肝移植治疗不可切除结直肠癌肝转移的研究进展  

Progress of liver transplantation for nonresectable colorectal liver metastases

作　　者：艾贵生 杨健[2] 蒋文涛[1,2,3] Guisheng Ai;Jian Yang;Wentao Jiang(The First Central Clinical School,Tianjin Medical University,Tianjin 300192,China;Liver Transplantation Department,Tianjin First Center Hospital,Tianjin 300112,China;Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer,Tianjin First Center Hospital,Tianjin 300112,China)

机构地区：[1]天津医科大学一中心临床学院,300192 [2]天津市第一中心医院肝移植科,300112 [3]天津市肝癌分子诊断与治疗重点实验室

出　　处：《中华移植杂志（电子版）》2024年第3期174-180,共7页Chinese Journal of Transplantation(Electronic Edition)

基　　金：国家自然科学基金项目(81870444);国家自然科学基金青年项目(82202399);天津市卫生健康科技项目(TJWJ2022QN032);天津市卫生健康委员会重点学科专项(TJWJ2022XK016);细胞生态海河实验室创新基金(22HHXBJC00001)。

摘　　要：结直肠癌是全球第4大常见恶性肿瘤,其肝转移发病率高,5年生存率仅为14%。早期关于肝移植治疗不可切除结直肠癌肝转移(NRCLM)的研究结果并不乐观。然而,随着外科技术和围手术期管理的进步,如何应用肝移植为NRCLM患者带来生存获益的问题重新受到关注。最近的研究表明,通过制订严格的受者选择标准,可以显著提高这些患者肝移植后的生存率。NRCLM肝移植术后肿瘤复发仍是一个重要问题,但最常见的转移部位是肺部,如果积极治疗,对总生存率的影响很小。供者肝脏的短缺是肝移植的一个主要限制因素,但这一问题可以通过使用扩展标准供者、活体肝移植和开发创新手术技术等策略得到缓解。总之,肝移植作为一种治疗NRCLM的方法前景广阔,但还需要更多的研究来完善相关技术和策略。Colorectal cancer is the fourth most common malignancy worldwide,with a high incidence of liver metastases and a 5-year survival rate of only 14%.Early studies on liver transplantation for the treatment of nonresectable colorectal liver metastases(NRCLM)were not promising.However,with advancement in surgical techniques and perioperative management,the question of how to apply liver transplantation to achieve survival benefits for patients with NRCLM has regained attention.Recent studies have shown that by establishing strict recipient selection criteria,the survival rate after liver transplantation for these patients can be significantly improved.Postoperative tumor recurrence remains a significant issue,but the most common site of metastasis is the lungs,which has a minimal impact on overall survival when treated aggressively.The shortage of donor livers is a major limitation for liver transplantation,but this issue can be alleviated by strategies such as using extended criteria donors,living donor liver transplantation,and developing innovative surgical techniques.Overall,liver transplantation as a treatment for NRCLM shows promising prospects,but more research is needed to refine the relevant techniques and strategies.

关 键 词：肝移植 不可切除结直肠癌肝转移 受者选择 化疗 

分 类 号：R735.37[医药卫生—肿瘤]