中国实用外科杂志

中国实用外科杂志

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肝内胆管癌新辅助治疗难点及策略

黄莉莉1，2，夏    勇2，沈    锋1，2   

  1. 1广东药科大学，广东广州510006；2海军军医大学第三附属医院肝外四科，上海200438
  • 出版日期:2023-03-01

  • Online:2023-03-01

摘要： 肝内胆管癌（ICC）是原发性肝癌中的第二大类，近年来发病率呈上升趋势。根治性手术是唯一可以获得长期生存的方式。由于ICC具有侵袭性强、发病隐匿、临床症状不典型等特征，确诊时肿瘤常具有体积大、多发、侵犯肝内重要管道、合并淋巴结转移等高危复发因素，导致术后复发率高，长期疗效不佳。新辅助治疗的目标主要是减少ICC的高危复发因素，增加ICC病人获得根治性切除的概率。目前尚无标准化的ICC新辅助治疗方案，新辅助治疗的时机及方式选择仍是外科医生面临的一大挑战，但近年来系统性和局部治疗技术的发展已经在ICC的新辅助治疗中表现出一定的潜力。

关键词: 肝内胆管癌, 新辅助治疗, 难点, 策略

Abstract: Difficulties and strategies of neoadjuvant therapy for intrahepatic cholangiocarcinoma        HUANG Li-li*, XIA Yong, SHEN Feng. *Guangdong Pharmaceutical University， Guangzhou 510006; The Fourth Department of Extrahepatic Surgery, the Third Affiliated Hospital of Naval Military Medical University, Shanghai 200438, China
Corresponding author: SHEN Feng，E-mail:shenfengehbh@
sina.com
Abstract    Intrahepatic cholangiocarcinoma（ICC）is the second-largest primary malignancy in liver, and its incidence rate has increased in recent years. Radical resection is the only way to achieve long-term survival. However, hidden disease and unspecific clinical symptoms of ICC have prevented its early identification. Most of the patients with ICC suffered from a high recurrence after resection due to large tumor, multiplicity, invasion of intrahepatic vessels or ducts, or lymphatic involvement. The aim of neoadjuvant therapy is to reduce the risk of recurrence among patients with ICC and increase their chance of achieving R0 resection. Although standard neoadjuvant treatment strategies are still lacking, the opportunity and mode selection of new adjuvant therapy is still a major challenge, systemic and loco-regional therapies have shown their potential in this field.

Key words: intrahepatic cholangiocarcinoma, neoadjuvant therapy, difficulties, treatment strategy