Intrahepatic cholangiocarcinoma (ICC) is a heterogeneous disease characterized by a dismal prognosis. Various attempts have been made to classify ICC subtypes with varying prognoses, but a consensus has yet to be reached. This systematic review aims to gather relevant data on the multi-omics-based ICC classification. The PubMed, Embase, and Cochrane databases were searched for terms related to ICC and multi-omics analysis. Studies that identified multi-omics-derived ICC subtypes and investigated clinicopathological predictors of long-term outcomes were included. Nine studies, which included 910 patients, were considered eligible. Mean 3- and 5-year overall survival were 25.7% and 19.6%, respectively, for the multi-omics subtypes related to poor prognosis, while they were 70.2% and 63.3%, respectively, for the subtypes linked to a better prognosis. Several negative prognostic factors were identified, such as genes’ expression profile promoting inflammation, mutations in the KRAS gene, advanced tumor stage, and elevated levels of oncological markers. The subtype with worse clinicopathological characteristics was associated with worse survival (Ref.: good prognosis subtype; pooled hazard ratio 2.06, 95%CI 1.67–2.53). Several attempts have been made to classify molecular ICC subtypes, but they have yielded heterogeneous results and need a clear clinical definition. More efforts are required to build a comprehensive classification system that includes both molecular and clinical characteristics before implementation in clinical practice to facilitate decision-making and select patients who may benefit the most from comprehensive molecular profiling in the disease’s earlier stages.
肝内胆管癌（ICC）是一种异质性疾病，预后较差。目前已有多种尝试对具有不同预后的ICC亚型进行分类，但尚未达成共识。本系统综述旨在收集基于多组学的ICC分类相关数据。通过检索PubMed、Embase和Cochrane数据库中与ICC及多组学分析相关的术语，筛选出识别多组学衍生的ICC亚型并研究长期结局临床病理预测因素的研究。最终纳入9项研究，共涉及910例患者。与不良预后相关的多组学亚型平均3年和5年总生存率分别为25.7%和19.6%，而与较好预后相关的亚型则分别为70.2%和63.3%。研究确定了多个不良预后因素，包括促进炎症的基因表达谱、KRAS基因突变、晚期肿瘤分期以及肿瘤标志物水平升高。具有较差临床病理特征的亚型与较差的生存率相关（参照：良好预后亚型；合并风险比2.06，95%置信区间1.67–2.53）。尽管已有多种分子ICC亚型分类的尝试，但结果存在异质性且缺乏明确的临床定义。在临床实践中应用前，需要更多努力构建一个包含分子和临床特征的综合分类系统，以辅助临床决策，并筛选在疾病早期阶段最可能从全面分子分析中获益的患者。
Multi-Omics Classification of Intrahepatic Cholangiocarcinoma: A Systematic Review and Meta-Analysis
肿瘤(癌症)患者之家