Wen Cong-Jian, Liu Hui, Sun Li-Ping, Zhao Chong-Ke, Yin Hao-Hao, Wang Li-Fan, Zhu Ming-Rui, Sun Yi-Kang, Zhang Ya-Qin, Chen Zi-Tong, Wang Xi, Xia Han-Sheng, Han Hong, Xu Hui-Xiong, Zhou Bo-Yang
Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China.
Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, Ultrasound Education and Research Institute, School of Medicine, Tongji University, Shanghai, China.
Insights Imaging. 2025 Jun 19;16(1):130. doi: 10.1186/s13244-025-02019-0.
Mass-forming intrahepatic cholangiocarcinomas (MF-ICCs) can be classified into ductal and parenchymal types using magnetic resonance imaging (MRI). We aimed to subclassify MF-ICC into biliary and parenchymal types based on ultrasound (US) findings and to investigate the differences in their contrast-enhanced ultrasound (CEUS) patterns, clinicopathologic features, and prognosis.
In this study, 141 patients who underwent US with pathologically proven MF-ICC from two hospitals were retrospectively enrolled. MF-ICCs were divided into biliary (bMF-ICCs) and parenchymal MF-ICC (pMF-ICCs) based on the signs of bile duct dilation in US images. Clinicopathological, imaging, and short-term survival data were collected from medical records and compared.
Among 141 patients (61.96 ± 10.15 years, 83 men), bMF-ICCs (33/141, 23.4%) showed significantly more CEA ≥ 5 µg/L (42.4% vs 20.2%, p = 0.01), microvascular invasion (54.5% vs 10.2%, p < 0.001), lymph node metastasis (48.5% vs 5.6%, p < 0.001), bile duct invasion (48.5% vs 5.6%, p < 0.001), and high Ki-67 expression (63.6% vs 38.9%, p = 0.01) than pMF-ICCs. Pathologically, bMF-ICCs were more inclined toward the large duct type (78.1% vs 11.7%, p < 0.001). In addition, the bMF-ICCs were usually located in the left lobe of the liver (63.6% vs 41.7%, p = 0.03). pMF-ICCs showed better overall survival than bMF-ICCs (p = 0.04).
Subclassification of MF-ICCs into biliary and parenchymal types based on US is useful for discriminating clinicopathological characteristics.
The subclassification of mass-forming intrahepatic cholangiocarcinoma (MF-ICC) into biliary (bMF-ICC) and parenchymal (pMF-ICC) subtypes using ultrasound can provide clinicopathological and prognostic information before surgery.
We subclassified mass-forming intrahepatic cholangiocarcinomas into biliary and parenchymal types using ultrasound. Biliary and parenchymal types have different clinicopathological features and postsurgical outcomes. Biliary type above and below 50 mm exhibits different unfavorable clinicopathological characteristics. Our classification has certain similarities with MRI classification in clinicopathological characteristics.
采用磁共振成像（MRI），肿块型肝内胆管癌（MF-ICC）可分为导管型和实质型。我们旨在根据超声（US）检查结果将MF-ICC进一步细分为胆管型和实质型，并研究其对比增强超声（CEUS）模式、临床病理特征及预后的差异。
本研究回顾性纳入了两家医院141例经病理证实为MF-ICC且接受过超声检查的患者。根据超声图像中胆管扩张的征象，将MF-ICC分为胆管型（bMF-ICC）和实质型MF-ICC（pMF-ICC）。从病历中收集临床病理、影像学及短期生存数据并进行比较。
141例患者（年龄61.96±10.15岁，男性83例）中，bMF-ICC（33/141，23.4%）的癌胚抗原（CEA）≥5μg/L（42.4% 对20.2%，p = 0.01）、微血管侵犯（54.5% 对10.2%，p < 0.001）、淋巴结转移（48.5% 对5.6%，p < 0.001）、胆管侵犯（48.5% 对5.6%，p < 0.001）及Ki-67高表达（63.6% 对38.9%，p = 0.01）的比例均显著高于pMF-ICC。病理上，bMF-ICC更倾向于大导管型（78.1% 对11.7%，p < 0.001）。此外，bMF-ICC通常位于肝左叶（63.6% 对41.7%，p = 0.03）。pMF-ICC的总生存期优于bMF-ICC（p = 0.04）。
基于超声将MF-ICC分为胆管型和实质型有助于鉴别临床病理特征。
利用超声将肿块型肝内胆管癌（MF-ICC）细分为胆管型（bMF-ICC）和实质型（pMF-ICC）亚型，可在术前提供临床病理及预后信息。
我们利用超声将肿块型肝内胆管癌分为胆管型和实质型。胆管型和实质型具有不同的临床病理特征及术后结局。50mm以上和以下的胆管型表现出不同的不良临床病理特征。我们的分类在临床病理特征方面与MRI分类有一定相似性。
