Diagnosis and surgical treatment of intrahepatic cholangiocarcinoma
10.3760/cma.j.cn115396-20200519-00159
- VernacularTitle:肝内胆管细胞癌的诊断和手术治疗进展
- Author:
Xiangmin DING
1
;
Guoqing JIANG
;
Shengjie JIN
;
Chi ZHANG
;
Baohuan ZHOU
;
Dousheng BAI
Author Information
1. 江苏省扬州大学临床医学院肝胆胰外科 225001
- From:
International Journal of Surgery
2020;47(6):416-420
- CountryChina
- Language:Chinese
-
Abstract:
Intrahepatic cholangiocarcinoma(ICC) is a malignant tumor that originates in the epithelium of the proximal proximal to the second-degree bile ducts and has a high degree of malignancy. The causes of ICC are widely geographically diverse. Pathogenesis of ICC involves multiple molecular alterations at the level of genome, epigenome and stromal environment resulting in several deregulated signal transduction pathways. There are three types of pathological classification: mass-forming, periductal infiltrating, and intraductal growth. The mixed type of mass-forming + periductal infiltrating has the highest degree of malignancy. Early diagnosis of ICC is not easy, and tumor biomarkers such as CA19-9, CEA and so on, have some reference values, and multiple imaging examinations are needed to confirm each other. The effect of surgery mainly depends on the characteristics of the tumor, the vascular invasion of the tumor, the resection margin of the tumor and lymphatic metastasis. Lymph node dissection is controversial. If local lymphatic metastasis is identified, standardized lymph node dissection can improve ICC prognosis. Some ICC patients benefit from laparoscopic staging. In experienced centers, minimally invasive treatment can provide oncological outcomes similar to open resection for specific ICC patients. Liver transplantation is feasible in early ICC patients, but further clinical validation is needed.
