【摘要】 目的：探讨双表型肝细胞癌（DPHCC）的组织学形态、免疫表型特点、鉴别诊断要点及预后。方法：回顾性分析2019年1月—2022年12月江门市中心医院收治的9例经手术切除并病理确诊的DPHCC患者临床资料，分析DPHCC的形态学特点及免疫组化特征，并复习相关文献。结果：9例DPHCC患者中，男5例，女4例；年龄31～74岁。临床症状表现为上腹部肝区闷痛不适4例，体检发现肝占位4例，婚检发现转氨酶升高1例。显微镜下肿瘤细胞呈梁索状、团片状或假腺样排列，细胞胞浆丰富，核圆形或不规则，核分裂象多见，微血管侵犯阳性3例，可见卫星结节1例。9例DPHCC患者肿瘤细胞均表达细胞角蛋白19，细胞角蛋白7阳性表达者5例。随访3～24个月，2例分别于术后8个月及12个月出现复发，其余均未见复发或转移。结论：DPHCC作为肝细胞癌的特殊亚型，更容易出现微血管侵犯，有转移和术后早期复发的高风险。因此，病理医生一定要精准诊断，为临床治疗和预后评估提供可靠的病理依据。更多还原

【Abstract】 Objective:To investigate the histological morphology, immunophenotypic features, differential diagnosis and prognosis of dual-phenotype hepatocellular carcinoma(DPHCC).Methods:A total of 9 patients with DPHCC who underwent surgical resection and were pathologically confirmed in Jiangmen Central Hospital from January 2019 to December 2022 were collected. The morphological and immunohistochemical characteristics of DPHCC were analyzed retrospectively, and the relevant papers were also reviewed.Results:Of the 9 DPHCC patients, 5 were males and 4 were females, the age was 31～74 years old.Clinical symptoms: 4 cases showed pain and discomfort in the upper abdominal liver area, 4 cases were found liver occupying by physical examination, and 1 case found elevated transaminase by premarital examination.Microscopically, the tumor cells showed beam shape, nests and solid sheet or pseudoadenoid arrangement, with abundant cytoplasm, round or irregular nuclei, and common mitotic images. 3 cases were positive for microvascular invasion, and 1 case showed satellite nodules.CK19 was expressed in all 9DPHCC cases, and CK7 was positive in 5 cases. During 3 to 24 months of follow-up, 2 cases recurred at 8 months and 12 months respectively, and the rest did not have recurrence or metastasis.Conclusion:As a special subtype of hepatocellular carcinoma,DPHCC is more prone to microvascular invasion and has a high risk of metastasis and early postoperative recurrence.Therefore,for patients with DPHCC, pathologists must make accurate diagnosis to provide reliable pathological basis for clinical treatment and prognosis assessment.更多还原