Clinicopathological features and prognosis of combined hepatocellular carcinoma and cholangiocarcinoma after surgery
Clinicopathological features and prognosis of combined hepatocellular carcinoma and cholangiocarcinoma after surgery
复制标题
DOI：
10.1016/s1499-3872(14)60275-7
复制
发表时间：
2014-12-15
影响因子：
3.3
通讯作者：
Hong, Eun Kyung
中科院分区：
文献类型：
--
作者：
Lee, Seung Duk;Park, Sang-Jae;Hong, Eun Kyung
背景技术背景：肝细胞癌和胆管细胞癌（cHCC-CC）是原发性肝癌的一种罕见亚型，包括肝细胞癌（HCC）和胆管细胞癌（CC）。由于这种肿瘤的罕见性，其特征知之甚少。方法：回顾性分析2001-2010年在我中心行手术治疗的cHCC-CC患者的临床病理特征，并与同期HCC和CC患者进行比较。根据AJCC癌症分期手册（第6版）进行癌症分期。结果：42例cHCC-CC、90例HCC和45例CC的临床病理特征差异有统计学意义（P < 0. 05）。与HCC患者相似，cHCC-CC患者经常出现B型肝炎病毒抗原阳性、微血管侵犯、肝硬化和高血清甲胎蛋白。与CC患者相似，cHCC-CC患者表现出胆管浸润增加和包膜减少。cHCC-CC患者的1年、3年和5年总生存率和无病生存率与分期匹配的CC患者无显著差异，但明显低于HCC患者。在II期患者的亚组分析中，cHCC-CC或CC患者的总生存率明显低于HCC患者。我们没有发现其他阶段患者的差异。cHCC-CC患者总生存期和无瘤生存期的单因素分析显示，血管侵犯和肝内转移是cHCC-CC患者的显著预测因素.结论：cHCC-CC患者与HCC或CC患者具有相似的临床病理特征，cHCC-CC或CC患者的预后较HCC患者差，尤其是在匹配的II期患者.
BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is a rare subtype of primary liver cancer consisting of both hepatocellular carcinoma (HCC) and cholangio carcinoma (CC). Because of the rarity of this tumor, its feature is poorly understood. The present study aimed to evaluate the clinicopathological features and long-term prognosis of patients with cHCC-CC after surgery and to compare with those of the patients with stage-matched HCC and CC.METHODS: The dinicopathological features of the patients who underwent surgery for cHCC-CC at our center during the period of 2001-2010 were retrospectively analyzed and compared with those of stage-matched HCC and CC patients. Cancer staging was performed according to the AJCC Cancer Staging Manual (6th ed.). Overall survival and disease-free survival were compared among the groups and prognostic factors of cHCC-CC were evaluated.RESULTS: Significant differences were observed in clinicopathological features among 42 patients with cHCC-CC, 90 patients with HCC and 45 patients with CC. Similar to HCC patients, cHCC-CC patients had frequent hepatitis B virus antigen positivity, microscopic vessel invasion, cirrhosis and high level of serum alpha-fetoprotein. Similar to CC patients, cHCC-CC patients showed increased bile duct invasion and decreased capsule. The 1-, 3-, and 5-year overall survival and disease-free survival of patients with cHCC-CC were not significantly different from those with stage-matched patients with CC; but significantly poorer than those with HCC. In subanalysis of patients with stage II, the overall survival in patients with cHCC-CC or CC was significantly poorer than that in patients with HCC. We did not find the difference in patients with other stages. Univariate analysis of overall and disease-free survival of patients with cHCC-CC showed that the vascular invasion and intrahepatic metastasis were the significant predictive factors.CONCLUSION: Patients with cHCC-CC showed similar dinicopathological features as those with HCC or CC, and patients with cHCC-CC or CC had a poorer prognosis compared with those with HCC, especially at matched stage II.