Taek Chung1, Hyungjin Rhee2, Ji Hae Nahm1, Youngsic Jeon3, Jeong Eun Yoo1, Young-Joo Kim4, Dai Hoon Han5, Young Nyun Park6. 1. Department of Pathology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea. 2. Department of Radiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea. 3. Department of Pathology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea. 4. Natural Products Research Center, Korea Institute of Science and Technology, Gangneung, Gangwon-do 25451, Republic of Korea. 5. Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea. 6. Department of Pathology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea. Electronic address: young0608@yuhs.ac.
Abstract
BACKGROUND: Intrahepatic cholangiocarcinoma (iCCA) is subclassified into mass-forming (MF), periductal-infiltrative (PI), and mixed types grossly; however, their clinicopathological significance remains controversial. METHODS: Clinicopathological characteristics of iCCA gross types were analysed according to histopathological type (small-duct, large-duct, indeterminate) or cholangiolocellular differentiation trait (CDT) in 108 iCCAs. The expression levels of inflammation-marker (CRP, FGB) and proliferation-marker (phospho-ERK1/2, Ki-67) were evaluated by immunohistochemistry. RESULTS: There were 87 MF, 8 PI, and 13 mixed-gross type. Small-duct-type (39, 44.8%) and CDT (19, 21.8%) were found only in MF-gross type. The inflammation-marker expression was higher in MF-type than in PI- and mixed-gross types (P = 0.023). It was high in small-duct-type, middle in indeterminate-type, and low in large-duct-type (P = 0.015), and iCCAs with CDT showed higher inflammation-marker expression compared to those without (P < 0.001). Proliferation-marker expression did not differ according to gross type; however it was lower in iCCA with CDT compared to those without (P = 0.004). Subgrouping of the gross type according to histopathological type or CDT revealed that MF-type with small-duct-type or CDT had better overall survival compared to the others (P < 0.05). CONCLUSION: MF-type iCCA is more heterogeneous than other gross types. High inflammation-marker/low proliferation-marker expression in MF-type with CDT or small-duct-type may be related to a good outcome.
BACKGROUND:Intrahepatic cholangiocarcinoma (iCCA) is subclassified into mass-forming (MF), periductal-infiltrative (PI), and mixed types grossly; however, their clinicopathological significance remains controversial. METHODS: Clinicopathological characteristics of iCCA gross types were analysed according to histopathological type (small-duct, large-duct, indeterminate) or cholangiolocellular differentiation trait (CDT) in 108 iCCAs. The expression levels of inflammation-marker (CRP, FGB) and proliferation-marker (phospho-ERK1/2, Ki-67) were evaluated by immunohistochemistry. RESULTS: There were 87 MF, 8 PI, and 13 mixed-gross type. Small-duct-type (39, 44.8%) and CDT (19, 21.8%) were found only in MF-gross type. The inflammation-marker expression was higher in MF-type than in PI- and mixed-gross types (P = 0.023). It was high in small-duct-type, middle in indeterminate-type, and low in large-duct-type (P = 0.015), and iCCAs with CDT showed higher inflammation-marker expression compared to those without (P < 0.001). Proliferation-marker expression did not differ according to gross type; however it was lower in iCCA with CDT compared to those without (P = 0.004). Subgrouping of the gross type according to histopathological type or CDT revealed that MF-type with small-duct-type or CDT had better overall survival compared to the others (P < 0.05). CONCLUSION: MF-type iCCA is more heterogeneous than other gross types. High inflammation-marker/low proliferation-marker expression in MF-type with CDT or small-duct-type may be related to a good outcome.
Authors: Rohit Chandwani; William R Jarnagin; Thomas Boerner; Esther Drill; Linda M Pak; Bastien Nguyen; Carlie S Sigel; Alexandre Doussot; Paul Shin; Debra A Goldman; Mithat Gonen; Peter J Allen; Vinod P Balachandran; Andrea Cercek; James Harding; David B Solit; Nikolaus Schultz; Ritika Kundra; Henry Walch; Michael I D'Angelica; Ronald P DeMatteo; Jeffrey Drebin; Nancy E Kemeny; T Peter Kingham; Amber L Simpson; Jaclyn F Hechtman; Efsevia Vakiani; Maeve A Lowery; J N M Ijzermans; S Buettner; B Groot Koerkamp; M Doukas Journal: Hepatology Date: 2021-09 Impact factor: 17.298