 0.033）、延迟强化（OR = 0.251，p = 0.001）和LR-M（OR = 1.586，p < 0.001）是与CCA成分≥30%的cHCC-CCA相关的显著因素。多变量回归分析显示，只有LR-M（OR = 1.522，p = 0.042）是CCA成分≥30%的cHCC-CCA的显著独立预测因子。
CCA成分≥30%的cHCC-CCA预后比iCCA差。因此，我们建议对于CCA成分≥30%的cHCC-CCA的术后治疗可基于iCCA的治疗策略。
