Cholangiocarcinoma(CCA)is a highly lethal malignancy that comprises approximately 15%of all the primary liver tumors and 3% of gastrointestinal cancers.Diagnosis is often done when the disease is already at advanced s...Cholangiocarcinoma(CCA)is a highly lethal malignancy that comprises approximately 15%of all the primary liver tumors and 3% of gastrointestinal cancers.Diagnosis is often done when the disease is already at advanced stages,resulting in poor outcomes.Prevention of risk factors and early diagnosis are the cornerstones for improving survival.Early diagnosis is feasible in the setting of surveillance programs in patients at high risk of CCA such as patients with primary sclerosing cholangitis.Regrettably,surveillance of CCA in this population is hampered by the low diagnostic accuracy of current tumor markers at earlier stages,the difficulties of imaging techniques for the differential diagnosis between benign and malignant biliary strictures,and the need for invasive procedures for diagnostic confirmation.In this review we discuss the rationale for surveillance of CCA in high-risk populations,particularly patients with primary sclerosing cholangitis,the recommended tools for surveillance and diagnostic work-up,and future perspectives.展开更多
基金funded by the Instituto de Salud Carlos Ⅲ(grant No PI17/00955 and PI21/00080)Andrés Cárdenas is funded by the Instituto de Salud Carlos Ⅲ and Plan Estatal de Investigación Ciéntifica y Técnica y de Innovación-Grant No PI19/00752+1 种基金funding for this work by“Fundación Marta Balust”Alejandro Forner is funded by the Instituto de Salud Carlos Ⅲ(grant No PI18/00542).
文摘Cholangiocarcinoma(CCA)is a highly lethal malignancy that comprises approximately 15%of all the primary liver tumors and 3% of gastrointestinal cancers.Diagnosis is often done when the disease is already at advanced stages,resulting in poor outcomes.Prevention of risk factors and early diagnosis are the cornerstones for improving survival.Early diagnosis is feasible in the setting of surveillance programs in patients at high risk of CCA such as patients with primary sclerosing cholangitis.Regrettably,surveillance of CCA in this population is hampered by the low diagnostic accuracy of current tumor markers at earlier stages,the difficulties of imaging techniques for the differential diagnosis between benign and malignant biliary strictures,and the need for invasive procedures for diagnostic confirmation.In this review we discuss the rationale for surveillance of CCA in high-risk populations,particularly patients with primary sclerosing cholangitis,the recommended tools for surveillance and diagnostic work-up,and future perspectives.
