Authors:	Gerber, Tiemo S. Müller, Lukas Bartsch, Fabian Gröger, Lisa-Katharina Schindeldecker, Mario Ridder, Dirk A. Goeppert, Benjamin Möhler, Markus Dueber, Christoph Lang, Hauke Roth, Wilfried Kloeckner, Roman Straub, Beate K.
Title:	Integrative analysis of intrahepatic cholangiocarcinoma subtypes for improved patient stratification : clinical, pathological, and radiological considerations
Online publication date:	19-Jan-2023
Year of first publication:	2022
Language:	english
Abstract:	Intrahepatic cholangiocarcinomas (iCCAs) may be subdivided into large and small duct types that differ in etiology, molecular alterations, therapy, and prognosis. Therefore, the optimal iCCA subtyping is crucial for the best possible patient outcome. In our study, we analyzed 148 small and 84 large duct iCCAs regarding their clinical, radiological, histological, and immunohistochemical features. Only 8% of small duct iCCAs, but 27% of large duct iCCAs, presented with initial jaundice. Ductal tumor growth pattern and biliary obstruction were significant radiological findings in 33% and 48% of large duct iCCAs, respectively. Biliary epithelial neoplasia and intraductal papillary neoplasms of the bile duct were detected exclusively in large duct type iCCAs. Other distinctive histological features were mucin formation and periductal-infiltrating growth pattern. Immunohistochemical staining against CK20, CA19-9, EMA, CD56, N-cadherin, and CRP could help distinguish between the subtypes. To summarize, correct subtyping of iCCA requires an interplay of several factors. While the diagnosis of a precursor lesion, evidence of mucin, or a periductal-infiltrating growth pattern indicates the diagnosis of a large duct type, in their absence, several other criteria of diagnosis need to be combined.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-8587
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Cancers 14 13
Pages or article number:	3156
Publisher:	MDPI
Publisher place:	Basel
Issue date:	2022
ISSN:	2072-6694
Publisher DOI:	10.3390/cancers14133156
Appears in collections:	DFG-491381577-G