Kirstein Martha M, Vogel Arndt
Department of Gastroenterology, Hepatology und Endocrinology, Hanover Medical School, Hanover, Germany.
Visc Med. 2016 Dec;32(6):395-400. doi: 10.1159/000453013. Epub 2016 Dec 1.
Cholangiocarcinoma (CCA) is the second most common primary liver cancer, being characterized by its late diagnosis and fatal outcome. Recent epidemiological reports indicate an increasing worldwide incidence of intrahepatic CCA but a decreasing incidence of extrahepatic CCA.
In this review, we present an overview of the incidence and epidemiology of CCA and possible strategies for screening and surveillance.
Efficient strategies for the screening and surveillance of CCA have not been established so far. The vast majority of CCA occur sporadically without any apparent cause; however, several risk factors such as liver flukes, chronic biliary and liver diseases, and lifestyle-related aspects causing chronic inflammation and cholestasis in the liver have been linked to the development of CCA. These risk factors likely contribute to the increased incidence observed in some countries and also explain the wide geographical differences in the incidence of CCA.
Several risk factors for CCA have been identified. Given the dismal prognosis of advanced CCA, regular surveillance examinations with a combination of ultrasonography and laboratory tests appear to be useful in patients at risk and need to be explored in prospective trials.
胆管癌（CCA）是第二常见的原发性肝癌，其特点是诊断较晚且预后不良。近期流行病学报告显示，全球肝内胆管癌发病率呈上升趋势，而肝外胆管癌发病率呈下降趋势。
在本综述中，我们概述了胆管癌的发病率、流行病学以及可能的筛查和监测策略。
目前尚未建立有效的胆管癌筛查和监测策略。绝大多数胆管癌为散发性，无明显病因；然而，一些危险因素，如肝吸虫、慢性胆道和肝脏疾病以及导致肝脏慢性炎症和胆汁淤积的生活方式相关因素，已与胆管癌的发生有关。这些危险因素可能导致一些国家观察到的发病率上升，也解释了胆管癌发病率在地理上的广泛差异。
已确定了胆管癌的几个危险因素。鉴于晚期胆管癌预后不佳，对于高危患者，联合超声检查和实验室检查进行定期监测似乎是有用的，需要在前瞻性试验中进行探索。
