Clinicopathological characteristics and surgical outcomes of sarcomatoid hepatocellular carcinoma  

作　　者：Jian-Ping Wang Zhi-Gang Yao Ya-Wen Sun Xi-Han Liu Feng-Kai Sun Cun-Hu Lin Fu-Xin Ren Bei-Bei Lv Shuai-Jun Zhang Yang Wang Fan-Ying Meng Shun-Zhen Zheng Wei Gong Jun Liu 

机构地区：[1]Department of Liver Transplantation and Hepatobiliary Surgery,Shandong Provincial Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250021,Shandong Province,China [2]Department of Liver Transplantation and Hepatobiliary Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong Province,China [3]Department of Pathology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong Province,China [4]Cancer Prevention and Control Research Office of Shandong Province,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,Shandong Province,China [5]Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong Province,China [6]Department of Gastroenterology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong Province,China [7]Shandong Medical Imaging Research Institute,Shandong University,Jinan 250021,Shandong Province,China [8]Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong Province,China

出　　处：《World Journal of Gastroenterology》2020年第29期4327-4342,共16页世界胃肠病学杂志（英文版）

基　　金：Supported by Shandong Provincial Natural Science Foundation,China,No.ZR2014HP065 and No.ZR2017BH072;National Natural Science Foundation of China,No.81373172 and No.81770646;and Shandong Key R&D Program,No.2015GGB14099 and No.

摘　　要：BACKGROUND Hepatocellular carcinoma(HCC)is the sixth most common type of cancer and the fourth leading cause of cancer-related death worldwide.Sarcomatoid HCC,which contains poorly differentiated carcinomatous and sarcomatous components,is a rare histological subtype of HCC that differs from conventional HCC.It is highly aggressive and has a poor prognosis.Its clinicopathological characteristics,surgical outcomes and underlying mechanisms of its highly aggressive nature have not been fully elucidated.AIM To examine the clinicopathological characteristics and surgical outcomes of sarcomatoid HCC and explore the histogenesis of sarcomatoid HCC.METHODS In total,196 patients[41 sarcomatoid HCC and 155 high-grade(Edmondson-Steiner grade III or IV)HCC]who underwent surgical resection between 2007 and 2017 were retrospectively reviewed.The characteristics and surgical outcomes of sarcomatoid HCC were compared with those of patients with high-grade HCC.The histological composition of invasive and metastatic sarcomatoid HCCs was evaluated.RESULTS Sarcomatoid HCC was more frequently diagnosed at an advanced stage with a larger tumor and higher rates of nonspecific symptom,adjacent organ invasion and lymph node metastasis than high-grade HCC(all P<0.05).Compared with high-grade HCC patients,sarcomatoid HCC patients are less likely to have typical dynamic imaging features of HCC(44.4%vs 72.7%,P=0.001)and elevated serum alpha-fetoprotein levels(>20 ng/mL;36.6%vs 78.7%,P<0.001).The sarcomatoid group had a significantly shorter median recurrence-free survival(5.6 mo vs 16.4 mo,log-rank P<0.0001)and overall survival(10.5 mo vs 48.1 mo,log-rank P<0.0001)than the high-grade group.After controlling for confounding factors,the sarcomatoid subtype was identified as an independent predictor of poor prognosis.Pathological analyses indicated that invasive and metastatic lesions were mainly composed of carcinomatous components.CONCLUSION Sarcomatoid HCC was associated with a more advanced stage,atypical dynamic imaging,lower serum alpha-

关 键 词：Sarcomatoid hepatocellular carcinoma Histological composition Liver resection Overall survival Recurrence-free survival 

分 类 号：R735.7[医药卫生—肿瘤]