Patel Tushar, Singh Pankaj
Department of Internal Medicine,Scott and White Clinic, Texas A&M University Health Science Center, Temple, TX 76508, USA.
Curr Opin Gastroenterol. 2007 May;23(3):317-23. doi: 10.1097/MOG.0b013e3280495451.
Cholangiocarcinomas are malignancies arising from biliary tract epithelia that are associated with a poor prognosis. The diagnosis, evaluation and management of these tumors continue to be clinically challenging. In this review, we will discuss recent information that may influence the approach to the diagnosis and management of this devastating tumor.
Epidemiological studies are defining patient groups at increased risk of cancer in regions of low prevalence. Emerging approaches that may improve evaluation and management include the potential use of genomic and proteomic markers, cytogenetic and digital image analysis, endoscopic ultrasound with fine needle aspiration, and cholangioscopy. Adoption of aggressive surgical approaches along with the use of preoperative portal vein embolization, hepatic and caudate lobe resection and preoperative laparoscopy may improve survival.
Recent conceptual and technical advances will impact the clinical approach to cholangiocarcinoma and offer the promise of improving outcomes from this difficult tumor.
胆管癌是起源于胆道上皮的恶性肿瘤，预后较差。这些肿瘤的诊断、评估和管理在临床上仍然具有挑战性。在本综述中，我们将讨论可能影响这种毁灭性肿瘤诊断和管理方法的最新信息。
流行病学研究正在确定低发病率地区癌症风险增加的患者群体。可能改善评估和管理的新兴方法包括基因组和蛋白质组标志物的潜在应用、细胞遗传学和数字图像分析、超声内镜引导下细针穿刺以及胆管镜检查。采用积极的手术方法，同时使用术前门静脉栓塞、肝叶和尾状叶切除以及术前腹腔镜检查可能会提高生存率。
最近的概念和技术进展将影响胆管癌的临床治疗方法，并有望改善这种难治性肿瘤的治疗效果。
