Clinical and pathological features of Allen's type C classification of resected combined hepatocellular and cholangiocarcinoma: A comparative study with hepatocellular carcinoma and cholangiocellular carcinoma
Clinical and pathological features of Allen's type C classification of resected combined hepatocellular and cholangiocarcinoma: A comparative study with hepatocellular carcinoma and cholangiocellular carcinoma
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DOI：
10.1016/j.gassur.2006.01.018
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发表时间：
2006-07-01
影响因子：
3.2
通讯作者：
Monden, Morito
中科院分区：
文献类型：
--
作者：
Tang, Di;Nagano, Hiroaki;Monden, Morito
艾伦氏C型肝细胞和胆管细胞癌（cHCC-CC）的临床特征尚不清楚。本研究旨在明确cHCC-CC的临床病理特征，并与肝细胞癌（HCC）和胆管细胞癌（CCC）的术前诊断和手术治疗结果进行比较。我们回顾性分析了过去20年来在我院治疗的13例cHCC-CC患者、509例HCC患者和41例CCC患者。病毒性肝炎B或C背景在HCC和cHCC-CC组中比CCC组更突出。在60.3%的HCC患者和46.2%的cHCC-CC患者中发现血清甲胎蛋白（AFP）水平升高。只有1例cHCC-CC患者术前诊断正确。cHCC-CC与HCC或CCC组之间的术后生存率无显著差异。cHCC-CC患者术后肝内、肝外复发均较常见，CCC成分复发较常见。总之，术前诊断是困难的;肝脏肿块类似于HCC，以及中度升高的血清AFP和CA 19 -9水平，是cHCC-CC的可靠指标。手术切除这种肿瘤的结果介于HCC和CCC之间。需要更多的病例来进一步确定这种肿瘤的特征。
The clinical features of Allen's type C of combined hepatocellular and cholangiocarcinoma (cHCC-CC) are not well known. In this study, we aim to define the clinicopathologic features of cHCC-CC and to evaluate the preoperative diagnosis and surgical treatment results in comparison with those of hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC). We retrospectively analyzed 13 patients with cHCC-CC, 509 patients with HCC, and 41 patients with CCC treated in our hospital within past two decades. Viral hepatitis B or C backgrounds were more prominent in HCC and cHCC-CC groups than in the CCC group. Elevated serum alpha-fetoprotein (AFP) levels were found in 60.3% of HCC patients and in 46.2% of cHCC-CC patients. Only one patient of cHCC-CC was correctly diagnosed before surgery. The postoperative survival rates between the cHCC-CC and HCC or the CCC group were not significantly different. Both intrahepatic and extrahepatic postoperative recurrences were frequent in cHCC-CC patients, and CCC component recurrences were more frequently seen. In conclusion, the preoperative diagnosis is difficult; liver masses similar to those of HCC, together with moderately elevated serum AFP and CA19-9 levels, are reliable indicators of cHCC-CC. Surgical resection of this tumor yields results intermediate between those of HCC and CCC in character. More cases are needed to further define the characteristics of this tumor.