Abstract
BackgroundNo universal classification method for intrahepatic cholangiocarcinoma (IHCC) has been reported based on the embryological origin of biliary epithelial cells. The aim of this study was to classify IHCC according to protein expression levels of somatostatin receptor 2 (SSTR2) and b-cell leukemia/lymphoma 2 (Bcl2) and to elucidate the clinicopathological features of each group.MethodsFifty-two IHCC patients who underwent hepatic resection were enrolled in this study. Protein expression levels of SSTR2 and Bcl2 were examined using immunohistochemistry. Clinicopathological factors were compared between the three groups and prognostic factors were investigated.ResultsThe patients were divided into three groups: SSTR2 positive and Bcl2 negative (p-Group H, n = 21), SSTR2 negative and Bcl2 positive (p-Group P, n = 14), and the indeterminate group (p-Group U, n = 17) for cases where SSTR2 and Bcl2 were both positive or both negative. All p-Group P cases displayed curability A or B. The 5-year survival rates of p-Group H and U patients were worse than those in p-Group P. p-Group H had higher T-factor, clinical stage, and incidence of periductal infiltration than p-Group P.ConclusionsThis method could be used to classify IHCC into peripheral and perihilar type by embryological expression patterns of SSTR2 and Bcl2.
Highlights
No universal classification method for intrahepatic cholangiocarcinoma (IHCC) has been reported based on the embryological origin of biliary epithelial cells
Patient selection Patients included in this study included 52 with IHCC, and 37 with extrahepatic cholangiocarcinoma (EHCC) as positive control was examined as control of large bile duct cancer, all of whom had undergone surgical resection at the Tokushima University Hospital between 1994 and 2017
Correlation between somatostatin receptor 2 (SSTR2) and b-cell leukemia/lymphoma 2 (Bcl2) expression and clinicopathological variables Tumor tissue was defined by cell staining for SSTR2 in the cell membrane (Fig. 1a) and Bcl2 in the cytoplasm (Fig. 1b)
Summary
No universal classification method for intrahepatic cholangiocarcinoma (IHCC) has been reported based on the embryological origin of biliary epithelial cells. Intrahepatic cholangiocarcinoma (IHCC) is a primary adenocarcinoma of the liver that arises from the intrahepatic bile ducts. It is the second most common primary hepatic tumor, after hepatocellular carcinoma (HCC), and comprises about 5–15% of total primary hepatic malignancies [1, 2]. The prognosis of patients with perihilar IHCC appears to be worse than those with peripheral IHCC [3, 4]. This heterogeneity may have resulted from the embryological origin of IHCC [1, 2, 5]. It is difficult to determine where the IHCC emerged from based only on gross
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