Selvaggi Federico, Lopetuso Loris Riccardo, Delli Pizzi Andrea, Melchiorre Eugenia, Murgiano Marco, Taraschi Alessio Lino, Cotellese Roberto, Diana Michele, Vivarelli Marco, Mocchegiani Federico, Catalano Teresa, Aceto Gitana Maria
ASL2 Lanciano-Vasto-Chieti, Unit of General Surgery, 66100 Chieti, Italy.
Villa Serena Foundation for Research, 65013 Città Sant'Angelo, Italy.
Diagnostics (Basel). 2025 Apr 16;15(8):1011. doi: 10.3390/diagnostics15081011.
The diagnosis of cholangiocarcinoma (CCA) remains challenging. Although new technologies have been developed and validated, their routine use in clinical practice is needed. Conventional cytology obtained during endoscopic retrograde cholangiopancreatography-guided brushings is the first-line technique for the diagnosis of CCA, but it has shown limited sensitivity when combined with endoscopic ultrasound-guided biopsy. Other diagnostic tools have been proposed for the diagnosis of CCA, with their respective advantages and limitations. Cholangioscopy with biopsy or cytology combined with FISH analysis, intraductal biliary ultrasound and confocal laser microscopy have made significant advances in the last decade. More recently, developments in the analytical "omics" sciences have allowed the mapping of the microbiota of patients with CCA, and liquid biopsy with proteomic and extracellular vesicle analysis has allowed the identification of new biomarkers that can be incorporated into the predictive diagnostics. Furthermore, in the preoperative setting, radiomics, radiogenomics and the integrated use of artificial intelligence may provide new useful foundations for integrated diagnosis and personalized therapy for hepatobiliary diseases. This review aims to evaluate the current diagnostic approaches and innovative translational research that can be integrated for the diagnosis of CCA.
胆管癌（CCA）的诊断仍然具有挑战性。尽管已经开发并验证了新技术，但仍需要将其常规应用于临床实践。在内镜逆行胰胆管造影引导下刷检获取的传统细胞学检查是CCA诊断的一线技术，但与内镜超声引导下活检联合使用时，其敏感性有限。已提出了其他用于CCA诊断的工具，各有其优缺点。在过去十年中，结合活检或细胞学检查以及FISH分析的胆管镜检查、导管内胆管超声检查和共聚焦激光显微镜检查都取得了重大进展。最近，分析性“组学”科学的发展使得能够绘制CCA患者的微生物群图谱，而蛋白质组学和细胞外囊泡分析的液体活检则能够识别可纳入预测诊断的新生物标志物。此外，在术前阶段，放射组学、放射基因组学以及人工智能的综合应用可能为肝胆疾病的综合诊断和个性化治疗提供新的有用基础。本综述旨在评估目前可用于CCA诊断的诊断方法和创新性转化研究。
