基于分子机制的肝内胆管癌研究和诊疗进展  

Advances in research,diagnosis and treatment of intrahepatic cholangiocarcinoma based on molecular mechanisms

作　　者：陈超波 仇毓东[2] Chen Chaobo;Qiu Yudong(Department of General Surgery,Xishan People′s Hospital of Wuxi City,Jiangsu Wuxi 214105,China;Department of Hepatic-Biliary-Pancreatic Surgery,Affiliated Drum Tower Hospital,Nanjing University Medical School,Jiangsu Nanjing 210008,China)

机构地区：[1]无锡市锡山人民医院,江苏无锡214105 [2]南京大学医学院附属鼓楼医院肝胆胰中心,江苏南京210008

出　　处：《腹部外科》2022年第4期245-251,共7页Journal of Abdominal Surgery

基　　金：国家自然科学基金(31971518);江苏省卫健委重点项目(ZD2021017);无锡市卫健委面上项目(M202160)。

摘　　要：胆管癌(cholangiocarcinoma,CCA)是一种高度致命的肝胆系统恶性肿瘤,发病率处于逐步上升的趋势。其中,病灶发源于肝脏实质内胆管的称为肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)或胆管细胞癌。根据大体形态,ICC可分为肿块形成型、导管周围浸润型、导管内生长型和混合型(肿块+管周浸润)。每个亚型都有不同的遗传变异性、临床表现和治疗方法。不同流行病学因素相关的ICC呈现显著的异质性,对于复发和不能切除的ICC病人,采用现有的治疗措施5年生存率依然欠佳,从而使临床诊治ICC成为一个非常棘手的难题。针对病理特点、分子发病机制的研究逐步深入,探索有效诊疗策略和干预措施显得极为重要和迫切。ICC是一种高度促结缔组织增生性癌症,分子靶向、免疫微环境等治疗可能是一种潜在的方法。此文对于ICC分子机制研究和治疗现状作一综述。Cholangiocarcinoma(CCA)is a highly lethal malignant tumor originating from hepatobiliary system and its incidence has been steadily rising yearly.The lesions originating from biliary ducts in liver parenchyma are termed as intrahepatic cholangiocarcinoma(ICC)or cholangiocarcinoma.Based upon gross morphology,CCA is classified into subtypes of mass forming(MF),periductal infiltration(PI)and mixture(MF+PI).Each subtype has different genetic variability,clinical manifestations and treatments.ICC is closely correlated with different epidemiological factors and it presents significant heterogeneity.For patients of recurrent and unresectable ICC,5-year survival rate has remained poor with existing treatments.And clinical diagnosis and treatment of ICC are rather problematic.With continuously deepening researches on pathological characteristics and molecular pathogenesis,it is imperative to explore effective diagnostic and therapeutic strategies for ICC.ICC is a highly desmoplastic cancer.Molecular targeting and immune microenvironment therapy may be promising.This review summarized current status of molecular mechanism researches of ICC.

关 键 词：胆管癌 肝内胆管癌 分子发病机制 信号通路 c-Jun N-末端激酶 手术治疗 分子靶向治疗 

分 类 号：R735.5[医药卫生—肿瘤]