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胆总管囊肿与恶性肿瘤:呼吁进行终身随访

Choledochal Cyst and Malignancy: A Plea for Lifelong Follow-Up.

作者信息

Madadi-Sanjani Omid, Wirth Thomas C, Kuebler Joachim F, Petersen Claus, Ure Benno M

机构信息

Centre of Pediatric Surgery, Hannover Medical School, Hannover, Germany.

Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany.

出版信息

Eur J Pediatr Surg. 2019 Apr;29(2):143-149. doi: 10.1055/s-0037-1615275. Epub 2017 Dec 19.

Abstract

Previous research has confirmed that patients with choledochal cyst have an elevated risk of cholangiocarcinoma and gallbladder carcinoma. Current data suggest a risk of malignancy of 6 to 30% in adults with choledochal cyst. Malignancy has also occasionally been identified in children and adolescents. Multiple factors, including the age of the patient, cyst type, histological findings, and localization, have an impact on the prognosis. Information on long-term outcomes after cyst excision is limited. However, recent data suggest a lifelong elevated risk of up to 4% of cancer development following operation. This paper presents a review of the literature on cancer in patients with choledochal cyst before and after excision. A postoperative follow-up concept that consists of annual controls of CA19-9 and abdominal ultrasound is introduced.

摘要

既往研究已证实,胆总管囊肿患者发生胆管癌和胆囊癌的风险升高。目前的数据表明,成人胆总管囊肿患者发生恶性肿瘤的风险为6%至30%。儿童和青少年中也偶尔发现有恶性肿瘤。多种因素,包括患者年龄、囊肿类型、组织学表现和部位,都会对预后产生影响。关于囊肿切除术后长期结局的信息有限。然而,最近的数据表明,术后发生癌症的终生风险高达4%。本文对胆总管囊肿患者切除前后癌症的文献进行了综述。介绍了一种术后随访方案,包括每年检测CA19-9和进行腹部超声检查。

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