肝内胆管癌的治疗现状及展望

The current status and prospects of treatment for intrahepatic cholangiocarcinoma

肝内胆管癌是原发性肝癌的一种,其发生率仅次于肝细胞肝癌.肝切除术是肝内胆管癌目前唯一可能获得长期生存的治疗方法.但是肝内胆管癌极易发生早期淋巴结转移、血管和神经侵犯,早期诊断率低,其术后五年生存率仅为25%~35%.肝移植对早期肝内胆管癌有较为肯定的治疗效果.对于晚期肝内胆管癌,有系统性化疗、动脉灌注化疗、TACE以及新兴的靶向治疗等多种方式可以选择.未来不仅要改进并规范肝内胆管癌的手术方式,而且要加快基础研究的步伐,找到针对肝内胆管癌的特殊靶向药物,以达到肝内胆管癌的精准治疗.

Intrahepatic cholangiocarcinoma is the second most common primary liver cancer with an incidence only secondary to hepatocellular carcinoma. Liver resection is the only treatment for the disease that may achieve long-term survival. ICC has high probability of early lymph node metastasis,vascular and nerve invasion and low rate of early diagnosis. Its five-year survival rate after surgery is only 25%~35%. Liver transplantation has a positive therapeutic effect on early intrahepatic cholangiocarcinoma. For advanced intrahepatic cholangiocarcinoma,there are some options such as systemic chemotherapy,transarterial chemoinfusion,TACE and emerging targeted therapy. In the future,we need to improve and standardize the surgical methods of intrahepatic cholangiocarcinoma as well as develop the basic research and find its special targeted drugs to achieve precision medicine.