摘要
肝内胆管细胞癌(ICC)是常见的二级及其以上肝内胆管上皮细胞来源的肝脏原发恶性肿瘤,具有早期症状体征不典型,误诊率高,预后差等特点。早期行根治性手术治疗一直被认为是治愈ICC唯一有效的方法。ICC易通过淋巴系统转移的特点,肝周围淋巴结清扫(LND)能否改善可根治性切除ICC患者的预后成为外科医师关注的焦点,并一直存在较大的争议。因此,进一步探讨根治性切除术是否应常规联合淋巴结清扫,已高度怀疑有淋巴结转移的患者或术前、术中未发现淋巴结转移的患者是否可以从淋巴结清扫中获益等对规范ICC的外科治疗及改善患者生存状况尤为重要。笔者根据国内外ICC淋巴结清扫的临床研究现状,结合笔者中心临床实践经验,分析和探讨淋巴结清扫的安全性和有效性,为淋巴结清扫的指征选择提供临床依据。
Intrahepatic cholangiocarcinoma (ICC) is a primary malignant tumor derived from epithelial cell of the subbranches of the intrahepatic bile ducts, which has characteristics of atypical clinical symptom, high misdiagnosis rate and poor prognosis. Radical surgery in early stage is considered as the only effective measure to cure ICC. Nowadays, it has been a focus and still remains debatable that whether perihepatic lymph node dissection (LND) could improve the long-time survival for ICC patients in consideration of that ICC is easy to migrate via lymphatic system. Therefore, for standardization of surgical treatment of ICC and improvement of patients′ survival, it is quite important to evaluate the necessity of LND in radical resection and benefits of LND in patients highly suspected lymph node metastasis or without lymph node metastasis preoperatively and intraoperatively. Based on the current situation of the global clinical research of LND in ICC, along with the clinical practice experience in authors′ clinical center, this paper focused on the safety and effectiveness of LND aiming to provide some evidences for the indication of LND in ICC patients.
作者
陈亚进
周睿
Chen Yajirt;Zhou Rui(Department of Hepatobiliary Surgery,Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University,Guangzhou 510120,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2019年第1期48-52,共5页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金(81572398、81672419)
广东省自然科学基金(2014A030313061、2013B021800101)
广东省科技规划项目(2015A050502023、2016A020216010).
关键词
肝内胆管细胞癌
肝周围淋巴结清扫
生存率
淋巴结转移
术后复发
Intrahepatic cholangiocarcinoma
hepatic lymph node dissection
rate
Lymph node metastasis
operative recurrence Peri-Survival Postoperative recurrence
