双表型肝细胞癌的临床病理特征分析及其与临床预后的关系

Clinicopathological characteristics of dual-phenotype hepatocellular carcinoma and its relationship with clinical prognosis

目的探讨双表型肝细胞癌(DPHCC)的临床病理特征及其与临床预后的关系。方法收集2016-08—2021-03苏州大学附属第一医院收治的DPHCC患者12例,回顾性描述其肿瘤的组织学形态、免疫组化特征、乙型肝炎病毒(HBV)感染与治疗情况及临床预后。结果12例DPHCC患者中男性9例,女性3例,年龄39~80岁(中位年龄57.5岁),临床表现主要为右上腹闷痛。其中10例有HBV感染史,仅1例患者规律抗病毒治疗。影像学检查5例为单发结节,7例为多发结节。组织学表现为HCC特征,免疫组化同时表达HCC和ICC标志物。10例出现不同程度的肝内或肝外转移,2例转移不除外。结论DPHCC是HCC的特殊亚型,其诊断主要依靠免疫组化染色。HBV是DHPCC的一个高危因素,规律抗病毒治疗有利于预防DPHCC的发生及改善其预后。

Objective To investigate the clinicopathological features of dual-phenotype hepatocellular carcinoma(DPHCC)and its relationship with clinical prognosis.Methods Twelve DPHCC patients admitted to the First Affiliated Hospital of Soochow University from August 2016 to March 2021 were retrospectively described in terms of histological morphology,immunohistochemical characteristics,HBV infection,treatment and clinical prognosis.Results Among the 12 DPHCC patients,there were 9 males and 3 females,aged 39-80 years(median age 57.5 years),and the main clinical manifestations were tightness and pain in the right upper abdomen.Among them,10 patients had a history of HBV infection,and only 1 patient received regular antiviral treatment.Imaging examination showed single nodules in 5 cases and multiple nodules in 7 cases.Histologically,HCC was characterized,and both HCC and ICC markers were expressed by immunohistochemistry.Conclusion DPHCC is a special subtype of HCC,and its diagnosis mainly depends on immunohistochemical staining.HBV is a high risk factor for DHPCC,and regular antiviral treatment is beneficial to prevent DPHCC and improve its prognosis.