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Biphenotypic (hepatobiliary) primary liver carcinomas: the work in progress.

Elizabeth M Brunt1,1, Valerie Paradis2,2, Christine Sempoux3,3

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|September 8, 2018
PubMed
Summary

The recent WHO classification for primary liver carcinomas is incomplete. Further research is needed to fully describe these biphenotypic tumors, which show mixed differentiation at tissue and cellular levels.

Keywords:
cholangiocarcinomacholangiolocellular carcinomacombined hepatocellular–cholangiocarcinomahepatocarcinogenesishepatocellular carcinomaliver progenitor cellliver stem cellmixed hepatobiliary carcinomaprimary liver carcinomastem cell tumorstemness

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Area of Science:

  • Hepatobiliary pathology
  • Tumor classification
  • Cancer research

Background:

  • The World Health Organization (WHO) classification for combined hepatocellular-cholangiocarcinoma and stem cell subtypes has spurred research.
  • This classification, while significant, appears insufficient for comprehensively describing all primary liver carcinomas exhibiting biphenotypic differentiation.

Purpose of the Study:

  • To review the historical context of primary liver carcinomas with biphenotypic differentiation.
  • To examine the broader spectrum of these tumors beyond the current WHO classification.
  • To highlight the complexities of mixed hepatobiliary phenotypes and immunophenotypes.

Main Methods:

  • Literature review of historical classifications and descriptions of primary liver carcinomas.
  • Analysis of existing research on tumors with biphenotypic differentiation.
  • Examination of phenotypic and immunophenotypic characteristics at both tissue and cellular levels.

Main Results:

  • Primary liver carcinomas with biphenotypic differentiation represent a diverse group of tumors.
  • Mixed hepatobiliary phenotypes are observed at the tissue level, with features of both hepatocellular and cholangiocarcinoma differentiation.
  • Mixed immunophenotypes occur at the cellular level, where individual cells exhibit characteristics of one cell type but express markers of both.

Conclusions:

  • The current WHO classification is inadequate for fully characterizing the spectrum of primary liver carcinomas with biphenotypic differentiation.
  • Further investigation is required to understand the pathobiology and clinical implications of these complex tumors.
  • Future research should address the pathobiologic and clinical questions raised by the diverse presentations of biphenotypic liver carcinomas.