Cholangiocarcinoma.
Cholangiocarcinoma.
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胆管癌
DOI：
10.1016/s0140-6736(13)61903-0
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发表时间：
2014-06-21
期刊：
影响因子：
168.9
通讯作者：
Gores, Gregory J.
中科院分区：
文献类型：
--
作者：
Razumilava, Nataliya;Gores, Gregory J.
胆管癌代表了一组不同的上皮癌，其诊断晚，预后差。对不同解剖位置（肝内、肝门周围和远端）的胆管癌采取特定的诊断和治疗方法。混合型肝细胞胆管癌已成为原发性肝癌的一个独特亚型。临床医生需要意识到肝硬化引起的肝内胆管癌，并正确评估胆管癌在这种情况下的肝脏肿块。肝门周围胆管癌必须处理胆道梗阻，先进的细胞学检查如荧光原位杂交对诊断有帮助。肝移植是治疗肝门周围癌而非肝内或远端胆管癌的一种选择。临床医生和科学家的国际努力正在帮助确定胆管癌进展的遗传驱动因素，这将揭示早期诊断标志物并指导个性化治疗的发展。
Cholangiocarcinoma represents a diverse group of epithelial cancers united by late diagnosis and poor outcomes. Specific diagnostic and therapeutic approaches are undertaken for cholangiocarcinomas of different anatomical locations (intrahepatic, perihilar, and distal). Mixed hepatocellular cholangiocarcinomas have emerged as a distinct subtype of primary liver cancer. Clinicians need to be aware of intrahepatic cholangiocarcinomas arising in cirrhosis and properly assess liver masses in this setting for cholangiocarcinoma. Management of biliary obstruction is obligatory in perihilar cholangiocarcinoma, and advanced cytological tests such as fluorescence in-situ hybridisation for aneusomy are helpful in the diagnosis. Liver transplantation is a curative option for selected patients with perihilar but not with intrahepatic or distal cholangiocarcinoma. International efforts of clinicians and scientists are helping to identify the genetic drivers of cholangiocarcinoma progression, which will unveil early diagnostic markers and direct development of individualised therapies.