Abstract: Characteristics of lymph node metastasis and prognostic significance of lymphadenectomy in intrahepatic cholangiocarcinoma        ZHOU Wei-ping, JIANG Bei-ge.The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Military Medical University, Shanghai 200438, China
Corresponding author: ZHOU Wei-ping, E-mail：ehphwp@126.com
Abstract    Intrahepatic cholangiocarcinoma（ICC）is a sort of bile duct epithelium malignant tumor originating from the intrahepatic interlobular bile duct to the secondary bile duct，accounting for 10% of the bile duct malignant tumors. Radical surgical resection remains the only hope for cure patients with ICC. Lymph node metastasis is the most important prognostic independent risk factor for ICC. There are obvious controversies on whether lymphadenectomy should be performed or the specific area of dissection for patients with ICC for radical resection.Current guidelines suggest that regional lymphadenectomy is a standard part of surgical management for surgically resectable ICC patients，providing decisions for accurate postoperative staging and selection patients for further adjuvant therapy. All ICC patients with lymph node metastasis should receive postoperative systematic treatment.However，some studies indicate that surgical resection for patients with LN-positive ICC may not improve survival compared to chemotherapy alone.

Key words: intrahepatic cholangiocarcinoma, lymph node metastasis, lymphadenectomy, prognosis

摘要： 肝内胆管癌（ICC）是起源于肝内小叶间胆管至二级胆管以上的胆管上皮源性恶性肿瘤，约占胆管源性恶性肿瘤的10%。根治性手术切除是ICC惟一可能治愈的手段。而淋巴结转移是影响ICC预后最重要的独立危险因素。对于ICC根治性切除术中是否需要行淋巴结清扫、清扫范围及意义，国际上对此尚有不少争议。多数研究认为对于可手术切除的ICC病人，区域淋巴结清扫是外科治疗的标准部分，有助于术后准确分期及选择有效的辅助治疗方法。同时伴有淋巴结转移的ICC病人都应接受术后系统性治疗。但也有研究表明单纯化疗相对于手术切除能为已有淋巴结转移的ICC病人提供更好的生存获益。

关键词: 肝内胆管癌, 淋巴结转移, 淋巴结清扫, 预后