中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝细胞癌合并胆管癌栓的诊疗进展

郭玉祥 王茂森 刘中原 张旭东 马鹏飞 王向坤 李仁锋

窦维佳, 周林, 吴开春. 慢性胰腺炎的危险因素分析[J]. 临床肝胆病杂志, 2011, 27(11): 1180-1183.
引用本文: 窦维佳, 周林, 吴开春. 慢性胰腺炎的危险因素分析[J]. 临床肝胆病杂志, 2011, 27(11): 1180-1183.
Dou WeiJia, Zhou Lin, Wu KaiChun. Risk factors of chronic pancreatitis[J]. J Clin Hepatol, 2011, 27(11): 1180-1183.
Citation: Dou WeiJia, Zhou Lin, Wu KaiChun. Risk factors of chronic pancreatitis[J]. J Clin Hepatol, 2011, 27(11): 1180-1183.

肝细胞癌合并胆管癌栓的诊疗进展

DOI: 10.12449/JCH250224
基金项目: 

国家自然科学基金 (82270538);

国家自然科学基金 (81800546);

河南省自然科学基金 (232300420038);

河南省自然科学基金 (232300420249)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:郭玉祥负责构思文章思路,设计文章结构并撰写文章;王茂森、刘中原、张旭东负责研究相关文献;马鹏飞负责设计并讨论文章构架;王向坤负责基础理论指导;李仁锋负责审核文章思路、设计文章结构、修改文章。
详细信息
    通信作者:

    李仁锋, lirenfengdog@126.com (ORCID: 0000-0002-8104-4608)

Advances in the diagnosis and treatment of hepatocellular carcinoma with bile duct tumor thrombus

Research funding: 

National Natural Science Foundation of China (82270538);

National Natural Science Foundation of China (81800546);

Natural Science Foundation of Henan Province (232300420038);

Natural Science Foundation of Henan Province (232300420249)

More Information
  • 摘要: 肝细胞癌合并胆管癌栓目前在临床上并不多见,且容易误诊,以往认为其是疾病进展至晚期的表现,且预后不佳,治疗常具有挑战性。然而,随着研究的不断深入,近年来对该疾病的认识不断深化,诊断和治疗理念也发生了显著变化,目前主要采取以手术为主的综合治疗,但在临床治疗策略选择方面仍存在争议。本文就该病的手术治疗方式以及预后进行详细探讨,以期为临床治疗选择提供参考。

     

  • [1] SIEGEL R, MILLER KD, WAGLE NS, et al. Cancer statistics, 2023[J]. CA Cancer J Clin, 2023, 73: 17- 48. DOI: 10.3322/caac.21763.
    [2] SUNG H, FERLAY J, SIEGEL RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71( 3): 209- 249. DOI: 10.3322/caac.21660.
    [3] FENG JK, CHEN ZH, SUN JX, et al. Concurrent bile duct resection versus concomitant thrombectomy for hepatocellular carcinoma associated with bile duct tumor thrombus: A propensity score matching analysis[J]. Ann Transl Med, 2021, 9( 6): 457. DOI: 10.21037/atm-20-6449.
    [4] DONG W, ZHANG T, WANG ZG, et al. Clinical outcome of small hepatocellular carcinoma after different treatments: a meta-analysis[J]. World J Gastroenterol, 2014, 20( 29): 10174- 10182. DOI: 10.3748/wjg.v20.i29.10174.
    [5] YANG X, QIU Z, RAN R, et al. Prognostic importance of bile duct invasion in surgical resection with curative intent for hepatocellular carcinoma using PSM analysis[J]. Oncol Lett, 2018, 16( 3): 3593- 3602. DOI: 10.3892/ol.2018.9108.
    [6] JIN Q, YU YB, JIANG B, et al. Progress in diagnosis and treatment of hepatocellular carcinoma with cancer thrombus in bile duct[J]. Med Recapitulate, 2020, 26( 16): 3201- 3205. DOI: 10.3969/j.issn.1006-2084.2020.16.015.

    金铨, 禹亚彬, 蒋彬, 等. 肝细胞肝癌合并胆管癌栓的诊疗进展[J]. 医学综述, 2020, 26( 16): 3201- 3205. DOI: 10.3969/j.issn.1006-2084.2020.16.015.
    [7] ZHOU D, HU GF, GAO WC, et al. Hepatocellular carcinoma with tumor thrombus in bile duct: A proposal of new classification according to resectability of primary lesion[J]. World J Gastroenterol, 2020, 26( 44): 7005- 7021. DOI: 10.3748/wjg.v26.i44.7005.
    [8] CONTICCHIO M, MAGGIALETTI N, RESCIGNO M, et al. Hepatocellular carcinoma with bile duct tumor thrombus: A case report and literature review of 890 patients affected by uncommon primary liver tumor presentation[J]. J Clin Med, 2023, 12( 2): 423. DOI: 10.3390/jcm12020423.
    [9] YANG XW, RAN RZ, DU J, et al. CCL20 is overexpressed in hepatocellular carcinoma with bile duct tumor thrombus and correlates negatively with surgical outcome[J]. Int J Clin Exp Pathol, 2018, 11( 8): 3977- 3983.
    [10] XU LB, QIN YF, SU LP, et al. Cathepsin-facilitated invasion of BMI1-high hepatocellular carcinoma cells drives bile duct tumor thrombi formation[J]. Nat Commun, 2023, 14( 1): 7033. DOI: 10.1038/s41467-023-42930-y.
    [11] Chinese Association of Liver Cancer and Chinese Medical Doctor Association. Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with bile duct tumor thrombus(2020)[J]. Chin J Pract Surg, 2021, 41( 3): 241- 247. DOI: 10.19538/j.cjps.issn1005-2208.2021.03.01.

    中国医师协会肝癌专业委员会. 肝细胞癌合并胆管癌栓多学科诊治中国专家共识(2020版)[J]. 中国实用外科杂志, 2021, 41( 3): 241- 247. DOI: 10.19538/j.cjps.issn1005-2208.2021.03.01.
    [12] WANG CL, YANG Y, SUN DL, et al. Prognosis of hepatocellular carcinoma patients with bile duct tumor thrombus after hepatic resection or liver transplantation in Asian populations: A meta-analysis[J]. PLoS One, 2017, 12( 5): e0176827. DOI: 10.1371/journal.pone.0176827.
    [13] CHIBA M, AOKAWA M, GOTO T, et al. Peroral cholangioscopy for the evaluation of bile duct stricture in hepatocellular carcinoma on a preoperative examination[J]. J Rural Med, 2024, 19( 1): 44- 48. DOI: 10.2185/jrm.2023-022.
    [14] WU JY, HUANG LM, BAI YN, et al. Imaging features of hepatocellular carcinoma with bile duct tumor thrombus: A multicenter study[J]. Front Oncol, 2021, 11: 723455. DOI: 10.3389/fonc.2021.723455.
    [15] ZHOU X, WANG J, TANG M, et al. Hepatocellular carcinoma with hilar bile duct tumor thrombus versus hilar Cholangiocarcinoma on enhanced computed tomography: a diagnostic challenge[J]. BMC Cancer, 2020, 20( 1): 54. DOI: 10.1186/s12885-020-6539-7.
    [16] LU RJ, SUN FF, DU J, et al. Hepatocellular carcinoma with bile duct tumor thrombus: A case report[J]. J Clin Hepatol, 2022, 38( 8): 1872- 1874. DOI: 10.3969/j.issn.1001-5256.2022.08.028.

    鲁人竭, 孙芳芳, 杜杰, 等. 肝细胞癌合并胆管癌栓1例报告[J]. 临床肝胆病杂志, 2022, 38( 8): 1872- 1874. DOI: 10.3969/j.issn.1001-5256.2022.08.028.
    [17] LU WP, TANG HW, YANG ZY, et al. A proposed modification for the Barcelona clinic liver cancer staging system: Adding bile duct tumor thrombus status in patients with hepatocellular carcinoma[J]. Am J Surg, 2020, 220( 4): 965- 971. DOI: 10.1016/j.amjsurg.2020.04.003.
    [18] FENG JK, WU YX, CHEN ZH, et al. The effect of bile duct tumor thrombus on the long-term prognosis of hepatocellular carcinoma patients after liver resection: A systematic review and meta-analysis[J]. Ann Transl Med, 2020, 8( 24): 1683. DOI: 10.21037/atm-20-4698.
    [19] FENG JK, CHEN ZH, WU YX, et al. Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: A systematic review and meta-analysis[J]. Ann Transl Med, 2020, 8( 23): 1567. DOI: 10.21037/atm-20-3935.
    [20] SHAN JJ, LI XC. Preoperative biliary drainage of hilar cholangiocarcinoma and its influence on safety of surgery[J/OL]. Chin J Hepat Surg(Electronic Edition), 2023, 12( 2): 157- 161. DOI: 10.3877/cma.j.issn.2095-3232.2023.02.007.

    单季军, 李相成. 肝门部胆管癌术前减黄及其对手术安全性的影响[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12( 2): 157- 161. DOI: 10.3877/cma.j.issn.2095-3232.2023.02.007.
    [21] LIN ZC, HAN MR, ZHOU Z. Prognosis for patients with hepatocellular carcinoma(HCC) with bile duct tumor thrombus(BDTT) after surgical treatment[J]. Biosci Trends, 2019, 13( 1): 77- 85. DOI: 10.5582/bst.2018.01234.
    [22] LIU ZH, SUN JX, FENG JK, et al. Prognostic comparison between liver resection and transcatheter arterial chemoembolization for hepatocellular carcinoma patients with bile duct tumor thrombus: A propensity-score matching analysis[J]. Front Oncol, 2022, 12: 835559. DOI: 10.3389/fonc.2022.835559.
    [23] CHOTIROSNIRAMIT A, LIWATTANAKUN A, JUNRUNGSEE S, et al. The benefit of curative liver resection with a selective bile duct preserving approach for hepatocellular carcinoma with macroscopic bile duct tumor thrombus[J]. Hepatobiliary Surg Nutr, 2020, 9( 6): 729- 738. DOI: 10.21037/hbsn.2019.10.26.
    [24] KIM DS, KIM BW, HATANO E, et al. Surgical outcomes of hepatocellular carcinoma with bile duct tumor thrombus: A Korea-Japan multicenter study[J]. Ann Surg, 2020, 271( 5): 913- 921. DOI: 10.1097/SLA.0000000000003014.
    [25] PHAM AT, DUC VU T, NGUYEN TD, et al. Surgical management for hepatocellular carcinoma with concurrent portal vein tumour thrombus and bile duct tumour thrombus: A case report[J]. Ann Med Surg(Lond), 2024, 86( 6): 3667- 3673. DOI: 10.1097/MS9.0000000000002035.
    [26] FENG JK, SUN JX, LIU ZH, et al. Efficacy and safety of transarterial chemoembolization for the treatment of unresectable hepatocellular carcinoma associated with bile duct tumor thrombus: A real-world retrospective cohort study[J]. Cancer Manag Res, 2021, 13: 3551- 3560. DOI: 10.2147/CMAR.S307065.
    [27] PENG QJ, DAI T, XIE GB, et al. Research advances in transcatheter arterial chemoembolization combined with targeted agents or anti-PD-1/PD-L1 monoclonal antibody in treatment of patients with unresectable hepatocellular carcinoma[J]. J Clin Hepatol, 2023, 39( 7): 1740- 1746. DOI: 10.3969/j.issn.1001-5256.2023.07.033.

    彭秋菊, 戴涛, 谢贵波, 等. 不可切除肝细胞癌的经肝动脉化疗栓塞术联合靶向药物或程序性死亡受体1及其配体单抗治疗进展[J]. 临床肝胆病杂志, 2023, 39( 7): 1740- 1746. DOI: 10.3969/j.issn.1001-5256.2023.07.033.
    [28] LEE JS, KIM J, RHU J, et al. Long-term outcomes of liver transplantation in hepatocellular carcinoma with bile duct tumor thrombus: A comparison with portal vein tumor thrombus[J]. Cancers(Basel), 2023, 15( 17): 4225. DOI: 10.3390/cancers15174225.
    [29] National Health Commission of the People’s Republic of China. Standard for diagnosis and treatment of primary liver cancer(2024 edition)[J]. J Clin Hepatol, 2024, 40( 5): 893- 918. DOI: 10.12449/JCH240508.

    中华人民共和国国家卫生健康委员会. 原发性肝癌诊疗指南(2024年版)[J]. 临床肝胆病杂志, 2024, 40( 5): 893- 918. DOI: 10.12449/JCH240508.
    [30] GORDAN JD, KENNEDY EB, ABOU-ALFA GK, et al. Systemic therapy for advanced hepatocellular carcinoma: ASCO guideline update[J]. J Clin Oncol, 2024, 42( 15): 1830- 1850. DOI: 10.1200/JCO.23.02745.
    [31] WU JY, SUN JX, WU JY, et al. Impact of bile duct tumor thrombus on the long-term surgical outcomes of hepatocellular carcinoma patients: A propensity score matching analysis[J]. Ann Surg Oncol, 2022, 29( 2): 949- 958. DOI: 10.1245/s10434-021-10799-0.
    [32] KIM JM, KWON CHD, JOH JW, et al. Incidental microscopic bile duct tumor thrombi in hepatocellular carcinoma after curative hepatectomy: A matched study[J]. Medicine(Baltimore), 2015, 94( 6): e450. DOI: 10.1097/MD.0000000000000450.
    [33] RAMMOHAN A, SATHYANESAN J, RAJENDRAN K, et al. Bile duct thrombi in hepatocellular carcinoma: Is aggressive surgery worthwhile?[J]. HPB(Oxford), 2015, 17( 6): 508- 513. DOI: 10.1111/hpb.12383.
    [34] CHI QY, SHI Z, ZHANG ZB, et al. Outcomes of resection for hepatocellular carcinoma with macroscopic bile duct tumour thrombus: A propensity score matched study[J]. Oncol Lett, 2020, 20( 4): 118. DOI: 10.3892/ol.2020.11979.
    [35] SHIOMI M, KAMIYA J, NAGINO M, et al. Hepatocellular carcinoma with biliary tumor thrombi: Aggressive operative approach after appropriate preoperative management[J]. Surgery, 2001, 129( 6): 692- 698. DOI: 10.1067/msy.2001.113889.
    [36] HUANG LM, ZENG ZX, WU JY, et al. Surgical outcomes of hepatocellular carcinoma with extrahepatic bile duct tumor thrombus: A multicenter study[J]. Front Oncol, 2023, 13: 1291479. DOI: 10.3389/fonc.2023.1291479.
    [37] SUN JX, WU JY, SHI J, et al. Thrombus-first surgery for hepatocellular carcinoma with bile duct tumor thrombus[J]. J Gastrointest Surg, 2021, 25( 8): 1973- 1979. DOI: 10.1007/s11605-020-04813-1.
    [38] LI YN, WEI SM, FU YK, et al. Long-term surgical outcomes of bile duct tumor thrombus versus portal vein tumor thrombus for hepatocellular carcinoma: A propensity score matching analysis[J]. Front Oncol, 2024, 14: 1372123. DOI: 10.3389/fonc.2024.1372123.
    [39] XIANG YJ, SUN JX, WU JY, et al. Recurrence hazard rate in patients with hepatocellular carcinoma and bile duct tumor thrombus: A multicenter observational study[J]. HPB(Oxford), 2022, 24( 10): 1703- 1710. DOI: 10.1016/j.hpb.2022.04.007.
  • 加载中
计量
  • 文章访问数:  137
  • HTML全文浏览量:  74
  • PDF下载量:  20
  • 被引次数: 0
出版历程
  • 收稿日期:  2024-06-15
  • 录用日期:  2024-07-08
  • 出版日期:  2025-02-25
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回