Pathologic and Phenotypic Characteristics of Intrahepatic Cholangiocarcinoma Arising in Chronic Advanced Liver Disease and Cholangiocarcioma Component of Combined Hepatocellular-Cholangiocarcinoma.
Yasuni Nakanuma, Jing Xu, Kenichi Harada, Yasunori Sato, Motoko Sasaki, Ji-Hun Kim, Eunsil Yu. Kanazawa University Graduate School of Medicine, Ishikawa Prefecture, Japan; Shanxi Medical University, Shanxi, Taiyuan, China; University of Ulsan College of Medicine, Seoul, Korea
Background: Intrahepatic cholangiocarcinoma (ICC) is known to arise in non-biliary, chronic advanced liver diseases (CALD), while its pathological features remain unexplored.
Design: We tried to characterize the pathologic and phenotypic features of ICC arising in non-biliary CALD in comparison with ICC arising in almost normal livers (non-CALD) and also ICC component of combined hepatocellular cholangiocarcinoma (HC-CC). A total of 471 cases of ICC were examined, and ICC component of HC-CC (30 cases) was compared with ICC.
Results: It was found that 53 cases of ICC were associated with non-biliary CALD, while the remaining 418 cases of ICC arose in non-CALD. When ICCs were classified into bile duct (conventional) adenocarcinoma, bile ductular adenocarcinoma, variants, and intraductal papillary neoplasm of bile duct (IPNB), a whole spectrum of such subtypes of ICC were found in non-CALD and also non-biliary CALD. A majority of ICCs belonged to bile duct type in both groups (67.9% in non-biliary CALD and 64.1% in non-CALD). Interestingly, bile ductular type was rather frequent (22.6%) in non-biliary CALD in comparison with non-CALD (8.4%). In contrast, IPNB was rather frequent in non-CALD (22.5%) in comparison with non-biliary CALD (3.8%). Comaparison of ICC component of HC-CC (30 cases) with ICC showed that expression of mucin was higher in ICC with non-CALD, while such expression was relatively lower in ICC with CALD and CC component of HC-CC. Expression of biliary markers (CK7, CK19, EMA and EpCAM) was relatively lower in CC with CALD and higher in CC component of HC-CC cases in comparison with CC with non-CALD. ICC with CALD and CC component of HC-CC showed higher expression of hepatic progenitor cell markers (NCAM and c-kit), while such epxression was lower in ICC with non-CALD.
Conclusions: A whole pathological spectrum of ICC arising in non-CALD were also found in non-biliary CALD. Bile ductular type was rather specifically frequent in non-biliary CALD, suggesting this type was rather characteristic to non-biliary CALD, probably involving hepatic progentitor cells. ICC arising in CALD and ICC component of combined HC-CC showing similar features, may have the cholangiocarcinogenesis involving hepatic progenitor cells.
Category: Liver & Pancreas
Wednesday, March 2, 2011 9:30 AM
Poster Session V # 198, Wednesday Morning