重视早发性肝内胆管癌的研究  

The research on early-onset intrahepatic cholangiocarcinoma should be taken seriously

作　　者：覃德龙 陈家璐 唐玥 李宗龙 汤朝晖[1] 全志伟[1] QIN Delong;CHEN Jialu;TANG Yue;LI Zonglong;TANG Zhaohui;QUAN Zhiwei(Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院普通外科,上海200092

出　　处：《临床肝胆病杂志》2024年第12期2345-2350,共6页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81772521);上海交通大学医学院附属新华医院院级临床研究培育基金(17CSK06);上海交通大学医学院多中心临床研究(DLY201807)。

摘　　要：肝内胆管癌(ICC)是一种高度恶性的胆道肿瘤,其中早发性ICC(EOICC)是指确诊年龄≤50岁的ICC,但通常具有更晚的临床分期、更显著的生物学侵袭性。目前EOICC的发病率正在迅速增长,但其研究仍处于早期阶段。现有的研究表明EOICC具有与晚发ICC显著不同的流行病学、临床和分子学特征。因此,重视EOICC高危因素及发病机制等方面的研究对于EOICC的早识别、早诊断以及针对性治疗具有重要意义。由于EOICC患者年龄较轻、身体状况较佳,可耐受风险更大的医疗干预措施,采取更积极的个体化诊疗方案,因此患者可能获得与晚发ICC相似甚至更好的生存预后。然而,EOICC的分子学特征与ICC显著不同,现有的靶向药物可能不适用于EOICC患者,晚期EOICC患者系统治疗面临巨大挑战。EOICC的临床和基础研究整体滞后,需要进一步深入阐明EOICC的人群特征及其发病因素,进而推动建立适合EOICC群体的预防及诊疗规范。Intrahepatic cholangiocarcinoma(ICC)is a highly malignant biliary tumor,and early-onset ICC(EOICC)refers to ICC with an age of≤50 years at the time of confirmed diagnosis and often has a higher clinical stage and more significant biological invasiveness.At present,the incidence rate of EOICC is increasing rapidly,but the research on EOICC is still in its early stage.Current evidence has shown that EOICC has significantly different epidemiological,clinical,and molecular characteristics from late-onset ICC.Therefore,the research on the high-risk factors and pathogenesis of EOICC is of great importance for the early identification,diagnosis,and targeted treatment of EOICC.Due to the younger age and better physical condition of EOICC patients,they can tolerate medical interventions with higher risks,and active individualized diagnosis and treatment regimens can be adopted,allowing patients to obtain similar survival and prognosis as those with late-onset ICC.However,due to the significant differences in molecular characteristics between EOICC and ICC,existing targeted drugs may not be suitable for EOICC patients,posing a huge challenge for the systematic treatment of patients with advanced EOICC.The clinical and basic research on EOICC is still lagging behind,and the population characteristics and pathogenic factors of EOICC should be further clarified,in order to promote the establishment of prevention,diagnosis,and treatment standards for the EOICC population.

关 键 词：胆管上皮癌 早发性肿瘤 流行病学 体征和症状 基因表达谱 

分 类 号：R735.7[医药卫生—肿瘤]