肝内胆管细胞癌诊断及治疗的现状与挑战

Current status and challenges for diagnosis and treatment of intrahepatic cholangiocarcinoma

肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)是一类起源于肝内胆管上皮细胞的恶性肿瘤。ICC发病较隐匿,早期无明显的临床症状,临床上尚缺少特异度高的早期筛查诊断标志物,很多患者在发现时已进展到中晚期,失去采取根治性切除术治疗的机会;即使手术切除,复发及转移等诸多因素也会导致ICC患者病死率高、远期生存预后差的局面。国际上尚无成熟的ICC个体化精准治疗推荐策略,现有的分期及预后模型主要基于手术切除的患者所创建,缺少普适性,临床应用受限。因此提高ICC患者早期确诊率、制定精准的治疗策略、探索预后风险因素是临床改善生存结局的途径。本文结合ICC研究进展,分析了ICC的诊断和治疗现状以及面临的挑战。

Intrahepatic cholangiocarcinoma（ICC） is a kind of malignant tumor originating from intrahepatic bile duct epithelial cells. Usually it is characterized by insidious attack, being asymptomatic at the early stage and absence of ideal specific biomarkers for the early screening and diagnosis. Many patients have developed into the advanced stage upon diagnosis, thus losing the opportunity of radical resection; the long-time survival prognosis is still poor and the mortality is still high due to tumor recurrence and metastasis even after surgical operation. There is no sophisticated individualized precision strategies for ICC at present. Current staging and prognostic models are mainly established based on the information of patients after resection, which is insufficient in universality and restricts clinical application. Therefore, it is critical to improve the clinical survival outcome through elevating the early diagnostic rate, formulating precise treatment strategy and exploring the prognostic risk factors. We herein reviewe the current status of diagnosis and management as well as the facing challenges based on the research progress of ICC.