Abstract:
Objective:To study the predictive value of serum levels of AFP, CA19-9 and WHO histological types for the prognosis of combined hepatocellular carcinoma-cholangiocarcinoma patients after surgery. Methods:From April 1999 to March 2017, 206 patients with cHCC-ICC who underwent curative surgical resection at Zhongshan Hospital, Fudan University were selected. The histological types of cHCC-ICC were reassessed and the clinicopathologic information of each patient was intact. According to the results of immunohistochemistry, pathological results were divided into type Ⅰ and type Ⅱ (Ⅱa, Ⅱb, and Ⅱc). According to the serum level of AFP and CA19-9, 206 cHCC-ICC patients were categorized into 3 groups: double positive group (AFP+CA19-9-, n=41), single positive group (AFP+CA19-9- or AFP-CA19-9-, n=114) and double negative group (AFP-CA19-9-, n=51). The correlation between different clinicopathological features was analyzed. Survival analysis was performed between different groups and histological types. Results:The double-positive group had a shorter overall survival time (OS) compared with the single positive group (P=0.002) or the double-negative group (P=0.008), and the incidence of microvascular invasion was higher than that of the single positive group (P=0.001) and the double negative group (P=0.006); whereas the tumor-free survival time did not differ among the groups. In patients with TNM-ICC stage Ⅰ, histological type Ⅱ a, type Ⅱ c had a shorter disease-free survival time (DFS) than patients with type Ⅰ (P=0.048). No correlation was found between histological types and OS or DFS in other stages. Conclusions:Histopathological classification based on the WHO classification criteria in 2010 has no significant correlation with the prognosis of cHCC-ICC. The combined application of serum AFP and CA19-9 is helpful to forecast the prognostic value of cHCC-ICC.