微血管侵犯预测在肝胆肿瘤治疗决策中的应用价值  

Application value of prediction of microvascular invasion in the treatment decision‑making of liver and biliary tumors

作　　者：伍路 张向化 夏勇 沈锋 Wu Lu;Zhang Xianghua;Xia Yong;Shen Feng(The Fourth Department of Hepatic Surgery,The Third Hospital Affiliated to Naval Medical University,Shanghai 200438,China)

机构地区：[1]海军军医大学第三附属医院外四科,上海200438

出　　处：《中华消化外科杂志》2024年第7期912-918,共7页Chinese Journal of Digestive Surgery

基　　金：上海市卫生健康委员会卫生行业临床研究专项(202240272);上海市浦江人才计划(21PJD015)。

摘　　要：肝胆肿瘤的微血管侵犯(MVI)一般被定义为肝血管腔内的微小转移性瘤灶,体现了肝胆肿瘤的恶性生物学特性,是决定肝胆肿瘤术后早期复发的关键因素之一,对肝胆肿瘤预后有重要影响。探讨基于MVI选择肝胆肿瘤治疗策略的可行性已经成为近年来的热点研究方向,可弥补传统分期对肝胆肿瘤生物学特性考量不足的缺陷。当前肝胆肿瘤的MVI诊断仍依赖基于手术切除肿瘤标本的病理学诊断。近年来,基于影像学、血清学等技术的研究进展使得术前预测肝胆肿瘤的MVI风险成为可能。笔者深入探讨MVI预测为导向的肝胆肿瘤治疗决策。Microvascular invasion(MVI),which is defined as micro‑metastatic tumor emboli within hepatic micro‑vessels,is deemed as an indicator of biologic traits and one of the determinants of early recurrence and survival of liver and biliary tract tumors after resection.The potential role of prediction of MVI in choosing treatment strategies for patients with liver and biliary tumors has become hotspot in recent years and partly contributed to the improve the discrimination capability of clinical staging by incorporating biologic traits.The diagnosis of MVI still relies on pathological analysis of specimen obtained by resection.Recently,progress of radiological and serological techniques has facilitated the preoperative prediction of MVI among patients with liver and biliary tract tumors.The authors attempt to summarize the clinical management of liver and biliary tract tumors based on the decision strategies oriented by prediction of MVI in this article.

关 键 词：胆道肿瘤 肝肿瘤 微血管侵犯 治疗 预后 

分 类 号：R735.7[医药卫生—肿瘤] R735.8[医药卫生—临床医学]