Maeda T, Adachi E, Kajiyama K, Sugimachi K, Tsuneyoshi M
Department of Pathology II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hum Pathol. 1995 Sep;26(9):956-64. doi: 10.1016/0046-8177(95)90084-5.
We herein evaluated 36 cases of combined hepatocellular and cholangiocarcinoma (cHCC-CC) (including 29 surgically resected and seven autopsy cases) by the immunohistochemical methods of anticytokeratin antibodies 7 and 19, and then analyzed the clinicopathologic features by comparing cHCC-CC with ordinary hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). The results indicated that even if mucin production could not be confirmed, nine cases with HCC areas that showed a histological resemblance to CC also showed immunohistological biliary differentiation. Therefore, we advocate that these HCC with biliary differentiation based on an immunohistochemical analysis should thus be included in the criteria of cHCC-CC in broad terms. Regardless of the extent of mucin production, the cHCC-CCs as indicated by an immunohistochemical analysis are considered to have a similar background to that of ordinary HCCs regarding such factors as the average age, male:female ratio, hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (HCVAb) positivity, alpha-fetoprotein level, and the presence of cirrhosis. However, cHCC-CCs tend to metastasize to many organs and the lymph nodes, and, as a result, have a poor prognosis.
我们在此通过抗细胞角蛋白抗体7和19的免疫组织化学方法评估了36例肝细胞癌合并胆管癌（cHCC-CC）（包括29例手术切除病例和7例尸检病例），然后通过将cHCC-CC与普通肝细胞癌（HCC）和胆管癌（CC）进行比较来分析其临床病理特征。结果表明，即使无法确认黏液分泌，9例肝细胞癌区域在组织学上与胆管癌相似的病例也显示出免疫组织学上的胆管分化。因此，我们主张基于免疫组织化学分析的这些具有胆管分化的肝细胞癌应广义上纳入cHCC-CC的标准。无论黏液分泌程度如何，免疫组织化学分析所示的cHCC-CC在平均年龄、男女比例、乙肝表面抗原（HBsAg）和丙肝病毒抗体（HCVAb）阳性率、甲胎蛋白水平以及肝硬化存在等因素方面，被认为与普通肝细胞癌具有相似的背景。然而，cHCC-CC往往会转移至多个器官和淋巴结，因此预后较差。
