胆管癌癌前病变的研究进展

Research progress on the precancerous lesions of cholangiocarcinoma

胆管癌是起源于胆管上皮的恶性肿瘤,起病隐匿,恶性程度高,临床确诊时大多属中晚期,预后极差。胆管癌病因迄今未明,胆管上皮内瘤变、胆管内乳头状肿瘤、胆管黏液性囊性肿瘤以及胆管内管状/管状乳头状肿瘤被认为是胆管癌的癌前病变。加强对胆管癌癌前病变的认识和了解,并对其进行早期干预及治疗,对改善患者的生活质量和预后,提高生存率具有重要的临床意义。但目前对胆管癌癌前病变认识有限,未来仍需依托于分子诊断技术的发展及对其研究的深入,尽早发现高敏感性和特异性的生物标志物以准确识别出高危人群,做到"早发现、早诊断、早治疗"。本文就如何认识和处理胆管癌癌前病变作一综述。

Cholangiocarcinoma is a malignant tumor originating from bile duct epithelium,with insidious onset and high degree of malignancy.Most of the patients were diagnosed at the middle and late stages and the survival rate is very poor.The etiology of cholangiocarcinoma is still unknown.Billary intraepithelial neoplasia,intraductal papillary neoplasm of the bile duct,biliary mucinous cystic neoplasm and intraductal tubular/tubulopapillary neoplasm of the bile duct are considered as precancerous lesions of cholangiocarcinoma.Improving the understanding of precancerous lesions of cholangiocarcinoma,and early treatment of these lesions are important for enhancingthe patients’quality of life.However,the current understanding of precancerous lesions of cholangiocarcinoma is limited.Development of molecular diagnostic technology is deeply needed.And sensitive and specific biomarkers are urgently needed for the early diagnosis of the high-risk persons accurately,so as to achieve"early detection,early diagnosis and early treatment".This article reviews how to recognize and deal with precancerous lesions of cholangiocarcinoma.