Doherty Bryan, Nambudiri Vinod E, Palmer William C
Grand Strand Medical Center, Myrtle Beach, SC, 29572, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
Curr Gastroenterol Rep. 2017 Jan;19(1):2. doi: 10.1007/s11894-017-0542-4.
Cholangiocarcinoma is a rare biliary adenocarcinoma associated with poor outcomes. Cholangiocarcinoma is subdivided into extrahepatic and intrahepatic variants. Intrahepatic cholangiocarcinoma is then further differentiated into (1) peripheral mass-forming tumors and (2) central periductal infiltrating tumors. We aimed to review the currently known risk factors, diagnostic tools, and treatment options, as well as highlight the need for further clinical trials and research to improve overall survival rates.
Cholangiocarcinoma has seen significant increase in incidence rates over the last several decades. Most patients do not carry the documented risk factors, which include infections and inflammatory conditions, but cholangiocarcinoma typically forms in the setting of cholestasis and chronic inflammation. Management strategies include multispecialty treatments, with consideration of surgical resection, systemic chemotherapy, and targeted radiation therapy. Surgically resectable disease is the only curable treatment option, which may involve liver transplantation in certain selected cases. Referrals to centers of excellence, along with enrollment in novel clinical trials are recommended for patients with unresectable or recurrent disease. This article provides an overview of cholangiocarcinoma and discusses the current diagnosis and treatment options. While incidence is increasing and more risk factors are being discovered, much more work remains to improve outcomes of this ominous disease.
胆管癌是一种罕见的胆管腺癌，预后较差。胆管癌可细分为肝外和肝内亚型。肝内胆管癌又进一步分为（1）周围肿块型肿瘤和（2）中央导管周围浸润型肿瘤。我们旨在综述目前已知的危险因素、诊断工具和治疗选择，并强调需要进一步开展临床试验和研究以提高总体生存率。
在过去几十年中，胆管癌的发病率显著上升。大多数患者没有记录在案的危险因素，这些因素包括感染和炎症性疾病，但胆管癌通常在胆汁淤积和慢性炎症的背景下形成。管理策略包括多学科治疗，考虑手术切除、全身化疗和靶向放疗。手术可切除的疾病是唯一可治愈的治疗选择，在某些特定病例中可能需要肝移植。对于不可切除或复发性疾病的患者，建议转诊至卓越中心，并参加新的临床试验。本文概述了胆管癌，并讨论了当前的诊断和治疗选择。虽然发病率在上升，且发现了更多的危险因素，但要改善这种凶险疾病的治疗效果仍有许多工作要做。
