肝内胆管癌的危险因素与发病机制

Recent advancement in research on intrahepatic cholangiocarcinoma:Risk factors and pathogenesis

肝内胆管癌(ICC)病因复杂,高度侵袭、预后不良,是仅次于肝细胞癌的第二大肝胆恶性肿瘤。早期手术切除仍是ICC的最佳治疗方案,但因其起病隐匿,恶性程度高,多数患者就诊时已处于中晚期,失去了最佳的手术时机。因此,临床上能够对ICC进行早期及时的识别和干预十分重要。目前已经有研究证实了原发性硬化性胆管炎、病毒性肝炎、肝内胆管结石等危险因素与ICC的密切关系,分子生物学和遗传学技术的迅速发展也为ICC发病机制的深入研究提供了更好的方法。现将近年来ICC的危险因素及发病机制相关研究作一综述,以期为其临床早期诊治提供更多有价值的信息。

Intrahepatic cholangiocarcinoma(ICC) accounts for the second highest hepatobiliary malignancy after hepatocellular carcinoma.ICC has a complex etiology and is a high invasive disease with a poor prognosis.To date,surgical resection is still the best treatment to cure early staged ICCs clinically;however,due to ICC diagnosis at the advanced stages of disease and tumor with high degree of malignancy,most patients miss the optimal time for surgery.Thus,it is crucial to detect and intervene ICC at the earliest stage of disease clinically.The ICC risk factors may include primary sclerosing cholangitis,viral hepatitis,and intrahepatic cholangiolithiasis.The rapid development of molecular biology and genetics provides a better methodology in in-depth study of ICC pathogenesis.This review summarized and discussed the most recent advancement in identification of the ICC risk factors and molecular mechanisms of ICC pathogenesis,which may provide valuable and insightful information for ICC early detection and potential treatment strategy.