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HPB (Oxford). 2019 Feb;21(2):226-234. doi: 10.1016/j.hpb.2018.07.021. Epub 2018 Aug 28.

Histological and molecular characterization of intrahepatic bile duct cancers suggests an expanded definition of perihilar cholangiocarcinoma.

Author information

1
Department of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
2
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
3
Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
4
Department of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
5
Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: yohzen@med.kobe-u.ac.jp.

Abstract

BACKGROUND:

Growing evidence has suggested that intrahepatic cholangiocarcinoma (iCCA) can be classified into small- and large-duct types. The present study aimed to elucidate how large-duct iCCA is similar and dissimilar to perihilar cholangiocarcinoma (pCCA).

METHODS:

The study cohort consisted of iCCA (n = 58) and pCCA (n = 44). After iCCA tumors were separated into small- (n = 36) and large-duct (n = 22) types based on our histologic criteria, genetic statuses of the three types of neoplasms were compared. Locations of iCCA were plotted on a three-dimensional image and their distances from the portal bifurcation were measured.

RESULTS:

Large-duct iCCA was distinct from small-duct iCCA in terms of frequency of bile duct reconstruction required, perineural infiltration, and survival, with these features more similar to pCCA. Large-duct iCCA and pCCA more frequently had the loss of SMAD4 expression and MDM2 amplifications than small-duct iCCA, whereas the loss of BAP1 expression and IDH1 mutations were mostly restricted to small-duct iCCA. From imaging analysis, most tumors of large-duct iCCA were present around the second branches of the portal vein.

CONCLUSION:

Large-duct type iCCA shared the molecular features with pCCA, and it may be reasonable to expand the definition of pCCA to include cancers originating from the second bile duct branches.

PMID:
30170977
DOI:
10.1016/j.hpb.2018.07.021

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