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重视早发性肝内胆管癌的研究
DOI: 10.12449/JCH241201
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：覃德龙负责确定选题，资料分析，撰写论文及修改；陈家璐、唐玥、李宗龙参与文章审阅，修改论文；汤朝晖、全志伟负责拟定写作思路，指导撰写文章并最后定稿。
The research on early-onset intrahepatic cholangiocarcinoma should be taken seriously
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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。Abstract: 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.
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Key words:
- Cholangiocarcinoma /
- Early-Onset Tumors /
- Epidemiology /
- Signs and Symptoms /
- Gene Expression Profiling
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[1] KHAN SA, TAVOLARI S, BRANDI G. Cholangiocarcinoma: Epidemiology and risk factors[J]. Liver Int, 2019, 39( Suppl 1): 19- 31. DOI: 10.1111/liv.14095. [2] FLORIO AA, FERLAY J, ZNAOR A, et al. Global trends in intrahepatic and extrahepatic cholangiocarcinoma incidence from 1993 to 2012[J]. Cancer, 2020, 126( 11): 2666- 2678. DOI: 10.1002/cncr.32803. [3] Chinese Society of Liver Cancer Cholangiocarcinoma Cooperative Group. Chinese expert consensus on management of intrahepatic cholangiocarcinoma(2022 edition)[J]. Chin J Dig Surg, 2022, 21( 10): 1269- 1301. DOI: 10.3760/cma.j.cn115610-20220829-00476.中国抗癌协会肝癌专业委员会胆管癌协作组. 原发性肝癌诊疗指南之肝内胆管癌诊疗中国专家共识(2022版)[J]. 中华消化外科杂志, 2022, 21( 10): 1269- 1301. DOI: 10.3760/cma.j.cn115610-20220829-00476. [4] DANPANICHKUL P, NG CH, TAN DJH, et al. The global burden of early-onset biliary tract cancer: Insight from the global burden of disease study 2019[J]. J Clin Exp Hepatol, 2024, 14( 2): 101320. DOI: 10.1016/j.jceh.2023.101320. [5] MILLER KD, FIDLER-BENAOUDIA M, KEEGAN TH, et al. Cancer statistics for adolescents and young adults, 2020[J]. CA Cancer J Clin, 2020, 70( 6): 443- 459. DOI: 10.3322/caac.21637. [6] LIU H, XU Z, SONG C, et al. Burden of gastrointestinal cancers among people younger than 50 years in China, 1990 to 2019[J]. Public Health, 2024, 234: 112- 119. DOI: 10.1016/j.puhe.2024.06.008. [7] MIMA K, HAMADA T, INAMURA K, et al. The microbiome and rise of early-onset cancers: Knowledge gaps and research opportunities[J]. Gut Microbes, 2023, 15( 2): 2269623. DOI: 10.1080/19490976.2023.2269623. [8] KOH B, TAN DJH, NG CH, et al. Patterns in cancer incidence among people younger than 50 years in the US, 2010 to 2019[J]. JAMA Netw Open, 2023, 6( 8): e2328171. DOI: 10.1001/jamanetworkopen.2023.28171. [9] UGAI T, SASAMOTO N, LEE HY, et al. Is early-onset cancer an emerging global epidemic? Current evidence and future implications[J]. Nat Rev Clin Oncol, 2022, 19( 10): 656- 673. DOI: 10.1038/s41571-022-00672-8. [10] TSILIMIGRAS DI, HAN X, GUGLIELMI A, et al. Early onset intrahepatic cholangiocarcinoma: Clinical characteristics, oncological outcomes, and genomic/transcriptomic features[J]. Ann Surg Oncol, 2024, 31( 5): 3087- 3097. DOI: 10.1245/s10434-024-15013-5. [11] PATEL SG, KARLITZ JJ, YEN T, et al. The rising tide of early-onset colorectal cancer: A comprehensive review of epidemiology, clinical features, biology, risk factors, prevention, and early detection[J]. Lancet Gastroenterol Hepatol, 2022, 7( 3): 262- 274. DOI: 10.1016/S2468-1253(21)00426-X. [12] SUDAN SK, SHARMA A, VIKRAMDEO KS, et al. Obesity and early-onset breast cancer and specific molecular subtype diagnosis in black and white women: NIMHD social epigenomics program[J]. JAMA Netw Open, 2024, 7( 7): e2421846. DOI: 10.1001/jamanetworkopen.2024.21846. [13] MUN DG, BHIN J, KIM S, et al. Proteogenomic characterization of human early-onset gastric cancer[J]. Cancer Cell, 2019, 35( 1): 111- 124. DOI: 10.1016/j.ccell.2018.12.003. [14] BEN-AHARON I, van LAARHOVEN HWM, FONTANA E, et al. Early-onset cancer in the gastrointestinal tract is on the rise-evidence and implications[J]. Cancer Discov, 2023, 13( 3): 538- 551. DOI: 10.1158/2159-8290.CD-22-1038. [15] STOFFEL EM, MURPHY CC. Epidemiology and mechanisms of the increasing incidence of colon and rectal cancers in young adults[J]. Gastroenterology, 2020, 158( 2): 341- 353. DOI: 10.1053/j.gastro.2019.07.055. [16] JAYAKRISHNAN T, KAMATH SD, NAIR KG, et al. Comparison of characteristics and outcomes of young onset versus average onset pancreatobiliary adenocarcinoma[J]. J Clin Oncol, 2022, 40( 16_suppl): 10522. DOI: 10.1200/jco.2022.40.16_suppl.10522. [17] GAO FL, XU XD, SUN Y. Clinical characteristics and prognosis of early-onset cholangiocarcinoma: A population-based study[J]. Scand J Gastroenterol, 2024, 59( 2): 183- 191. DOI: 10.1080/00365521.2023.2277663. [18] RAHMAN R, LUDVIGSSON JF, von SETH E, et al. Age trends in biliary tract cancer incidence by anatomical subtype: A Swedish cohort study[J]. Eur J Cancer, 2022, 175: 291- 298. DOI: 10.1016/j.ejca.2022.08.032. [19] LEBEAUD A, ANTOUN L, PACCARD JR, et al. Management of biliary tract cancers in early-onset patients: A nested multicenter retrospective study of the ACABI GERCOR PRONOBIL cohort[J]. Liver Int, 2024, 44( 8): 1886- 1899. DOI: 10.1111/liv.15922. [20] HORI M, MATSUDA T, SHIBATA A, et al. Cancer incidence and incidence rates in Japan in 2009: A study of 32 population-based cancer registries for the monitoring of cancer incidence in Japan(MCIJ) project[J]. Jpn J Clin Oncol, 2015, 45( 9): 884- 891. DOI: 10.1093/jjco/hyv088. [21] ARIAKE K, UNNO M, YOSHIDA H, et al. Risk factors and characteristics of young patients with the biliary tract carcinoma: Results of a project study for biliary surgery by the Japanese society of hepato-biliary-pancreatic surgery[J]. J Hepatobiliary Pancreat Sci, 2020, 27( 9): 571- 580. DOI: 10.1002/jhbp.776. [22] VERA R, CASTRO N, LABIANO I, et al. The TEOGIC study project: A comprehensive characterization of early onset gastrointestinal cancer in the Northern area of Spain[J]. BMC Cancer, 2024, 24( 1): 668. DOI: 10.1186/s12885-024-12454-9. [23] FENG H, TONG H, YAN JY, et al. Genomic features and clinical characteristics of adolescents and young adults with cholangiocarcinoma[J]. Front Oncol, 2020, 9: 1439. DOI: 10.3389/fonc.2019.01439. [24] KANEKO R, KUBO S, SATO Y. Comparison of clinical characteristics between occupational and sporadic young-onset cholangiocarcinoma[J]. Asian Pac J Cancer Prev, 2015, 16( 16): 7195- 7200. DOI: 10.7314/apjcp.2015.16.16.7195. [25] KIM JH, CHEON YK, LEE TY, et al. Effect of age on the prognosis of intrahepatic cholangiocarcinoma[J]. Korean J Intern Med, 2023, 38( 1): 39- 47. DOI: 10.3904/kjim.2022.146. [26] HE TC, LI JN, XU ZH, et al. Biological and clinical implications of early-onset cancers: A unique subtype[J]. Crit Rev Oncol Hematol, 2023, 190: 104120. DOI: 10.1016/j.critrevonc.2023.104120. [27] MILNE ANA, CARVALHO R, MORSINK FM, et al. Early-onset gastric cancers have a different molecular expression profile than conventional gastric cancers[J]. Mod Pathol, 2006, 19( 4): 564- 572. DOI: 10.1038/modpathol.3800563. [28] PERSONENI N, LLEO A, PRESSIANI T, et al. Biliary tract cancers: Molecular heterogeneity and new treatment options[J]. Cancers(Basel), 2020, 12( 11): 3370. DOI: 10.3390/cancers12113370. [29] LIN JZ, CAO YH, YANG X, et al. Mutational spectrum and precision oncology for biliary tract carcinoma[J]. Theranostics, 2021, 11( 10): 4585- 4598. DOI: 10.7150/thno.56539. -
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