title: Combined hepatocellular cholangiocarcinoma: Controversies to be addressed.
abstract: 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.
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: An-Qiang
authors.initials: AQ
authors.lastname: Wang
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Yong-Chang
authors.initials: YC
authors.lastname: Zheng
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Du
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Cheng-Pei
authors.initials: CP
authors.lastname: Zhu
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Han-Chun
authors.initials: HC
authors.lastname: Huang
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Shan-Shan
authors.initials: SS
authors.lastname: Wang
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Liang-Cai
authors.initials: LC
authors.lastname: Wu
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Xue-Shuai
authors.initials: XS
authors.lastname: Wan
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Hao-Hai
authors.initials: HH
authors.lastname: Zhang
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Ruo-Yu
authors.initials: RY
authors.lastname: Miao
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Xin-Ting
authors.initials: XT
authors.lastname: Sang
authors.affiliation: An-Qiang Wang, Yong-Chang Zheng, Juan Du, Cheng-Pei Zhu, Han-Chun Huang, Shan-Shan Wang, Liang-Cai Wu, Xue-Shuai Wan, Hao-Hai Zhang, Xin-Ting Sang, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100191, China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Zhao
mesh_terms: D001650:Bile Duct Neoplasms / Q000145:classification / Q000235:genetics / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000145:classification / Q000235:genetics / Q000473:pathology*; D002454:Cell Differentiation; D019070:Cell Lineage; D018281:Cholangiocarcinoma / Q000145:classification / Q000235:genetics / Q000473:pathology*; D020022:Genetic Predisposition to Disease; D006801:Humans; D008113:Liver Neoplasms / Q000145:classification / Q000235:genetics / Q000473:pathology*; D018193:Neoplasms, Complex and Mixed; D010641:Phenotype; D011379:Prognosis
keywords: Combined hepatocellular cholangiocarcinoma; Pathology classification; Progenitor cell origin