PARProceedings of Anticancer Research2208-35452208-3553Bio-Byword Scientific Publishing Pty. Ltd.10.26689/par.v10i3.14766ArticleAnalysis of Clinicopathological Features of Dual- Phenotype Hepatocellular Carcinomahttps://artdesignp.com/journal/PAR/10/3/10.26689/par.v10i3.14766ShiQingtao,QiuHuilei,ChuZhanshuo20261032026-05-31Objective: To investigate the clinical manifestations, histopathological features, and differential diagnosis of dual-phenotype hepatocellular carcinoma. Methods: Histopathological observation and immunohistochemical study were performed on 3 cases of dual-phenotype hepatocellular carcinoma. Results: The tissues of 3 cases of dual-phenotype hepatocellular carcinoma showed irregular, unevenly sized nests and trabeculae. One case was dominated by fibrous stroma with indistinct sinusoids, and 2 cases had obvious sinusoids. The cells were large, polygonal, with strong cell adhesion, relatively clear cell boundaries, and abundant and strongly eosinophilic cytoplasm. The cell nuclei exhibited significant pleomorphism and atypia, with thick nuclear membranes, coarse chromatin in clumps, obvious nucleoli, and visible mitoses. Conclusion: Dual-phenotype hepatocellular carcinoma is a unique and highly aggressive subtype of primary liver cancer, which is relatively rare and often occurs in patients with hepatitis and cirrhosis, with abdominal pain as the main clinical symptom. It has the biological behaviors of both hepatocellular carcinoma (HCC) and cholangiocarcinoma, and the clinical prognosis is poor.

Lu X, Xi T, Lau W, et al., 2011, Hepatocellular Carcinoma Expressing Cholangiocytic Phenotype Is a Novel Subtype with Highly Aggressive Behavior. Ann Surg Oncol, 18(8): 2210–2217.

Zheng Q, Feng C, Lian Y, et al., 2020, Clinicopathological Analysis of Six Cases of Dual-Phenotype Hepatocellular Carcinoma. Chinese Journal of Pathology, 49(12): 1320–1322.

Zhang J, Qi Y, Ma N, et al., 2020, Overexpression of EpCAM and CD133 Correlates with Poor Prognosis in Dual-Phenotype Hepatocellular Carcinoma. J Cancer, 11(11): 3400–3406.

Wang H, Cong W, 2017, Advances in Clinicopathological Research on a New Subtype of Dual-Phenotype Hepatocellular Carcinoma. Chinese Journal of Clinical Oncology, 44(12): 616–619.

Liver Cancer Committee of the Chinese Anti-Cancer Association, Liver Cancer Group of the Hepatology Branch of the Chinese Medical Association, Pathology Committee of the Chinese Anti-Cancer Association, et al., 2015, Guidelines for Standardized Pathological Diagnosis of Primary Liver Cancer (2015 Edition). Chinese Journal of Hepatobiliary Surgery, 21(3): 145–151.

Sayiner M, Golabi P, Younossi Z, 2019, Disease Burden of Hepatocellular Carcinoma: A Global Perspective. Digestive Diseases and Sciences, 64(4): 910–917.

Ford M, Ivanina E, Desai P, et al., 2017, Geographic Epidemiology of Hepatocellular Carcinoma, Viral Hepatitis, and Socioeconomic Position in New York City. Cancer Causes Control, 28(7): 779–789.

Slin S, Upadhyay N, Greeffbaum T, et al., 2015, Ablation of Foxl1-Cre-Labeled Hepatic Progenitor Cells and Their Descendants Impairs Recovery of Mice from Liver Injury. Gastroenterology, 148(1): 192–202.

Lee J, Heo J, Libbrecht L, et al., 2006, A Novel Prognostic Subtype of Human Hepatocellular Carcinoma Derived from Hepatic Progenitor Cells. Nature Medicine, 12(4): 410–416.

Kowalik M, Sulas P, Ledda-Columbano G, Giordano S, Columbano A, Perra A, 2015, Cytokeratin-19 Positivity Is Acquired Along Cancer Progression and Does Not Predict Cell Origin in Rat Hepatocarcinogenesis. Oncotarget, 6(36): 38749–38763.

Stavraka C, Rush H, Ross P, 2019, Combined Hepatocellular Cholangiocarcinoma (cHCC-CC): An Update on Genetics, Molecular Biology, and Therapeutic Interventions. J Hepatocellular Carcinoma, 6: 11–21.

Komuta M, Yeh M, 2019, A Review and Update on Combined Hepatocellular Cholangiocarcinoma. Semin Liver Dis, 40(2): 124–130.

Ueno S, Sudo T, Oka N, et al., 2013, Absence of Human Papillomavirus Infection and Activation of PI3K-AKT Pathway in Cervical Clear Cell Carcinoma. Int J Gynecol Cancer, 23(6): 1084–1091.