吴凤东, 史斌. 肝内胆管癌肝移植及其综合治疗[J]. 器官移植, 2021, 12(3): 344-350. DOI: 10.3969/j.issn.1674-7445.2021.03.014
引用本文: 吴凤东, 史斌. 肝内胆管癌肝移植及其综合治疗[J]. 器官移植, 2021, 12(3): 344-350. DOI: 10.3969/j.issn.1674-7445.2021.03.014
Wu Fengdong, Shi Bin. Liver transplantation and comprehensive treatment of intrahepatic cholangiocarcinoma[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 344-350. DOI: 10.3969/j.issn.1674-7445.2021.03.014
Citation: Wu Fengdong, Shi Bin. Liver transplantation and comprehensive treatment of intrahepatic cholangiocarcinoma[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 344-350. DOI: 10.3969/j.issn.1674-7445.2021.03.014

肝内胆管癌肝移植及其综合治疗

Liver transplantation and comprehensive treatment of intrahepatic cholangiocarcinoma

  • 摘要: 肝移植是治疗肝内胆管癌(ICC)的有效手段,由于ICC侵袭性强、易淋巴结转移,肝移植术后肿瘤复发率较高,需要严格掌握适应证。直径≤2 cm的单发ICC肝移植效果良好,进展期ICC则需先进行包括局部治疗和全身化学药物治疗(化疗)在内的新辅助治疗,根据新辅助治疗的反应决定是否进行肝移植,并于术后进行个体化辅助治疗。目前已经发现多个胆管癌基因突变靶点及靶向治疗药物。肝移植术前、术后辅以综合治疗可拓展ICC肝移植的适应证,改善受者预后。本文从ICC肝移植治疗、ICC肝移植术前新辅助治疗和术后辅助治疗以及ICC靶向治疗等方面进行综述。

     

    Abstract: Liver transplantation is an effective approach to treat intrahepatic cholangiocarcinoma (ICC). It is necessary to strictly control surgical indications of ICC because of its high invasiveness, lymph node metastasis and recurrence rate after liver transplantation. Liver transplantation yields high efficacy for single ICC with a diameterof ≤2 cm. For advanced ICC, neoadjuvant therapies including locoregional treatment and systemic chemotherapy should be initially delivered. According to the response of these neoadjuvant therapies, whether liver transplantation should be performed can be determined, and individualized adjuvant therapy should be delivered after operation. At present, multiple gene mutation targets and targeted therapeutic drugs for cholangiocarcinoma have been identified. Comprehensive treatment before and after liver transplantation may expand surgical indications of liver transplantation for ICC and improve clinical prognosis of the recipients. In this article, liver transplantation for ICC, neoadjuvant therapy before liver transplantation, postoperative adjuvant therapy and targeted therapy for ICC were reviewed.

     

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