关键词: 混合型肝细胞胆管细胞癌, 肝细胞癌, 肝内胆管扩张, 肿瘤包膜, 预后

Abstract: Objective To investigate the clinical characteristics and prognosis of hepatocellular carcinoma (HCC) and combined hepatocellular-cholangiocarcinoma (cHCC-CC). Methods From December 2014 to December 2017, 60 patients with HCC and 60 patients with cHCC-CC in our hospital were enrolled as HCC group and cHCC-CC group. The clinical data of the patients were collected. On the day of admission, 2 ml of elbow vein blood was collected to examine the levels of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). The receiver operating characteristic (ROC) curve was drawn to evaluate the value of related indexes in differential diagnosis for HCC and cHCC-CC. And the 2-year prognosis was compared between the 2 groups. Results The proportions of local infiltration, intrahepatic biliary ductal dilatation, portal vein involvement and tumor capsule in cHCC-CC group were significantly higher than those in HCC group (P<0.05). Serum CA19-9 level in cHCC-CC group was significantly higher than that in HCC group (P<0.05). There was no difference in serum CEA level between the 2 groups (P>0.05). The area under the ROC curve of serum CA19-9 for the identification of cHCC-CC and HCC was 0.735 (standard error = 0.046, P=0.000, 95% confidence interval = 0.644 ~ 0.825), and the optimal cut-off was 215.400 mIu/L. There was no significant difference in the 2-year tumor-free survival rate between the 2 groups (P>0.05). And the overall survival rate in the cHCC-CC group was significantly lower than that in the HCC group (P<0.05). Conclusion There were significant differences in the rates of local infiltration, intrahepatic biliary ductal dilatation, portal vein involvement and tumor capsule between HCC and cHCC-CC patients. And serum CA19-9 can be used as an important indicator to distinguish them. The prognosis of cHCC-CC patients is relatively poor.

Key words: Combined hepatocellular-cholangiocarcinoma, Hepatocellular carcinoma, Intrahepatic biliary ductal dilatation, Tumor capsule, Prognosis