Moreover, microvascular invasion (MVI), higher Ki-67 index and tumor in vein (also termed as macrovascular invasion) were considered important predictors of prognosis in various tumors [24–27], so their high prevalence in large duct iCCA conformed to the fact that large duct iCCA exhibits more aggressive pathological features and worse prognosis, as described in the 5th WHO classification [3–8]. This evidence concerns the gene MKI67 and neoplasm.