肝内胆管细胞癌的治疗策略研究进展  

Treatment of intrahepatic cholangiocarcinoma

作　　者：公磊[1] 黄鑫[1] 束斌[1] 张琪佳 王良[1] 汤睿[1] 肖颖[2] 项灿宏[1] Gong Lei;Huang Xin;Shu Bin;Zhang Qijia;Wang Liang;Tang Rui;Xiao Ying;Xiang Canhong(Department of Hepatopancreatobiliary Surgery,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China;Department of Pathology,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院肝胆胰外科,102218 [2]清华大学附属北京清华长庚医院病理科,102218

出　　处：《国际外科学杂志》2020年第6期386-391,F0004,共7页International Journal of Surgery

摘　　要：肝内胆管细胞癌(ICC)手术可切除率低、复发率高、生存期短,制定并优化手术效果的策略至关重要。尽管肝移植也有一定的应用前景,但目前ICC仍然唯一可能有效的治疗方法是手术切除。ICC在大体分为肿块型、管内生长型、管周浸润型和混合(肿块+管周浸润)型4种分型。临床上主要根据ICC的大体分型来决定治疗策略。术前门静脉栓塞、新辅助治疗、淋巴结清扫等的应用,使得更多的患者手术切除成为可能,并提高了手术的效果。术后辅助应用化疗、放疗等可以较为显著地改善患者的预后。分子靶向治疗、免疫治疗迅猛发展,正逐渐改变着ICC的临床治疗模式。Intrahepatic cholangiocarcinoma has low resectability rate,high recurrence and short survival.It is very important to formulate and optimize the strategy of surgical treatment.The only potentially effective treatment for intrahepatic cholangiocarcinoma is surgical resection.Liver transplantation also has some application prospects.Intrahepatic cholangiocarcinoma can be divided into four types:mass forming type,intraductal growth type,periductal infiltration type,mass forming+periductal infiltration(mixed)type.Clinically,the treatment strategy is mainly determined according to the general classification.The application of methods such as preoperative portal vein embolism,neoadjuvant therapy and lymph node dissection make it possible for more patients to undergo surgical resection and improve the surgical effect.Adjuvant treatment including chemotherapy and radiotherapy can significantly improve the prognosis of the patients.The rapid development of molecular targeted therapy and immunotherapy is gradually changing the clinical treatment of intrahepatic cholangiocarcinoma.

关 键 词：胆管肿瘤 治疗应用 肿瘤辅助疗法 肝内胆管细胞癌 手术切除 

分 类 号：R735.8[医药卫生—肿瘤]