Clinicopathological analysis of 14 patients with combined hepatocellular carcinoma and cholangiocarcinoma
Clinicopathological analysis of 14 patients with combined hepatocellular carcinoma and cholangiocarcinoma
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肝细胞癌合并胆管癌14例临床病理分析
DOI：
10.1016/s1499-3872(11)60105-7
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发表时间：
2011-12-01
影响因子：
3.3
通讯作者：
Liu, Chao
中科院分区：
文献类型：
--
作者：
Yu, Xian-Huan;Xu, Lei-Bo;Liu, Chao
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，预后较差。本研究旨在探讨cHCC-CC的预后和临床病理特征，包括其可能的细胞起源。方法：在我院1998年1月至2008年4月接受肝切除术的852例原发性肝癌患者中，14例确诊为cHCC-CC。回顾性分析14例患者的临床病理特征。采用免疫组化法检测肿瘤组织中肝脏干细胞标志物（c-kit、CD90、CD133、CK19）的表达情况，并采用Kaplan-Meier法评估生存情况。结果：14例患者中，9例出现腹痛，3例出现厌食、衰弱，其余2例患者无症状。平均年龄为 53.6 +/- 3.0（范围 38-74）岁。纳入患者中，血清甲胎蛋白水平升高11例，乙型肝炎病毒感染13例，血管侵犯9例，淋巴结转移1例。肿瘤的平均直径为9.9+/-1.1（范围5.0-16.0）cm。中位总生存时间为 7.9 +/- 1.0 个月。此外，肝脏干细胞标志物c-kit、CD90、CD133和CK19的存在率分别为71.4%、85.7%、92.9%和78.6%。 8例病例中这4种标志物同时表达。结论：cHCC-CC具有侵袭性，预后极差。肿瘤组织中肝干细胞标志物的高表达提示这些肿瘤可能来源于肝干细胞。
BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an uncommon subtype of primary hepatic carcinoma, and its prognosis is poor. This study was undertaken to investigate the prognosis and the clinicopathological characteristics of cHCC-CC, including their possible cellular origin.METHODS: Among 852 patients with a primary hepatic carcinoma who underwent hepatectomy from January 1998 to April 2008 at our hospital, cHCC-CC was identified in 14 patients. The clinicopathological characteristics of the 14 patients were analyzed retrospectively. The expression of the liver stem cell markers (c-kit, CD90, CD133 and CK19) in the tumor tissue was detected by immunohistochemistry, and the Kaplan-Meier method was used to evaluate survival.RESULTS: Among the 14 patients, 9 presented with abdominal pain, 3 with anorexia and debilitation, and the remaining two patients were asymptomatic. The mean age was 53.6 +/- 3.0 (range 38-74) years. Among the included patients, 11 had an elevated serum alpha-fetoprotein level, 13 were infected with hepatitis B virus, 9 had vascular invasion and 1 had lymph node metastasis. The average diameter of the tumors was 9.9 +/- 1.1 (range 5.0-16.0) cm. The median overall survival time was 7.9 +/- 1.0 months. In addition, the presence of the liver stem cell markers, c-kit, CD90, CD133 and CK19 was 71.4%, 85.7%, 92.9% and 78.6%, respectively. All four markers were simultaneously expressed in eight cases.CONCLUSIONS: cHCC-CC has aggressive characteristics and the prognosis is extremely dismal The high expression of liver stem cell markers in the tumor tissue suggests that these tumors may derive from liver stem cells.