VEGF-Positive Mass-Forming Intrahepatic Cholangiocarcinoma: New Subtype Based on Radiological and Molecular...

Area of Science:

• Hepatobiliary surgery
• Surgical pathology
• Oncology

Background:

• Mass-forming (MF) intrahepatic cholangiocarcinoma (ICC) can be hypervascular (H-ICC) on imaging, correlating with better outcomes.
• The molecular basis of H-ICC remains largely undefined.

Purpose of the Study:

• To investigate the molecular characteristics of hypervascular ICC (H-ICC) by analyzing gene expression and immunohistochemical markers.
• To correlate imaging features with prognosis and molecular profiles in MF-ICC.

Main Methods:

• Retrospective analysis of 109 MF-ICC patients.
• Classification into hypervascular (H-ICC), hypovascular (h-ICC), and nonvascular (N-ICC) based on dynamic CT enhancement.
• Comparison of arterial vessel density (AVD) and profiling of angiogenesis genes, focusing on VEGFA.

Main Results:

• H-ICC demonstrated a significantly better prognosis compared to h-ICC and N-ICC.
• H-ICC exhibited higher AVD and increased VEGFA expression.
• VEGF positivity (≥70%) was identified as an optimal marker for H-ICC.

Conclusions:

• H-ICC represents a distinct clinicopathological subset of MF-ICC.
• Hyperenhancement on dynamic CT, high AVD, and elevated VEGFA expression characterize H-ICC.
• VEGF immunostaining can aid in identifying H-ICC.