肝内胆管细胞癌的诊疗现状与思考  

Diagnosis and treatment of intrahepatic cholangiocarcinoma:Current status and thoughts

作　　者：夏龙 夏医君 张磊 朱曙光[1] 武慧军 李华[1] 陈规划[1] XIA Long;XIA Yijun;ZHANG Lei;ZHU Shuguang;WU Huijun;LI Hua;CHEN Guihua(Department of Hepatic Surgery&Liver Transplantation Center,The Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China;Department of Biliary-Pancreatic Surgery,The Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China;Department of Hepatobiliary-Pancreatic-Splenic Surgery,The People’s Hospital of Inner Mongolia Autonomous Region,Hohhot 010010,China)

机构地区：[1]中山大学附属第三医院肝脏外科暨肝脏移植中心 [2]中山大学附属第三医院胆胰外科,广州510630 [3]内蒙古自治区人民医院肝胆胰脾外科,呼和浩特010010

出　　处：《临床肝胆病杂志》2020年第10期2380-2385,共6页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81172038)。

摘　　要：肝内胆管细胞癌(ICC)是发生率仅次于肝细胞癌极具恶性生物学行为的原发性肝癌,近年来,发生率及病死率均呈明显升高趋势。由于生物学特性与肝细胞癌和肝外胆管癌存在显著差异,不仅缺乏特征性临床症状和肿瘤标志物,且侵袭性强,手术切除率低,术后易复发转移,致使总体预后极差。随着分子生物学技术的发展及诊疗经验的累积,对ICC的生物学特性及临床转归认识的逐渐深入,相应的外科诊疗策略和技术手段正发生着深刻变革,当前基于多学科讨论以手术为主的综合治疗是ICC主流治疗模式,强调R0切除和区域性淋巴结清扫有助于提高疗效、改善预后。然而在实现对ICC早期诊断、精准化、规范化、个性化治疗的道路上,尚存一些值得深思的问题。Intrahepatic cholangiocarcinoma(ICC)is a primary liver cancer with malignant biological behaviors and ranks only second to hepatocellular carcinoma in incidence rate,and in recent years,the incidence and mortality rates of ICC have been increasing significantly.Since ICC has significant different biological characteristics from hepatocellular carcinoma and extrahepatic cholangiocarcinoma,ICC lacks characteristic clinical symptoms and specific tumor markers and has strong invasion,a low surgical resection rate,and a tendency of recurrence and metastasis after surgery,which results in poor overall prognosis.With the development of molecular biology techniques and the accumulation of diagnosis and treatment experience,there is a gradually deepened understanding of the biological characteristics and clinical outcomes of ICC,and the corresponding surgical diagnosis and treatment strategies and technical means are undergoing profound transformation.At present,multidisciplinary comprehensive treatment,mainly surgery,is the mainstream paradigm for the treatment of ICC,and emphasis on R0 resection and regional lymph node dissection helps to improve clinical outcome and prognosis.However,there are still some problems for consideration on the way to the early diagnosis and the precise,standardized,and individualized treatment of ICC.

关 键 词：胆管上皮癌 异质性 早期诊断 治疗学 

分 类 号：R735.7[医药卫生—肿瘤]