Clinicopathologic Characteristics of Hepatocellular Carcinoma With Reactive Ductule-like Components, a Subset of Liver Cancer Currently Classified as Combined Hepatocellular-Cholangiocarcinoma With Stem-Cell Features, Typical Subtype

Abstract

The aim of this study was to elucidate the clinicopathologic characteristics of hepatocellular carcinoma with reactive ductule-like components (HCC-RD), corresponding to combined hepatocellular-cholangiocarcinoma (CHC) with stem cell features, typical subtype. Retrospective clinicopathologic analysis was performed on HCCs surgically treated at the University of Tokyo Hospital between 1995 and 2013. RD components were defined as neoplastic ductular structures composed of small "stem/progenitor-like" cells. There were 46 HCC-RDs, comprising about 3% of all HCCs. Thirty-eight cases of CHC, classical type (classical CHC), were identified during the study period. When compared with conventional HCC, HCC-RD was characterized by younger patient age (P=0.016), higher frequency of female patients (P<0.001), and higher serum α-fetoprotein levels (P=0.005). Serum carbohydrate antigen 19-9 elevation was also more frequently observed in HCC-RD than in conventional HCC (P=0.002). Histologically, clear cell constituents and interstitial fibrosis were more frequent in HCC-RD than in conventional HCC (P=0.003 and <0.001, respectively). When compared with HCC-RD and conventional HCC, classical CHC was characterized by a poorly differentiated HCC component, frequent vascular invasion, and lymph node metastasis (P<0.05). There was little prognostic difference between HCC-RD and conventional HCC, whereas overall and disease-free survival in classical CHC was significantly worse than in conventional HCC. In conclusion, although HCC-RDs do have some unique clinicopathologic characteristics, they have no prognostic significance, and it is not reasonable to include these tumors in the CHC category.

Clinicopathological, radiologic, and molecular study of 23 combined hepatocellular-cholangiocarcinomas with stem cell features, cholangiolocellular type

“…Because of its rarity, the clinicopathologic and molecular characteristics of CHC-SC-CLC remain elusive [9][10][11].…”

Combined hepatocellular-cholangiocarcinoma: Gadoxetic acid-enhanced MRI findings correlated with pathologic features and prognosis

“…Combined hepatocellular cholangiocarcinoma (cHCC‐CC) is an uncommon primary liver cancer, accounting for 1.1–6.3% of all primary liver cancers, which comprises a mixture of hepatocellular carcinoma (HCC), cholangiocarcinoma (CC), and/or components with hepatic progenitor/stem cell (HPC) features; cHCC‐CC reportedly has a poorer postsurgical/‐transplantation prognosis than HCCs . With an increasing understanding of the role of HPCs in the development of cHCC‐CCs, the 2010 World Health Organization (WHO) classification system categorized cHCC‐CCs into classical type and subtypes with stem cell features .…”

“…With an increasing understanding of the role of HPCs in the development of cHCC‐CCs, the 2010 World Health Organization (WHO) classification system categorized cHCC‐CCs into classical type and subtypes with stem cell features . However, this classification system's clinical and prognostic implications are still controversial …”

The effectiveness of transarterial chemoembolization in recurrent hepatocellular-cholangiocarcinoma after resection

“…Our institution used the traditional classification until 2012, and most of the enrolled patients underwent surgery before 2012. Additionally, the clinical and prognostic implications of the 2010 WHO classification system are still controversial [ 29 – 32 ].…”