A clinicopathological study on combined hepatocellular and cholangiocarcinoma
A clinicopathological study on combined hepatocellular and cholangiocarcinoma
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DOI：
10.1111/j.1440-1746.1996.tb00327.x
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发表时间：
1996-08-01
影响因子：
4.1
通讯作者：
Kojiro, M
中科院分区：
文献类型：
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作者：
Taguchi, J;Nakashima, O;Kojiro, M
我们对23例手术切除的肝细胞胆管合并癌（HCC-CC）进行了临床病理研究。在我们的研究对象中，患有原发性肝癌并接受肝切除术的人患这种癌症的频率为6.3%。患者平均年龄64.0岁，男女比例为1.9:1。70%的病例血清甲胎蛋白呈阳性，多数病例血清甲胎蛋白水平相对较低（小于或等于1000 ng/mL）。血清癌胚抗原阳性率为18%，水平也较低。在肝炎病毒标志物方面，20例合并HCC-CC病例中，HBs抗原阳性占17%，HCV抗体阳性占70%。在23例合并HCC-CC病例中，9例（39%）合并肝硬化。肿瘤在宏观上分为分离型（HCC和CC明显分离17%），HCC为主型（类似HCC 49%）和CC为主型（类似CC 34%）。分离型和hcc为主型分别在50%和55%的病例中与肝硬化相关。在组织学上，所有病例均可分为I型（HCC和CC有明显区别，占17%）、II型（HCC和CC相邻且有共同的过渡性特征，占66%）和III型（癌细胞既可评估为HCC，也可评估为CC，认为是中间类型，占17%）。细胞角蛋白免疫组织染色可用于鉴别HCC和CC，其中细胞角蛋白7和19阳性。肿瘤中，HCC和CC几乎无法区分（如III型），表明存在可以分化为HCC或CC的中间肿瘤细胞。
We clinicopathologically studied 23 surgically resected cases of combined hepatocellular and cholangiocarcinoma (HCC-CC). The frequency of this cancer in our subjects, who had primary liver cancer and who underwent hepatectomy, was 6.3%. The mean age of patients was 64.0 years old and the male : female ratio was 1.9:1. Serum alpha-fetoprotein was positive in 70% of cases and its levels were relatively low (less than or equal to 1000 ng/mL) in most cases. The positive rate of serum carcinoembryonic antigen was 18% and its levels were also low. In regard to hepatitis virus markers, 17% of the 20 combined HCC-CC cases were positive to HBs antigen and 70% were positive to the HCV antibody. Of the 23 combined HCC-CC cases, 9 cases (39%) were associated with liver cirrhosis. Tumours were classified macroscopically into a separated type (HCC and CC are clearly separated 17%), a HCC-predominant type (resembles HCC 49%), and a CC-predominant type (resembles CC 34%). The separated and HCC-predominant types were associated with liver cirrhosis in 50 and 55% of cases, respectively. These cases with liver cirrhosis presented the features of HCC more apparently, while those without liver cirrhosis presented the features of CC. Histologically, all cases were classified into either Type I (HCC and CC were clearly distinguished; 17%), Type II (HCC and CC were contiguous and shared transitional features; 66%), and Type III (cancer cells were able to be evaluated as either HCC or CC and were considered to be an intermediate type; 17%). Immunohistological stains for cytokeratin were useful to distinguish HCC and CC. Specifically, CC was positive to cytokeratin 7 and 19. The tumour, in which HCC and CC were almost indistinguishable, such as Type III), indicates the presence of intermediate tumour cells that can differentiate either to HCC or CC.