胆囊癌发病机制及外科治疗的研究进展

Research advances in the pathogenesis and surgical treatment of gallbladder carcinoma

胆囊癌(GBC)在临床上常易被一些良性疾病所掩盖而发生意外胆囊癌(IGBC)。在病因方面,胆囊结石的长期刺激、>1 cm的胆囊息肉、胆囊腺瘤及胆囊腺肌症等与GBC的关系密切。在分子生物学机制家方面,长链非编码RNA、微小RNA、表面生长因子受体以及一些膜蛋白等均参与GBC的发生发展,有望为临床提供一定的参考价值。GBC的术中、术后的外科处理至关重要,关乎患者的生存期。在术中高度怀疑或已证实GBC的患者中,充分评估病情,应及早中转开腹,避免二次手术。术后病理检查发现的IGBC,应尽早行二次手术,以免肿瘤进展和扩散。

Gallbladder carcinoma （GBC） is often obscured by some benign diseases in clinical practice and thus unsuspected GBC tends to occur.As for etiology,long-term stimulation by gallstones,gallbladder polyps larger than 1 cm,gallbladder adenoma,and adenomyomatosis of the gallbladder are closely associated with GBC.In the aspect of molecular biology,long non-coding RNA,microRNA,surface growth factor receptor,and some membrane proteins are involved in the development and progression of GBC,which may provide a reference for clinical practice.It is of great importance to perform intraoperative and postoperative surgical management of GBC,which is related to patients＇survival.Patients with highly suspected or proven GBC should be converted to open surgery after disease assessment,in order to avoid reoperation.Reoperation should be performed for patients with unsuspected GBC found by postoperative pathological examination,in order to avoid tumor progression and metastasis.