摘要
胆囊癌是胆道系统最常见的恶性肿瘤,美国NCCN指南2018年V1版胆囊癌更新内容主要包括:(1)AJCC分期T2期细化为T2a(腹腔侧)和T2b(肝脏侧),N分期改为以阳性淋巴结数目(NMLN)作为分期标准。(2)术前检查评估更为全面。(3)手术方式和范围更为规范。(4)肯定了新辅助治疗的作用。(5)辅助治疗增加了放疗内容。(6)首次提出对无法切除肿瘤患者增加MSI检测,对MSI-H患者增加哌姆单抗治疗选择。本文就NCCN指南内容更新版胆囊癌诊治进展做一述评。
Gallbladder cancer is the most common of all the biliary tract cancers.The main revisions of NCCN guideline version 1 in 2018 are as follows.（1） The stage T2 tumor was divided as T2 a（peritoneal-sided）and T2 b（hepaticsided）,and the number of metastatic lymph nodes（NMLN）was revised as the new N staging system according to the 8 th edition of AJCC cancer staging system.（2） The preoperative workup and assessment was more comprehensive.（3） The procedure and extent of surgery was more standard.（4） The role of neoadjuvant chemotherapy was affirmed.（5） Radiation therapy was added in the adjuvant management.（6） Microstellite instability（MSI）testing was proposed for unresectable diseases in the first time and Pembrolizumab was recommended only for MSI-H tumors.The development on diagnosis and management of gallbladder cancer was introduced according to the update of the NCCN guideline in 2018.
作者
耿智敏
汤朝晖
GENG Zhimin;TANG Zhaohui(0Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an 710061, China;Department of General Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China)
出处
《西部医学》
2018年第7期937-942,947,共7页
Medical Journal of West China
基金
国家自然科学基金(81572420)
陕西省重点研发计划(2017ZDXM-SF-055)
关键词
胆囊癌
美国国立综合癌症网络
指南
Gallbladder cancer
National Comprehensive Cancer Network
Guideline
