摘要
肝内胆管癌(intrahepatic cholangiocarcinoma, ICC)是一种起源于肝内胆管上皮细胞的原发性肝癌,其发病隐匿,恶性程度高,缺乏有效治疗方法。根治性手术切除是目前可能治愈ICC的唯一治疗手段,手术方式选择、切除范围、淋巴结清扫等对于改善病人的长期预后意义重大。部分局部晚期病人可以通过多维度的转化治疗降期后获得手术切除的机会,其中基于分子分型的精准靶向治疗是近年来的研究热点,在ICC转化治疗方面有较大的发展空间。随着ICC外科治疗及转化治疗的理念和手段不断发展更新,其治疗模式也转变为以外科手术为基础的多学科综合治疗。然而,一些争议问题仍需要开展多中心、大样本的前瞻性研究进行验证以达成共识,从而规范治疗体系,改善病人总体预后。
Intrahepatic cholangiocarcinoma(ICC)is one primary liver cancer derived from intrahepatic bile duct epithelial cells.With an insidious onset,its malignancy is high and efficacy remains poor.Radical resection represents a sole curative option for ICC.Selection of surgical approaches,resection scope and lymph node dissection are vital for improving the long-term prognosis of patients.Some locally advanced patients may achieve tumor down-staging through multi-dimensional conversion therapy to obtain an opportunity of surgical resection.Among them,precise targeted therapy based upon molecular typing has become a research hotspot in recent years.And there is a great potential for ICC transformation therapy.With rapid development and updating of concepts and techniques of surgery and conversion therapy for ICC,treatment mode has shifted to multidisciplinary protocols based upon surgery.However,some controversial issues should be resolved through multi-center and large-sample prospective studies.Clinical consensus helps to standardize the treatment protocols and improve the overall prognosis of patients.
作者
李照
韦鹏程
朱继业
Li Zhao;Wei Pengcheng;Zhu Jiye(Department of Hepatobiliary Surgery,Peking University People′s Hospital,Beijing 100044,China)
出处
《腹部外科》
2023年第3期153-159,共7页
Journal of Abdominal Surgery
基金
首都卫生发展科研专项(首发2022-2-4084)。
关键词
肝内胆管癌
外科治疗
转化治疗
预后
Intrahepatic cholangiocarcinoma
Surgical treatment
Conversion therapy
Prognosis
