Histological and molecular characterization of intrahepatic bile duct cancers suggests an expanded definition of perihilar cholangiocarcinoma
Histological and molecular characterization of intrahepatic bile duct cancers suggests an expanded definition of perihilar cholangiocarcinoma
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DOI：
10.1016/j.hpb.2018.07.021
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发表时间：
2019-02-01
期刊：
影响因子：
2.9
通讯作者：
Zen, Yoh
中科院分区：
文献类型：
--
作者：
Akita, Masayuki;Sofue, Keitaro;Zen, Yoh
背景：越来越多的证据表明，肝内胆管癌（iCCA）可分为小管型和大管型。本研究旨在阐明大管胆管癌与肝门周围胆管癌（pCCA）的异同。方法：研究队列包括iCCA （n = 58）和pCCA （n = 44）。根据我们的组织学标准将iCCA肿瘤分为小管型（n = 36）和大管型（n = 22）后，比较三种肿瘤的遗传状况。在三维图像上绘制iCCA的位置，并测量其与门静脉分叉的距离。结果：大胆管iCCA与小胆管iCCA在需要胆管重建的频率、神经周围浸润和生存率方面不同，这些特征与pCCA更相似。与小导管iCCA相比，大导管iCCA和pCCA更常见的是SMAD4表达缺失和MDM2扩增，而BAP1表达缺失和IDH1突变大多局限于小导管iCCA。从影像学分析来看，大多数大导管iCCA肿瘤出现在门静脉第二支周围。结论：大胆管型iCCA与pCCA具有相同的分子特征，将pCCA的定义扩大至包括起源于第二胆管分支的肿瘤可能是合理的。
Background: Growing evidence has suggested that intrahepatic cholangiocarcinoma (iCCA) can be classified into small- and large-duct types. The present study aimed to elucidate how large-duct iCCA is similar and dissimilar to perihilar cholangiocarcinoma (pCCA).Methods: The study cohort consisted of iCCA (n = 58) and pCCA (n = 44). After iCCA tumors were separated into small- (n = 36) and large-duct (n = 22) types based on our histologic criteria, genetic statuses of the three types of neoplasms were compared. Locations of iCCA were plotted on a three-dimensional image and their distances from the portal bifurcation were measured.Results: Large-duct iCCA was distinct from small-duct iCCA in terms of frequency of bile duct reconstruction required, perineural infiltration, and survival, with these features more similar to pCCA. Large-duct iCCA and pCCA more frequently had the loss of SMAD4 expression and MDM2 amplifications than small-duct iCCA, whereas the loss of BAP1 expression and IDH1 mutations were mostly restricted to small-duct iCCA. From imaging analysis, most tumors of large-duct iCCA were present around the second branches of the portal vein.Conclusion: Large-duct type iCCA shared the molecular features with pCCA, and it may be reasonable to expand the definition of pCCA to include cancers originating from the second bile duct branches.