Pathogenesis and classification of intrahepatic cholangiocarcinoma: different characters of perihilar large duct type versus peripheral small duct type
Pathogenesis and classification of intrahepatic cholangiocarcinoma: different characters of perihilar large duct type versus peripheral small duct type
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DOI：
10.1002/jhbp.154
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发表时间：
2015-02-01
影响因子：
3
通讯作者：
Oda, Yoshinao
中科院分区：
文献类型：
--
作者：
Aishima, Shinichi;Oda, Yoshinao
肝内胆管细胞癌（ICC）是由来自肝脏不同解剖部位的异质性癌组成。两种类型的候选干/祖细胞的胆道树被假定存在于周围的胆管腺体的大胆管和在运河的赫林小管和肝细胞。根据最近的观察，ICC可分为两种类型：肿瘤涉及大胆管，其大小与肝内第二分支相当，由管状或乳头状成分组成，具有高柱状上皮;肿瘤涉及比节段性分支小的胆管，由小管和立方上皮组成。肝门周围大导管型ICC可解释为起源于大胆管型ICC，而周围小导管型ICC可起源于小胆管型或导管型ICC。慢性胆道炎症引起大胆管的肿瘤性改变，从而进展为肝门周围大胆管型ICC，其大体上可分为管周过滤型ICC和管内生长型ICC，而慢性肝炎或肝硬化引起团块形成的外周小管型ICC。不同的形态学和分子特征，包括基质成分和肿瘤血管，支持这一假设，即肝门周围大导管型ICC和周围小导管型ICC产生于不同的背景，具有不同的致癌途径，并表现出不同的生物学行为。
Intrahepatic cholangiocarcinomas (ICCs) are made up of heterogenous carcinomas arising from different anatomical sites of the liver. Two types of candidate stem/progenitor cells of the biliary tree are postulated to exist at the peribiliary glands for large bile ducts and at the canals of Hering for small ducts and hepatocytes. According to the recent observations, ICCs can be subclassified into two types: tumors involving the large bile ducts comparable in size to the intrahepatic second branches and composed of a tubular or papillary component with tall columnar epithelium, and tumors involving the smaller duct than segmental branches and composed of small tubules with cuboidal epithelium. Perihilar large duct type ICCs can be interpreted as arising from large bile duct type ICCs, and peripheral small duct type ICCs may arise from small bile duct type or ductular type ICCs. Chronic biliary inflammation induces neoplastic change of the large bile ducts and thereby progression to the perihilar large duct type ICC, which can be grossly classified into periductal filtrating type ICC and intraductal growth type ICC, while chronic hepatitis or cirrhosis induces mass-forming peripheral small duct type ICC. The different morphological and molecular features, including stromal components and tumor vasculature, support the hypothesis that perihilar large duct type ICCs and peripheral small duct type ICCs arise from different backgrounds, have different carcinogenetic pathways, and exhibit different biologic behaviors.