肝门胆管癌不同临床分期及分型对手术根治性切除及预后的评估价值  

Value of clinical staging and typing of hilar cholangiocarcinoma in evaluating radical resection and prognosis

作　　者：辛奇 于小源 刘兴凯[3] 张平[3] XIN Qi;YU Xiaoyuan;LIU Xingkai(Second Ward of Department of General Surgery,Xi’an Third Hospital,Xi’an 710016,China)

机构地区：[1]西安市第三医院普外科二病区,西安710016 [2]西安市第三医院血液与肿瘤科,西安710016 [3]吉林大学第一医院肝胆外一科,长春130021

出　　处：《临床肝胆病杂志》2020年第2期472-475,共4页Journal of Clinical Hepatology

基　　金：国家自然科学基金青年科学基金项目(8180081118)

摘　　要：肝门胆管癌(HCCA)是一种胆管黏膜上皮癌,累及肝总管、左右肝管及其汇合部。其起病隐匿,当出现黄疸时大多已进入晚期,被公认为外科领域的治疗难题。根治性切除是治疗HCCA的最佳方法,是影响肿瘤复发率和患者生存期的重要因素。因此,术前评估肿瘤的可切除性是治疗HCCA的重要一步。目前,HCCA的分型和分期方法主要有8种: Bismuth-Corlette分型、改良T分期、TNM分期、JSBS分期、Gazzaniga分期、国际胆管癌协会分期系统、梅奥分期、Blechacz分期。在临床实践中,不同分期和分型均存有各自的优缺点。主要对HCCA的分期和分型方法作一系统综述,重点评述各分期和分型在术前评估根治性切除和预后方面的临床价值。Hilar cholangiocarcinoma (HCCA) is a malignant tumor arising from the epithelium of the bile duct, which involves the common hepatic duct, the left and right hepatic ducts, and the confluence areas of these bile ducts. HCCA has an insidious onset and most patients are in the advanced stage when jaundice is observed, and therefore it is considered a difficult issue in the field of surgery. Radical resection is the optimal method for the treatment of HCCA and has great influence on recurrence rate of tumor and patients’ survival time. Therefore, preoperative evaluation of tumor resectability is an important step of HCCA treatment. At present, there are eight main methods for HCCA staging and typing, i.e., Bismuth-Corlette classification system, modified T staging system, TNM staging system, JSBS staging system, Gazzaniga staging system, International Cholangiocarcinoma Group staging system, Mayo staging system, and Blechacz staging system. Each staging and typing system has its own advantages and disadvantages in clinical practice. This article reviews the staging and typing methods for HCCA, with a focus on the clinical value of each staging and typing system in preoperative evaluation of radical resection and prognosis.

关 键 词：Klatskin肿瘤 肿瘤分期 外科手术 预后 

分 类 号：R735.8[医药卫生—肿瘤]