A Review on the Update of Combined Hepatocellular Cholangiocarcinoma

Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a primary liver tumor with neoplastic components of both hepatocytic and cholangiocytic differentiation. This unique neoplasm is gaining increasing recognition due to the intriguing pathology, tumor biology, and clinical behavior. It also poses challenges in diagnosis, treatment, and research, largely because of its histological and phenotypic diversity that lead to confusion in terminology and classification. There have been efforts attempting to unify the terminology of this neoplasm recently. Advances in investigation in various aspects have also been made. This review aims to update the terminology, classification, and clinical and pathological characteristics of cHCC-CCA.

Albumin-to-Alkaline Phosphatase Ratio is an Independent Prognostic Indicator in Combined Hepatocellular and Cholangiocarcinoma

“…cHCC-CCA is a distinct form of primary liver cancer showing features of both HCC and CC [20]. Due to the low incidence of cHCC-CCA, there is still a lack of investigation on prognostic prediction in cHCC-CCA.…”

“…Regarding CP grade, it has been set as an important index in several staging systems including the Barcelona Clinic Liver Cancer (BCLC) staging system 36 , the Cancer of the Liver Italian Program (CLIP) score 37 and the Japan integrated staging (JIS) score 38 . However, the CP grade was initially derived from patients with liver cirrhosis, and cirrhosis is not always accompanied with cHCC-CCA 20 . Our previous study has identified that cHCC-CCA is a liver malignancy with lower incidence of cirrhosis in comparison with HCC 39 .…”

“…Surgical resection is the only curative option for localized cHCC-CCA 20 . Several recent studies showed postoperative TACE 41 - 43 and chemotherapy 7 , 44 , 45 may be effective adjuvant treatments for cHCC-CCA undergoing surgical treatment.…”

Sp1 Induced Long Non-coding Rna Agap2-as1 Promotes Cholangiocarcinoma Proliferation via Silencing of Cdkn1a

“…Because there are no specific biomarkers or special clinical manifestations, CCA is usually diagnosed as advanced [4,5]. Molecular targeting drugs have no effect on CCA, mainly because the molecular mechanism of CCA is not clear [1,6]. In order to improve the diagnosis rate and cure rate of CCA, we need to further explore and clarify the molecular pathogenesis of CCA.…”

SP1 induced Long non-coding RNA AGAP2-AS1 promotes cholangiocarcinoma proliferation via silencing of CDKN1A 

“…Because there are no speci c biomarkers or special clinical manifestations, CCA is usually diagnosed as advanced [4,5]. Molecular targeting drugs have no effect on CCA, mainly because the molecular mechanism of CCA is not clear [1,6]. In order to improve the diagnosis rate and cure rate of CCA, we need to further explore and clarify the molecular pathogenesis of CCA.…”