这项单中心回顾性研究旨在阐明肿块型肝内胆管癌的临床和病理背景。共选取2007年至2021年53例肿块型肝内胆管癌患者，根据术前CT等多项参数进行分析。模式（动态对比增强计算机断层扫描的动脉期增强）、临床数据和通过免疫组织化学评估的肿瘤微环境。超增强 (n = 13) 和低增强 (n = 40) 组是使用比肝实质衰减更高的肿瘤的 50% 截止值来定义的。超增强组的特点是总体生存率高于低增强组（5 年）存活率：分别为 86% 与 27%；P < .001）以及瘤周（92% 与 58%；P = .020）和瘤内 CD3 阳性 T 淋巴细胞（85% 与 35%；P = .002）。相反，低增强组的特点是与瘤周 CD163 阳性肿瘤相关巨噬细胞（60% vs 8%；P = .001）、瘤周五聚蛋白 3 阳性肿瘤相关巨噬细胞（50% vs 15%；P = .001）相比具有更高的浸润。 = .024），以及瘤内 α-平滑肌肌动蛋白阳性癌症相关成纤维细胞（15% vs 68%；P = .001）。进行多元回归分析以预测微环境的总生存率，独立的不良预测因素是瘤内 CD3 阳性 T 淋巴细胞低（风险比 = 2.75）、瘤周高（风险比 = 2.38）和瘤内 CD163 阳性肿瘤-相关巨噬细胞（风险比 = 2.81）（所有 P 值 < 0.05）。与低血管相比，血管丰富的肝内肿块形成性肝内胆管癌具有更好的肿瘤免疫和预后。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

This single-center retrospective study aimed to clarify the clinical and pathologic background of mass-forming intrahepatic cholangiocarcinomas.A total of 53 patients with mass-forming intrahepatic cholangiocarcinomas were selected from 2007 to 2021 and analyzed based on several parameters, including the preoperative computed tomography pattern (enhancement in the arterial phase of dynamic contrast-enhanced computed tomography), clinical data, and tumor microenvironment evaluated by immunohistochemistry. The hyperenhancement (n = 13) and hypoenhancement (n = 40) groups were defined using the 50% cutoff of tumors with higher attenuation than the liver parenchyma.The hyperenhancement group was characterized by a better overall survival than the hypoenhancement group (5-year survival: 86% vs 27%, respectively; P < .001) and by a higher infiltration of peritumoral (92% vs 58%; P = .020) and intratumoral CD3-positive T lymphocytes (85% vs 35%; P = .002). Conversely, the hypoenhancement group was characterized by a higher infiltration versus peritumoral CD163-positive tumor-associated macrophages (60% vs 8%; P = .001), peritumoral pentraxin 3-positive tumor-associated macrophages (50% vs 15%; P = .024), and intratumoral α-smooth muscle actin-positive cancer-associated fibroblasts (15% vs 68%; P = .001). A multiple regression analysis was performed to predict overall survival from the microenvironment, and the independent poor predictor factors were low intratumoral CD3-positive T lymphocytes (hazard ratio = 2.75), high peritumoral (hazard ratio = 2.38), and intratumoral CD163-positive tumor-associated macrophages (hazard ratio = 2.81) (all P values < 0.05).Compared with hypovascular, hypervascular mass-forming intrahepatic cholangiocarcinomas have better tumor immunity and prognosis.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.