壶腹癌病理分型与临床应用  

Pathological classification and clinical application of ampullary carcinoma

作　　者：陈歆妮 王锋 龚新雷 CHEN Xinni;WANG Feng;GONG Xinlei(Department of Oncology,Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210002,China)

机构地区：[1]南京大学医学院附属金陵医院肿瘤科,南京210002

出　　处：《临床肿瘤学杂志》2024年第9期918-923,共6页Chinese Clinical Oncology

基　　金：东部战区总医院2022年院内课题启航项目(22LCYY-QH2)。

摘　　要：壶腹部周围区域解剖结构复杂,涉及胆总管下段、胰头、壶腹和十二指肠等多个部位。壶腹肿瘤起源,一方面通过主要病灶在宏观上的位置来确定,另一方面通过免疫组织化学来定论,如肠型与胰胆管型。而组织学分型又受到染色方法、阳性阈值和病理科医师主观评估的限制。尽管多数文献认为壶腹癌恶性程度相对胰头癌较低,但对于其亚型评估的不一致性阻碍了临床诊断与治疗的进展,且国内相关性数据十分有限。本文通过整理近年来国内外报道的壶腹癌病理分型的方法和标准,以及基于此类方法实现的个体化抗肿瘤方案与临床应用的相关内容,旨在为临床治疗及预后判断提供更多的参考依据。Objective The anatomy of the periampullary region is complex.The origin of tumors in this area can be determined both by macroscopic location of main lesions and through immunohistochemical analysis,such as intestinal type and pancreaticobiliary type.However,histopathological type is limited by factors like staining methods,positive thresholds,and subjective evaluation by pathologists.Although most literature suggests that ampullary cancer has relatively low malignancy compared to pancreatic cancer,the lack of consistency in subtype assessment hinders progress in clinical diagnosis and treatment,with limited relevant data available domestically.This article aims to provide more references for clinical treatment and postoperative judgment by summarizing recent domestic and foreign reports on methods and standards for pathological typing of ampullary cancer,as well as content related to individualized anti-tumor schemes and clinical applications based on these methods.

关 键 词：壶腹癌 肠型 胰胆管型 混合型 组织学分型 

分 类 号：R735[医药卫生—肿瘤]