Combined Hepatocellular-Cholangiocarcinoma: An Update on Pathology and Diagnostic Approach

Choi, Jung-Hwa; Ro, Jae Y.

doi:10.3390/biomedicines10081826

Cited by 8 publications

(6 citation statements)

References 73 publications

(86 reference statements)

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“…[7][8][9][10][11] However, compelling evidence suggests that proliferative HCCs behave differently from nonproliferative HCCs, with distinct prognoses and prognostic factors. 1,2,[12][13][14][15][16] As mentioned by Kang et al, proliferative HCC is an independent factor for poor over-all survival, higher rate of intrahepatic distant recurrence, and extrahepatic metastasis after curative surgery. In addition, rim arterial phase hyperenhancement at gadoxetate-enhanced MRI was independent predictors for proliferative HCC and poor prognosis.…”

Section: Introductionmentioning

confidence: 94%

Prognostic Factors for Patients with Proliferative Hepatocellular Carcinoma After Liver Resection

Li,

Huang,

et al. 2023

JHC

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There is a scarcity of predictive models currently accessible for prognosticating proliferative hepatocellular carcinoma (HCC), an integrated class of subtype, characterized by a dismal prognosis. Consequently, this study aimed to develop and validate a novel prognostic model capable of accurately predicting the prognosis of proliferative HCC after curative resection. Patients and Methods: This retrospective multicenter study included patients with solitary HCC who underwent curative liver resection from August 2014 to December 2020 (n = 816). Patients were stratified into either the proliferative HCC cohort (n = 259) or the nonproliferative HCC cohort (n = 557) based on histological criteria. Disease-free survival (DFS) was compared between the two groups before and after one-to-one propensity score matching (PSM). Of all the proliferative HCC patients, 203 patients were assigned to training cohort, and 56 patients were assigned to validation cohort. Univariate and multivariate analyses were performed in training cohort to identify risk factors associated with worse DFS. Thereafter, a predictive model was constructed, subsequently validated in the validation cohort. Results: The DFS of proliferative HCC was significantly worse than nonproliferative HCC before and after PSM. Meanwhile, multivariate regression analysis revealed that liver cirrhosis (P = 0.032) and larger tumor size (P = 0.000) were independent risk factors of worse DFS. Lastly, the discriminative abilities of the predictive model for 1, 3, 5-year DFS rates, as determined by receiver operating characteristic (ROC) curves, were 0.702, 0.720, and 0.809 in the training cohort and 0.752, 0.776, and 0.851 in the validation cohort, respectively. Conclusion:This study developed a predictive model with satisfactory accuracy to predict the worse DFS in proliferative HCCs after liver resection. Moreover, this predictive model may serve as a valuable tool for clinicians to predict postoperative HCC recurrence, thereby enabling them to implement early preventative strategies.

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Section: Introductionmentioning

confidence: 94%

Prognostic Factors for Patients with Proliferative Hepatocellular Carcinoma After Liver Resection

Li,

Huang,

et al. 2023

JHC

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“… 11 Risk factors associated with the development of cHCC-CCA, such as hepatitis B, hepatitis C, and cirrhosis, are similar to those of HCC in Asian populations. 12 However, studies conducted in Europe and the USA have reported that most cases of cHCC-CCA occur without accompanying chronic liver diseases and arise de novo. 13 These findings suggest that geographical factors may influence the clinical characteristics of patients with cHCC-CCA.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

“… 30 It is worth noting that prominent pseudoglands commonly found in conventional HCC tend to be mistakenly identified as true glandular structures and the reactive ductular reaction at the edge of HCC tends to be considered as an ICC component, leading to the misdiagnosis of cHCC-CCA. 12 Some variants of ICC and ICC arising adjacent to hepatocellular nodular lesions (nodular regenerative hyperplasia) may have histopathological features that resemble cHCC-CCA. However, regardless of the differentiation and immunophenotype, ICC lacking a distinct HCC component should not be diagnosed as cHCC-CCA.…”

Section: Pathological Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

Chu,

Kawaguchi,

Wang

et al. 2023

J Clin Transl Hepatol

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Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single tumor. The fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for cHCC-CCA. However, the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment. A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma, a mixed enhancement pattern on imaging, and a discrepancy between the elevation of tumor marker and the imaging enhancement pattern. Histopathological examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA, and comprehensive examination of resection or biopsy specimens is crucial for an accurate diagnosis. Currently, there is no standard treatment for cHCC-CCA, and surgery is the mainstay. Anatomic hepatectomy with lymphadenectomy is among the recommended surgical procedures. The role of liver transplantation in the management of cHCC-CCA is still uncertain. Transarterial chemoembolization may be effective for unresectable cHCC-CCA, particularly for hypervascular tumors. However, the available evidence does not support systemic therapy for advanced cHCC-CCA. The prognosis of cHCC-CCA is generally poor, and there is no established staging system. Further research is needed to better understand the histogenesis and clinical management of cHCC-CCA. This review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics, pathological diagnosis, and management.

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“…Ayrıca kombine hepatoselülerkolanjiyokarsinom tümörleri de nadir olarak gözlenen primer karaciğer malignitelerinden biridir ve histolojik olarak karışık bir kanser türü olduğundan dolayı noninvaziv ve doğru teşhisin konulması hemen hemen imkansızdır [5,6]. Bunun yanı sıra klinikte LIHC ve iCHOL'ün ameliyat öncesi süreçte noninvaziv ayırıcı tanısının esas olarak görüntülemeye dayandığı bilinmektedir.…”

Section: Introductionunclassified

Kolanjiyokarsinom ve Hepatoselüler Karsinom Hastalarında Farklı Genler Tarafından Tetiklenen Ortak Biyolojik Yolaklar

Ayna Duran

2024

Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi

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Kolanjiyokarsinom (CHOL) erken teşhis edilmesi zor olan ve oldukça yüksek düzeyde öldürücü bir kanser türüdür. CHOL tanısında radyolojik görüntülemede kısıtlılıklar mevcuttur ve biyopsi ile tanı yöntemi gibi invaziv tanı yöntemleri dışında genetik tabanlı ve özgün biyobelirteçlerin belirlenmesi zorunlu hale gelmektedir. Literatürde bu amaçlar gerçekleştirilen çalışmalar çalışmalardan farklı olarak bizim çalışmamızda öncelikle intrahepatik (iCHOL) ve ekstrahepatik (eCHOL) kolanjiyokarsinom hastalarında ortak upregüle olan genler belirlenmiştir. Ayrıca çalışmamızda klinikte CHOL kanserlerinin LIHC kanserinden ayırt edici tanısının zor olması sebebiyle CHOL hastalarında hepatoselüler karsinomdan (LICH) farklı olarak ve LIHC hastaları ile ortak olarak upregüle edilen genlerin tespit edilmesi de amaçlanmıştır. Hastaların gen yoğunluk verileri NCBI Gene Expression Omnibus (GEO) veri tabanından (GSE121248, GSE132305 ve GSE45001) sağlanmıştır. Çalışmada R LIMMA paketinde yer alan lineer modelleme yöntemi kullanılarak kanserli olan ve olmayan örnekler arasında upregüle genler (differentially expressed genes-DEGs) tespit edilmiştir. Tespit edilen genlerin hangi biyolojik yolaklara etki ettiğini belirlemek için Gen seti zenginleştirme analizi (Fonksiyonel zenginleştirme analizi) (GSEA) ShinyGO 0.80 webtool kullanılarak yapılmıştır. Sonuçlarımıza göre CHOL hastalarında LIHC hastalarından farklı olarak upregüle edilen 4 gene (F2R, ITGA11, LAMC2 ve LAMB3) odaklanılmıştır. CHOL ve LIHC hastalarında ise ortak olarak upregüle edilen 2 gen (COL1A1, ITGA2) tespit edilmiştir. Söz konusu genlerinin ortak olarak işaret ettiği biyolojik yolaklar PI3K-Akt sinyal yolağı ve ekstraselüler matriks (ECM)-reseptör etkileşimi süreçleridir. Belirlenen genler ile protein-protein ve ilaç etkileşim çalışmaları sonuçları klinik denemeler ile desteklenip CHOL ile LIHC kanserlerinin ayırt edilmesinde etkin bir şekilde hedeflenebilecektir.

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Combined Hepatocellular-Cholangiocarcinoma: An Update on Pathology and Diagnostic Approach

Cited by 8 publications

References 73 publications

Prognostic Factors for Patients with Proliferative Hepatocellular Carcinoma After Liver Resection

Prognostic Factors for Patients with Proliferative Hepatocellular Carcinoma After Liver Resection

Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

Kolanjiyokarsinom ve Hepatoselüler Karsinom Hastalarında Farklı Genler Tarafından Tetiklenen Ortak Biyolojik Yolaklar

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