肝胆肿瘤临床诊疗实践系列指南解读:肝细胞癌和肝内胆管癌  

Interpretation of clinical practice guidelines of diagnosis and treatment of hepatobiliary tumors:hepatocellular carcinoma and intrahepatic cholangiocarcinoma

作　　者：石明亮 申洋 王明达 杨田 Shi Mingliang;Shen Yang;Wang Mingda;Yang Tian(Department of General Surgery,The First Affiliated Hospital of Henan University,Kaifeng 475001,China;Department of Hepatic Surgery,Eastern Hepatobiliary Surgery Hospital,Naval Medical University,Shanghai 200438,China)

机构地区：[1]河南大学第一附属医院普通外科,开封475001 [2]海军军医大学第三附属医院肝脏外科,上海200438

出　　处：《中华消化外科杂志》2024年第2期188-196,共9页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(82273074、81972726);上海市优秀学术带头人计划项目(23XD1424900);上海市卫生健康学科带头人项目(2022XD001);上海市自然科学基金(22ZR1477900);河南省医学科技攻关计划(LH⁃GJ20210564)。

摘　　要：原发性肝癌是一种起病隐匿且高度恶性的消化道肿瘤,常伴有局部进展或远处转移等特征。手术通常是局部可切除患者的首选治疗方法,但术后高复发率仍然是影响患者长期生存的最大障碍。鉴于原发性肝癌的巨大异质性和治疗的复杂性,目前通常采取包括手术切除、系统治疗(如靶向治疗、化学治疗、免疫治疗)和(或)局部治疗的多模式综合方案。而随着原发性肝癌领域研究的不断进展,对于外科肿瘤学家而言,了解并掌握最新的外科诊疗方法和最佳的患者选择以及管理策略至关重要。因此,笔者深入解析原发性肝癌外科治疗的最新实践指南,系统介绍原发性肝癌(主要包括肝细胞癌和肝内胆管癌)的评估要点和临床治疗的相关建议,旨在为原发性肝癌患者的临床管理和决策制订提供更多基于循证医学的证据。Primary liver cancer is a highly malignant tumor of the digestive tract,characterized by an insidious onset and frequently accompanied by local progression or distant metastasis.Although surgical resection is typically the optimal treatment for patients with locally resectable tumors,the major challenge in achieving long-term survival prognosis lies in the high postoperative recurrence rate.Due to the substantial heterogeneity and complexity of primary liver cancer,a multimodal comprehensive treatment approach involving surgical resection,systemic therapy(e.g.,targeted therapy,chemotherapy,immunotherapy),and/or local treatment is commonly employed.As research regarding primary liver cancer continues to progress,it becomes crucial for surgical oncologists to acquire a deep understanding and proficiency in the latest surgical diagnostic and treatment methods,along with optimal patient selection and management strategies.The authors aim to comprehensively elaborate on the latest practice guidelines for surgically treatment of primary liver cancer and systematically outline the key points in evaluating primary liver cancer,primarily focusing on hepatocellular carcinoma and intrahepatic bile duct carcinoma,and offer pertinent recommendations for clinical treatment,thus providing robust evidence in the clinical management and decision-making for patients with primary liver cancer.

关 键 词：肝肿瘤 原发性 诊断 外科手术 围手术期 管理 指南 解读 

分 类 号：R735.7[医药卫生—肿瘤]