胆囊癌综合诊治中应重视的几个关键问题

Several key issues that should be paid attention to in the comprehensive diagnosis and treatment of gallbladder cancer

胆囊癌恶性程度高且预后较差,提高影像学诊断的敏感度和准确率,发现特异性分子诊断靶点,引入人工智能技术,有助于早期诊断。外科治疗是该病最主要的治疗方法,术前精准评估是手术治疗成功的前提,腹腔镜根治手术、淋巴结清扫范围、血管重建和多器官切除仍存在一定争议。神经浸润可能是胆囊癌术后短期复发的危险因素,需引起重视。新辅助治疗充分发挥了化疗、靶向、免疫药物对肿瘤细胞的作用,使部分晚期病人从中获益。

Gallbladder carcinoma has a high degree of malignancy and poor prognosis.Improving the sensitivity and accuracy of imaging diagnosis,and discovering specific molecular diagnostic targets is helpful for early diagnosis.Surgical treatment is still the most important treatment for this disease,and accurate preoperative evaluation is the prerequisite for successful surgical treatment.There are still some controversies in laparoscopic radical resection,lymph node dissection,revascularization,and multi-organ resection.Nerve invasion may be a risk factor for short-term recurrence after surgery and should be highly concerned.Neoadjuvant therapy gives full play to the effects of chemotherapy,targeted therapy,and immune therapy on tumor cells,which can benefit some patients with advanced gallbladder cancer.