Published online May 14, 2016. doi: 10.3748/wjg.v22.i18.4459
Peer-review started: February 17, 2016
First decision: March 7, 2016
Revised: March 16, 2016
Accepted: April 7, 2016
Article in press: April 7, 2016
Published online: May 14, 2016
Combined hepatocellular cholangiocarcinoma (CHC) accounts for 0.4%-14.2% of primary liver cancer cases and possesses pathological features of both hepatocellular carcinoma and cholangiocarcinoma. Since this disease was first described and classified in 1949, the classification of CHC has continuously evolved. The latest definition and classification of CHC by the World Health Organization is based on the speculation that CHC arises from hepatic progenitor cells. However, there is no evidence demonstrating the common origin of different components of CHC. Furthermore, the definition of CHC subtypes is still ambiguous and the identification of CHC subtype when a single tumor contains many components has remained unresolved. In addition, there is no summary on the newly recognized histopathology features or the contribution of CHC components to prognosis and outcome of this disease. Here we provide a review of the current literature to address these questions.
Core tip: This review article focuses on the current views about the histopathology and clinical characteristics of combined hepatocellular cholangiocarcinoma (CHC). Whether the different components of CHC share a common cell origin is still ambiguous. Furthermore, the definition of CHC subtype is still ambiguous and the identification of CHC subtype when a single tumor contains many components has remained unresolved. The features between hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) make CHC has better prognosis than CC but poorer than HCC.