肝内胆管细胞癌的临床病理学观察

常见肝内胆管恶性肿瘤有肝内胆管癌（ICC）、细胆管细胞癌（CLC）及混合细胞型肝癌（CHC）中的胆管癌成分。ICC是肝脏第二常见恶性肿瘤，根据我院手术切除的3．3万余例肝脏恶性肿瘤的病理资料统计，肝细胞癌（HCC）和ICC分别占85．6％和7．7％，ICC的发病呈逐年上升趋势，具有易转移复发的生物学特性；CLC少见，因起源于肝脏双向分化的前体细胞而具有侵袭性强的特点；CHC的病理检出率有增多趋势，预后较HCC和ICC更差。准确的病理分型对于临床诊治和预后评估具有实际意义。

Clinicopathological study of intrahepatic bile duct cancers from 1982 to 2011

Based on tumor histogenesis, intrahepatic bile duct cancers can be classified as intrahepatic cholangiocarcinoma （ICC）, cholan-giocellular carcinoma （CLC） , or combined hepatocellular-cholangiocarcinoma （CHC）. ICC is the second most common hepatic malignant tumor type, after hepatocellular carcinoma （HCC）. Pathological analysis of more than 33 000 malignant liver tumors surgically resected from patients in our hospital between January 1982 and December 2011 revealed that HCC and ICC types accounted for 85.6% and 7.7%, respectively. In addition, elinicopathological analyses of these tumors and patient cases revealed an annual increase in incidence of ICC that was accompanied by similar positive trends in metastasis and recurrence. CLC cases were rare, but generally characterized as aggressive and originating from bipotential hepatic progenitor cells. For CHC tumors, there was an increasing trend for the pathological detection rates, but the prognosis of CHC cases remained worse than that for either HCC or ICC. The accumulated data of our institute＇s cases of intrahepatic bile duct cancers over the past 30 years indicate that pathological classification has important clinical implications for treatment and outcome.