Diagnosis strategies for intrahepatic cholangiocarcinoma
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摘要:
肝内胆管癌是比较少见的恶性肿瘤,近30年来其发病率逐渐上升,因早期无特异临床表现,不易诊断,晚期治疗根治性切除率低,预后差。因此,对于肝内胆管癌患者,早期筛查及诊断尤为重要。影像学检查是检测肝内胆管癌的重要手段,可以联合实验室指标、病理学检查提高诊断率,降低漏诊率,临床上应根据患者具体情况合理选择。
Abstract:Intrahepatic cholangiocarcinoma is an uncommon malignant tumor,and its incidence has been increasing in the recent 30 years.Since patients have no specific clinical manifestations in early stage,the diagnosis of this disease is often very difficult,with a low rate of radical resection in late stage and poor prognosis. Therefore,as for patients with intrahepatic cholangiocarcinoma,early screening and diagnosis is of vital importance. Imaging examination is an important method for the diagnosis of intrahepatic cholangiocarcinoma,and when combined with laboratory markers and pathological examination,it can increase diagnostic rate and reduce the rate of missed diagnosis. It is important in clinical practice to select reasonable methods based on the patient's actual condition.
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Key words:
- bile duct neoplasms /
- diagnosis /
- prognosis /
- review
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[1] Chinese Chapter of International Hepato-Pancreato-Biliary Association,Hepatic Surgery Group,Chinese Society of Surgery,Chinese Medical Association.Diagnosis and treatment of cholangiocarcinoma:surgical expert consensus[J].J Clin Hepatol,2015,31(1):12-16.(in Chinese)国际肝胆胰学会中国分会,中华医学会外科学分会肝脏外科学组.胆管癌诊断与治疗——外科专家共识[J].临床肝胆病杂志,2015,31(1):12-16. [2]PATEL T.Worldwide trends in mortality from biliary tract malignancies[J].BMC Cancer,2002,2:10. [3]POULTSIDES GA,ZHU AX,CHOTI MA,et al.Intrahepatic cholangiocarcinoma[J].Surg Clin North Am,2010,90(4):817-837. [4]SHIN HR,OH JK,MASUYER E,et al.Comparison of incidence of intrahepatic and extrahepatic cholangiocarcinoma——focus on East and South Eastern Asia[J].Asian Pac J Cancer Prev,2010,11(5):1159-1166. [5]MAVROS MN,ECONOMOPOULOS KP,ALEXIOU VG,et al.Treatment and prognosis for patients with intrahepatic cholangiocarcinoma:systematic review and meta-analysis[J].JAMA Surg,2014,149(6):565-574. [6]LEE CC,WU CY,CHEN GH.What is the impact of coexistence of hepatolithiasis on cholangiocarcinoma?[J].J Gastroenterol Hepatol,2002,17(9):1015-1020. [7]ZHOU H,WANG H,ZHOU D,et al.Hepatitis B virus-associated intrahepatic cholangio-carcinoma and hepatocellular carcinoma may hold common disease process for carcino-genesis[J].Eur J Cancer,2010,46(6):1056-1061. [8]NAKANUMA Y,SATO Y,HARADA K,et al.Pathological classification of intrahepatic cholangiocarcinoma based on a new concept[J].World J Hepatol,2010,2(12):419-427. [9]SEMPOUX C,JIBARA G,WARD SC,et al.Intrahepatic Cholangiocarcinoma:new insights in pathology[J].Semin Liver Dis,2011,31(1):49-60. [10]GUAN CN,CUI F,SU H,et al.Roles of four tumor markers in differential diagnosis of intrahepatic cholangiocarcinoma and hepatocellular carcinoma:a clinical study[J].Chin Hepatol,2015,20(11):864-866.(in Chinese)管超楠,崔峰,苏华,等.四种肿瘤标记物鉴别诊断肝内胆管癌与肝细胞癌的临床研究[J].肝脏,2015,20(11):864-866. [11]ZHANG YL.The strategy of clinical diagnosis in biliary tract tumors[J].J Surg Concepts Pract,2003,8(2):95-96.(in Chinese)张延龄.诊断胆道肿瘤的临床思路[J].外科理论与实践,2003,8(2):95-96. [12]DHANASEKARAN R,HEMMING AW,ZENDEJAS I,et al.Treatment outcomes and prognostic factors of intrahepatic cholangiocarcinoma[J].Oncol Rep,2013,29(4):1259-1267. [13]GALASSI M,IAVARONE M,ROSSI S,et al.Patterns of appearance and risk of misdiagnosis of intrahepatic cholangiocarcinoma in cirrhosis at contrast enhanced ultrasound[J].Liver Int,2013,33(5):771-779. [14]MAO R,XU EJ,LI K,et al.Usefulness of contrast.Enhanced ultrasound in the diagnosis of biliary leakage following T-tube removal[J].J Clin Ultrasound,2010,38(1):3840. [15]ITO K,FUJITA N,NODA Y,et al.Preoperative evaluation of ampullary neoplasm with EUS and transpapillary intraductal US:a prospective and histopathologically controlled study[J].Gastrointest Endosc,2007,66(4):740-747. [16]SONAVANE SK,MENIAS CO.Imaging biliary strictures—a pictorial review[J].Curt Probl Diagn Radiol,2014,43(1):14-34. [17] Anti-Cancer Association of China.Guideline for the diagnosis and therapy of hilar cholangiocarcinoma(2015)[J].Chin J Hepatobiliary Surg,2015,21(8):505-511.(in Chinese)中国抗癌协会.肝门部胆管癌规范化诊治专家共识(2015)[J].中国肝胆外科杂志,2015,21(8):505-511. [18]SASAKI R,KONDO T,ODA T,et al.Impact of three-Dimensional analysis of multidetector row computed tomography cholangiocarcinoma in operative planning for hilar cholangio-carcinoma[J].Am J Surg,2011,202(4):441-448. [19] MENG XC.How to diagnose intrahepatic cholangiocellular carcinoma[N].China Medical Tribune Tumor Today,2015,12(1).孟晓春.如何诊断肝内胆管细胞癌[N].中国医学论坛报今日肿瘤,2015,12(1). [20]de BONDT RB,HOEBERIGS MC,NELEMANS PJ,et al.Diagnostic accuracy and additinal value of difusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cel I carcinoma[J].Neuroradiology,2009,51(3):183-192. [21] Chinese Society of Liver Cancer,Chinese Anti-Cancer Association;Liver Cancer Study Group,Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Pathology,Chinese AntiCancer Association,et al.Evidence-based practice guidelines for the standardized pathological diagnosis of primary liver cancer in China(2015 update)[J].J Clin Hepatol,2015,31(6):833-839.(in Chinese)中国抗癌协会肝癌专业委员会,中华医学会肝病学分会肝癌学组,中国抗癌协会病理专业委员会,等.原发性肝癌规范化病理诊断指南(2015年版)[J].临床肝胆病杂志,2015,31(6):833-839.
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