ORIGINAL ARTICLE
The prognostic relationship between histopathological and immunohistochemical features of hepatocellular carcinoma, intrahepatic cholangiocarcinoma and mixed type
 
More details
Hide details
1
Department of Pathology, İstanbul Bilim University, İstanbul, Turkey
 
2
Department of Hepatobiliary and Organ Transplant Center, Şişli Florence Nigthingale Hospital İstanbul, Turkey
 
3
Department of Gastroentorology, İstanbul Bilim University, İstanbul, Turkey
 
 
Submission date: 2019-03-08
 
 
Final revision date: 2019-07-04
 
 
Acceptance date: 2019-12-23
 
 
Publication date: 2020-07-21
 
 
Pol J Pathol 2020;71(2):79-86
 
KEYWORDS
TOPICS
ABSTRACT
Hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and combined hepatocellular and cholangiocarcinoma are the most common cancers of the liver. In this study, our first aim is to evaluate the relationship between prognosis and clinicopathological parameters. The second aim involves investigating the need for immunohistochemical staining and patterns of tumours to differentiate between them.
Sixty-one cases were included in this study. For IHC, we used Hep par-1, CK7, CK19, CD56 and p53 staining, and the patterns of tumours were evaluated in haematoyxylin-eosin sections.
No significant differences were found in Kaplan-Meier life analysis between the tumour types and OS and DFS values, but these values were greater in HCC than in ICC. There were no relationships between clinicopathologic parameters and OS and DFS. Although the multifocality, stage and grade of tumour were higher in HCC than in ICC, the perineural invasion and lymph node metastasis were more common in ICC than in HCC.
The diagnosis was changed in 4 cases, from HCC to ICC in one case and to combined type in 3 cases after IHC. Pathologist should be alert to mixed patterns in terms of diagnosis and IHC, because it helps differential diagnosis in these cases.
REFERENCES (28)
1.
Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011; 61: 69-90.
 
2.
Bosman FT, Carneiro F, Hruban RH, et al. WHO Classification of Tumours of the Digestive System. 4th ed. IARC Press, Geneva 2010.
 
3.
Nakanuma Y, Sato Y, Harada K, et al. Pathological classification of intrahepatic cholangiocarcinoma based on a new concept. World J Hepatol 2010; 2: 419-427.
 
4.
Nakanuma Y, Sasaki M, Ikeda H, et al. Pathology of peripheral intrahepatic cholangiocarcinoma with reference to tumorigenesis. Hepatol Res 2008; 38: 325-334.
 
5.
Gera S, Ettel M, Acosta-Gonzalez G, Xu R. Clinical features, histology, and histogenesis of combined hepatocellular-cholangiocarcinoma. World J Hepatol 2017; 9: 300-309.
 
6.
Yin X, Zhang BH, Qiu SJ, et al. Combined hepatocellular carcinoma and cholangiocarcinoma: clinical features, treatment modalities, and prognosis. Ann Surg Oncol 2012; 19: 2869-2876.
 
7.
Shaib YH, El-Serag HB, Davila JA, et al. Risk factors of intrahepatic cholangiocarcinoma in the United States: a case-control study. Gastroenterology 2005; 128: 620-626.
 
8.
Odze RD, Goldblum JR (eds.). Surgical Pathology of the GI tract, Liver, Biliary tract and pancreas. In: Ferrell LD (ed.). Benign and malignant tumors of the liver. 3rd ed. Elsevier, Philadelphia 2015; 1540-1562.
 
9.
Aishima S, Kurado Y, Nishihara Y, et al. Proposal of progression model for intrahepatic cholangiocarcinoma: clinicopathologic differences between hilar type and peripheral type. Am J Surg Pathol 2007; 31: 1059-1067.
 
10.
Akiba J, Nakashima O, Hattori S, et al. Clinicopathologic analysis of combined hepatocellular-cholangiocarcinoma according to the latest WHO classification. Am J Surg Pathol 2013; 37: 496-505.
 
11.
Chan AW, Tong JH, Chan SL, et al. Expression of stemness markers (CD133 and EpCAM) in prognostication of hepatocellular carcinoma. Histopathology 2014; 64: 935-950.
 
12.
Sempoux C, Fan C, Singh P, et al. Cholangiolocellular carcinoma: an innocent-looking malignant liver tumor mimicking ductular reaction. Semin Liver Dis 2011; 31: 104-110.
 
13.
Sung JJ, Noh SJ, Bae JS, et al. Immunohistochemical Expression and Clinical Significance of Suggested Stem Cell Markers in Hepatocellular Carcinoma. J Pathol Transl Med 2016; 50: 52-57.
 
14.
Gospodarowicz MK, Wittekind C (eds.). TNM classification of malignant tumours. 8th ed. In: Brierley JD, Mary K. Digestive system tumours. 2016; 55-105.
 
15.
Shibahara J, Hayashi A, Misumi K, et al. 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. Am J Surg Pathol 2016; 40: 608-616.
 
16.
Koh KC, Lee H, Choi MS, et al. Clinicopathologic features and prognosis of combined hepatocellular cholangiocarcinoma. Am J Surg 2005; 189: 120-125.
 
17.
Chang CC, Chen YJ, Huang TH, et al. Living Donor Liver Transplantation for Combined Hepatocellular Carcinoma and Cholangiocarcinoma: Experience of a Single Center. Ann Transplant 2017; 22: 115-120.
 
18.
Ariizumi S, Kotera Y, Katagiri S, et al. Long-term survival of patients with cholangiolocellular carcinoma after curative hepatectomy. Ann Surg Oncol 2014; 21 Suppl 3: S451-S458.
 
19.
Tao CY, Liu WR, Jin L, et al. Surgical Treatment of Combined Hepatocellular-Cholangiocarcinoma is as Effective in Elderly Patients as it is in Younger Patients: A Propensity Score Matching Analysis. J Cancer 2018; 9: 1106-1112.
 
20.
Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet 2012; 379: 1245-1255.
 
21.
Kumagai A, Kondo F, Sano K, et al. Immunohistochemical study of hepatocyte, cholangiocyte and stem cell markers of hepatocellular carcinoma: the second report: relationship with tumor size and cell differentiation. J Hepatobiliary Pancreat Sci 2016; 23: 414-421.
 
22.
Jia SQ, Ren JJ, Dong PD, Meng XK. Probing the hepatic progenitor cell in human hepatocellular carcinoma. Gastroenterol Res Pract 2013; 2013: 145253.
 
23.
Sempoux C, Paradis V, Saxena R. Variant differentiation patterns in primary liver carcinoma. Semin Diagn Pathol 2017; 34: 176-182.
 
24.
Li Z, Han C, Feng J. Relationship of the expression levels of XIAP and p53 genes in hepatocellular carcinoma and the prognosis of patients. Oncol Lett 2017; 14: 4037-4042.
 
25.
Park JO, Yeh MM. Clinical significance and implication of neoangiogenesis in hepatocellular carcinoma. J Gastroenterol Hepatol 2011; 26: 792-793.
 
26.
Fodor D, Jung I, Turdean S, et al. Angiogenesis of hepatocellular carcinoma: An immunohistochemistry study. World J Hepatol 2019; 11: 294-304.
 
27.
Wang L, Yao M, Pan LH, et al. Glypican-3 is a biomarker and a therapeutic target of hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int 2015; 14: 361-366.
 
28.
Moudi B, Heidari Z, Mahmoudzadeh-Sagheb H. Meta-analysis and systematic review of prognostic significance of Glypican-3 in patients with hepatitis B-related hepatocellular carcinoma. Virusdisease 2019; 30: 193-200.
 
eISSN:2084-9869
ISSN:1233-9687
Journals System - logo
Scroll to top