肝内胆管细胞癌预防性清扫淋巴结现状与前景

张荷月; 鞠明光; 徐锋

doi:10.3969/j.issn.1001-5256.2020.09.044

肝内胆管细胞癌预防性清扫淋巴结现状与前景

DOI: 10.3969/j.issn.1001-5256.2020.09.044

中国医科大学附属盛京医院肝胆脾外科

基金项目:

国家自然科学基金(81400659,81974377)；辽宁省自然科学基金(2017225032,20180551193)；

详细信息

中图分类号: R735.7
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出版历程
- 出版日期: 2020-09-20

Current status and prospect of prophylactic lymph node dissection for intrahepatic cholangiocarcinoma

Department of Hepatobiliary and Splenic Surgery, Shengjing Hospital of China Medical University

Research funding:

摘要

摘要:
肝内胆管细胞癌是一种具有高度侵袭性的肝脏恶性肿瘤,手术切除是目前唯一可能获得治愈的有效手段。淋巴结转移给准确判断根治性切除范围带来困难,国际上对于是否需要常规行淋巴结清扫以及清扫范围尚无共识。归纳并分析了目前对术前诊断无淋巴结转移的患者行预防性清扫淋巴结所存在的争议和问题,希望能为肝内胆管细胞癌的根治性切除提供参考。
- 胆管上皮癌 /
- 淋巴结切除术 /
- 治疗学
Abstract:
Intrahepatic cholangiocarcinoma is a highly invasive malignant tumor,and at present,surgical resection is the only effective way for cure. Lymph node metastasis makes it difficult to accurately judge the extent of radical resection,and no international consensus has been reached on the need for routine lymph node dissection and the extent of lymph node dissection. This article summarizes and analyzes the disputes and problems in preventive lymph node dissection for patients without lymph node metastasis before surgery,hoping to provide a reference for radical resection of intrahepatic cholangiocarcinoma.
- cholangiocarcinoma /
- lymph node excision /
- therapeutics

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参考文献(38)

[1] CHEN ZS,TANG CW,TANG ZH,et al. Research advances in the clinical diagnosis of intrahepatic cholangiocarcinoma[J]. J Clin Hepatol,2019,35(12):2638-2643.(in Chinese)陈志升，唐陈伟，汤朝晖，等．肝内胆管癌的临床诊断策略[J]．临床肝胆病杂志，2019,35(12):2638-2643.

[2] YAMAOKA R,ISHII T,KAWAI T,et al. CD90 expression in human intrahepatic cholangiocarcinoma is associated with lymph node metastasis and poor prognosis[J]. J Surg Oncol,2018,118(4):664-674.

[3] YAMAMOTO Y,SUGIURA T,TODAKA A,et al. Surgical indication for advanced intrahepatic cholangiocarcinoma according to the optimal preoperative carbohydrate antigen 19-9cutoff value[J]. World J Surg,2018,42(10):3331-3340.

[4] MENG ZW,LIN XQ,ZHU JH,et al. A nomogram to predict lymph node metastasis before resection in intrahepatic cholangiocarcinoma[J]. J Surg Res,2018,226:56-63.

[5] YOH T,HATANO E,SEO S,et al. Preoperative criterion identifying a low-risk group for lymph node metastasis in intrahepatic cholangiocarcinoma[J]. J Hepatobiliary Pancreat Sci,2018,25(6):299-307.

[6] BAI HH,DENG JY. Advances in imaging diagnosis and staging of lymph node metastasis of gastric cancer[J]. Chin J New Clin Med,2019,12(12):1345-1349.(in Chinese)白惠惠，邓靖宇．胃癌淋巴结转移的分期与影像学诊断研究进展[J]．中国临床新医学，2019,12(12):1345-1349.

[7] SAINANI NI,CATALANO OA,HOLALKERE NS,et al. Cholangiocarcinoma:Current and novel imaging techniques[J]. Radiographics,2008,28(5):1263-1287.

[8] ADACHI T,EGUCHI S,BEPPU T,et al. Prognostic impact of preoperative lymph node enlargement in intrahepatic cholangiocarcinoma:A multi-institutional study by the kyushu study group of liver surgery[J]. Ann Surg Oncol,2015,22(7):2269-2278.

[9] XU SH,FENG LL,CHEN YM,et al. Study on the sensitivity of multi-slice spiral CT in diagnosis of lymph node metastasis in different lymph node stations of gastric cancer[J]. Chin J Gastrointestinal Surg,2019,22(10):984-989.(in Chinese)许舒航，冯玲玲，陈永明，等．多层螺旋CT对胃癌各淋巴结分区淋巴结转移诊断敏感性研究[J]．中华胃肠外科杂志，2019,22(10):984-989.

[10] KILIM，GNDOGˇDU SB，ZDEN S,et al. The prognostic value of different node staging systems in patients with≤15lymph nodes following surgery for gastric adenocarcinoma[J]. Acta Chir Belg,2018,118(1):1-6.

[11] ZHANG JF,GENG J,NI RZ,et al. Diagnostic value of endoscopic ultrasound elastography in preoperative lymph node staging of gastric cancer[J]. Jiangsu Med J,2019,45(7):656-659.(in Chinese)张健锋，耿静，倪润洲，等．超声内镜弹性成像对胃癌术前淋巴结分期的诊断价值[J]．江苏医药，2019,45(7):656-659.

[12] MA ZL,ZHAO BQ,WU W,et al. The clinical value of EUS combined with CT in determine resectability of pancreatic carcer[J]. J Anhui Health Vocational Technical Coll,2016,15(4):29-30,32.(in Chinese)马中林，赵本泉，吴伟，等．超声内镜联合CT判断胰头癌可切除性的临床价值[J]．安徽卫生职业技术学院学报，2016,15(4):29-30,32.

[13] ZU DM,FENG LL,ZHANG L,et al. Evaluation of mesenteric lymph nodes in a pediatric population with mesenteric lymphadenitis using superb microvascular imaging[J]. Med Sci Monit,2019,25:5336-5342.

[14] ZHANG XF,BEAL EW,BAGANTE F,et al. Early versus late recurrence of intrahepatic cholangiocarcinoma after resection with curative intent[J]. Br J Surg,2018,105(7):848-856.

[15] OTSUKA S,EBATA T,YOKOYAMA Y,et al. Clinical value of additional resection of a margin-positive distal bile duct in perihilar cholangiocarcinoma[J]. Br J Surg,2019,106(6):774-782.

[16] KIM DH,CHOI DW,CHOI SH,et al. Is there a role for systematic hepatic pedicle lymphadenectomy in intrahepatic cholangiocarcinoma? A review of 17 years of experience in a tertiary institution[J]. Surgery,2015,157(4):666-675.

[17] BRAUER DG,FIELDS RC,TAN BR,et al. Optimal extent of surgical and pathologic lymph node evaluation for resected intrahepatic cholangiocarcinoma[J]. HPB(Oxford),2018,20(5):470-476.

[18] YOH T,CAUCHY F,LE ROY B,et al. Prognostic value of lymphadenectomy for long-term outcomes in node-negative intrahepatic cholangiocarcinoma:A multicenter study[J].Surgery,2019,166(6):975-982.

[19] ZHOU R,LU D,LI W,et al. Is lymph node dissection necessary for resectable intrahepatic cholangiocarcinoma? A systematic review and meta-analysis[J]. HPB(Oxford),2019,21(7):784-792.

[20] MAZZAFERRO V,GORGEN A,ROAYAIE S,et al. Liver resection and transplantation for intrahepatic cholangiocarcinoma[J]. J Hepatol,2020,72(2):364-377.

[21] MANTEL HT,WIGGERS JK,VERHEIJ J,et al. Lymph node micrometastases are associated with worse survival in patients with otherwise node-negative hilar cholangiocarcinoma[J].Ann Surg Oncol,2015,22(Suppl 3):s1107-s1115.

[22] ZHANG XF,CHAKEDIS J,BAGANTE F,et al. Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma[J]. Br J Surg,2018,105(7):857-866.

[23] ADACHI T,EGUCHI S. Lymph node dissection for intrahepatic cholangiocarcinoma:A critical review of the literature to date[J]. J Hepatobiliary Pancreat Sci,2014,21(3):162-168.

[24] BAGANTE F,GANI F,SPOLVERATO G,et al. Intrahepatic cholangiocarcinoma:Prognosis of patients who did not undergo lymphadenectomy[J]. J Am Col Surg,2015,221(6):1031-1040.

[25] YU Y,RHEE E,KIM M,et al. A proposal of imaging classification of intrahepatic mass forming cholangiocarcinoma into ductal and parenchymal types:Clinicopathologic significance[J]. Int J Med Radiol,2019,42(4):504-505.(in Chinese)于洋，RHEE E,KIM M，等．影像学划分肝内肿块型胆管细胞癌为胆管型和实质型的临床病理意义[J]．国际医学放射学杂志，2019,42(4):504-505.

[26] MENG ZW,PAN W,HONG HJ,et al. Macroscopic types of intrahepatic cholangiocarcinoma and the eighth edition of AJCC/UICC TNM staging system[J]. Oncotarget,2017,8(60):101165-101174.

[27] UCHIYAMA K,YAMAMOTO M,YAMAUE H,et al. Impact of nodal involvement on surgical outcomes of intrahepatic cholangiocarcinoma:A multicenter analysis by the Study Group for Hepatic Surgery of the Japanese Society of Hepato-BiliaryPancreatic Surgery[J]. J Hepatobiliary Pancreat Sci,2011,18(3):443-452.

[28] ZHANG XF,CHEN Q,KIMBROUGH CW,et al. Lymphadenectomy for intrahepatic cholangiocarcinoma:Has nodal evaluation been increasingly adopted by surgeons over time? A national database analysis[J]. J Gastrointest Surg,2018,22(4):668-675.

[29] WANG JQ,GONG LY,HAN SX,et al. Relationship between the peroperative lymphocyte to monocyte ratio and clinical feature and prognosis of intrahepatic cholangiocarcinoma[J].Med J West China,2018,30(9):1306-1309.(in Chinese)王纪全，龚柳云，韩苏夏，等．肝内胆管细胞癌患者术前淋巴细胞与单核细胞比值与临床病理特征及预后关系[J]．西部医学，2018,30(9):1306-1309.

[30] GUO YP,DU LX. Study on the predictive effect of tumor markers on lymph node metastasis in patients with intrahepatic cholangiocarcinoma[J]. Guizhou Med J,2019,43(12):1863-1866.(in Chinese)郭育鹏，杜立学．肿瘤标志物对肝内胆管细胞癌患者发生淋巴结转移的预测效果研究[J]．贵州医药，2019,43(12):1863-1866.

[31] JEONG S,LUO G,WANG ZH,et al. Impact of viral hepatitis B status on outcomes of intrahepatic cholangiocarcinoma:A meta-analysis[J]. Hepatol Int,2018,12(4):330-338.

[32] JUTRIC Z,JOHNSTON WC,HOEN HM,et al. Impact of lymph node status in patients with intrahepatic cholangiocarcinoma treated by major hepatectomy:A review of the national cancer database[J]. HPB(Oxford),2016,18(1):79-87.

[33] VITALE A,MOUSTAFA M,SPOLVERATO G,et al. Defining the possible therapeutic benefit of lymphadenectomy among patients undergoing hepatic resection for intrahepatic cholangiocarcinoma[J]. J Surg Oncol,2016,113(6):685-691.

[34] LU W,TANG ZH,QUAN ZW. Viewpoint of systematic lymphadenectomy for intrahepatic cholangiocarcinoma patients[J].Chin J Surg,2019,57(4):247-252.(in Chinese)陆巍，汤朝晖，全志伟．肝内胆管癌淋巴结相关问题的探讨[J]．中华外科杂志，2019,57(4):247-252.

[35] RAHNEMAI-AZAR AA,WEISBROD AB,DILLHOFF M,et al.Intrahepatic cholangiocarcinoma:Current management and emerging therapies[J]. Expert Rev Gastroenterol Hepatol,2017,11(5):439-449.

[36] NAKANO M,ARIIZUMI SI,YAMAMOTO M. Intrahepatic cholangiocarcinoma[J]. Semin Diagn Pathol,2017,34(2):160-166.

[37] LEE AJ,CHUN YS. Intrahepatic cholangiocarcinoma:The AJCC/UICC 8th edition updates[J]. Chin Clin Oncol,2018,7(5):52.

[38] MORINE Y,SHIMADA M. The value of systematic lymph node dissection for intrahepatic cholangiocarcinoma from the viewpoint of liver lymphatics[J]. J Gastroenterol,2015,50(9):913-927.

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