caa a22 4500 445336323 CHVBK 20180317142756.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1585-7 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1585-7 Hepatocellular Carcinoma Expressing Cholangiocyte Phenotype Is a Novel Subtype with Highly Aggressive Behavior [Elektronische Daten] [Xin-Yuan Lu, Tao Xi, Wan-Yee Lau, Hui Dong, Zhen Zhu, Feng Shen, Meng-Chao Wu, Wen-Ming Cong] Background: The pathobiological features and surgical outcomes of patients with classical hepatocellular carcinoma (HCC)-expressing cholangiocyte markers that we named dual-phenotype HCC (DPHCC) remain unclear. The purpose of this study was to assess the association between the phenotype and surgicopathologic features of DPHCC. Methods: A retrospective single-center study was performed on the surgicopathologic features of DPHCC from 1530 consecutive surgical specimens. Immunohistochemical staining was performed with antibodies to hepatocytes (Hep Par 1/pCEA) and cholangiocytes (cytokeratin 19 [CK19]/mucin core protein-1 [MUC-1]). Results: DPHCC accounted for 10.1% (n=155) of total HCCs. The serum alfa-fetoprotein and CA19-9 were elevated in 87.7% (n=136) and 20.7% (n=32) of patients, respectively; the former had close correlation with the immunostaining of CK19 (P<0.01). The combination of immunostaining intensities of CK19 and MUC-1 was significantly associated with tumor size, microvascular invasion, and satellite nodule formation (P<0.05-0.01). Compared to patients with pure HCC, those with DPHCC had significantly lower overall survival (30.4±3.7 vs. 43.6±3.9months, P<0.05) and recurrence-free survival (13.2±2.0 vs. 23.4±2.5months, P<0.01), respectively. Multivariate Cox regression analyses identified CK19-positive expression to be an independent prognostic factor for both overall survival and recurrence-free survival. Conclusions: DPHCC is a novel surgicopathologic entity that has a highly aggressive behavior and worse postoperative prognosis than pure HCC. Because the morphological features between DPHCC and conventional HCC overlap, we recommend that CK19 be routinely used in the pathological diagnosis of HCC for screening DPHCC. Society of Surgical Oncology, 2011 Lu Xin-Yuan Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Xi Tao Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Lau Wan-Yee Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Dong Hui Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Zhu Zhen Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Shen Feng Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Wu Meng-Chao Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Cong Wen-Ming Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2210-2217 1068-9265 18:8<2210 2011 18 10434 https://doi.org/10.1245/s10434-011-1585-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1585-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lu Xin-Yuan Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 700 1- Xi Tao Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 700 1- Lau Wan-Yee Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 700 1- Dong Hui Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 700 1- Zhu Zhen Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 700 1- Shen Feng Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 700 1- Wu Meng-Chao Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 700 1- Cong Wen-Ming Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2210-2217 1068-9265 18:8<2210 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer