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Clinicopathologic features of patients with intrahepatic cholangiocarcinoma who are seropositive for α‐fetoprotein‐L3 and those with combined hepatocellular and cholangiocarcinoma
Author(s) -
Okuda Hiroaki,
Shiratori Keiko,
Yamamoto Masakazu,
Takasaki Ken,
Nakano Masayuki
Publication year - 2006
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04257.x
Subject(s) - intrahepatic cholangiocarcinoma , medicine , hepatocellular carcinoma , gastroenterology , alpha fetoprotein , hepatectomy , surgery , resection
Background: Some patients who are seropositive for lectin‐reactive α‐fetoprotein (AFP‐L3) have intrahepatic cholangiocarcinoma (ICC). There have been no studies regarding the features of ICC patients seropositive for AFP‐L3. Thus, the purpose of the present paper was to compare the features of ICC patients from the viewpoint of two different tumor markers, AFP‐L3 and carbohydrate antigen (CA) 19‐9. Methods: The ICC patients who underwent hepatectomy ( n = 51) were divided into three groups, and their clinicopathologic features were compared: (i) group A, seropositive for AFP‐L3 ≥ 15%; (ii) group B, seropositive for CA 19‐9 ≥ 37 U/mL; and (iii) group C, seronegative for both AFP‐L3 and CA 19‐9. The features of combined hepatocellular and cholangiocarcinoma ( n = 11) were also studied. Results: Group A had a higher positivity rate for hepatitis viruses than group B (60% vs 20%, P < 0.05). More patients in group A were misdiagnosed as having hepatocellular carcinoma (HCC) at surgery (70% vs 5.7%, P < 0.001) who also had chronic liver disease (80% vs 25.7%, P < 0.01) than in group B. Seven, 10 and 11 of the 11 patients with combined hepatocellular and cholangiocarcinoma were seropositive for AFP‐L3, CA 19‐9 and hepatitis viruses, respectively. Ten were diagnosed as having HCC at surgery and nine had chronic liver disease. Conclusions: Patients with ICC seropositive for AFP‐L3 and those with combined hepatocellular and cholangiocarcinoma have features close to HCC. The present study has, for the first time, identified a subgroup of ICC patients, seropositive for AFP‐L3, having features close to HCC that are very different from those of the classical ICC patients seropositive for CA 19‐9.