肝细胞-胆管细胞癌联合诊断与治疗的现代方法
A Contemporary Approach to Diagnosis and Treatment of Combined Hepatocellular-Cholangiocarcinoma.
作者信息
Raevskaya Olga, Appelman Henry, Razumilava Nataliya
机构信息
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
出版信息
Curr Hepatol Rep. 2020 Dec;19(4):478-485. doi: 10.1007/s11901-020-00556-4. Epub 2020 Oct 31.
PURPOSE OF REVIEW
To provide updates on terminology, epidemiology, diagnosis, and treatment of combined hepatocellular-cholangiocarcinoma (cHCC-CCA).
RECENT FINDINGS
cHCC-CCAs are tumors that in the same nodule contain a variable degree of HCC and CCA components with a transition zone. cHCC-CCAs develop in cirrhotic and non-cirrhotic livers like and is associated with poor outcomes. Mutations in , promoter, and are the most common genetic aberrations in cHCC-CCA. Fusion gene is unique for cHCC-CCA. A biopsy is required for diagnosis. Surgical resection remains treatment of choice, while liver transplantation for early cHCC-CCA is associated with favorable outcomes. Gemcitabine-based therapy shows benefits for advanced cHCC-CCA.
SUMMARY
cHCC-CCAs are a heterogeneous group of primary liver cancers with unique biological behavior. Multicenter studies are required for a molecular analysis to inform novel therapeutic approaches, and understand epidemiology and benefits of liver transplantation, liver-directed and targeted therapies for this rare aggressive cancer.
综述目的
提供关于肝细胞-胆管细胞癌（cHCC-CCA）的术语、流行病学、诊断和治疗的最新信息。
最新发现
cHCC-CCA是在同一结节中包含不同程度的HCC和CCA成分以及一个过渡区的肿瘤。cHCC-CCA可发生于肝硬化和非肝硬化肝脏，且预后较差。 、 启动子和 的突变是cHCC-CCA中最常见的基因畸变。融合基因 是cHCC-CCA所特有的。诊断需要活检。手术切除仍然是首选治疗方法，而早期cHCC-CCA的肝移植与良好的预后相关。基于吉西他滨的治疗对晚期cHCC-CCA有疗效。
总结
cHCC-CCA是一组具有独特生物学行为的原发性肝癌异质性群体。需要进行多中心研究以进行分子分析，为新的治疗方法提供依据，并了解这种罕见侵袭性癌症的流行病学以及肝移植、肝导向和靶向治疗的益处。
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