肝门部胆管癌神经侵袭的研究进展

Research Progress in Perineural Invasion of Perihilar Cholangiocarcinoma

摘要: 肝门部胆管癌(Perihilar Cholangiocarcinoma, HCCA)起源于左、右肝管或其汇合部的肝外胆管腺癌，与远端胆管癌和肝内胆管癌共同组成了胆管上皮起源的胆道肿瘤家族，亦称高位胆管癌、近端胆管癌或Klatskin肿瘤，根治性切除仍然是获得远期生存的唯一办法。部分早期发现的HCCA患者可以行根治性切除，但是因神经侵袭(perineural invasion, PNI)转移能力强，患者发病早期症状不明显，就诊时已是中晚期，造成根治性手术切除率低，术后早期复发，患者术后生存时间短。PNI常发生在肝门部胆管癌患者中，是影响手术切除后患者生存的一个重要的预后因素。针对肝门部胆管癌PNI的患者，术前准确诊断PNI对评估肝门部胆管癌患者的预后有至关重要的意义。

Abstract: Perihilar Cholangiocarcinoma (HCCA) originates from the extrahepatic bile duct adenocarcinoma of the left and right hepatic ducts or their confluence, and together with distal and intrahepatic bile duct carcinoma, forms a family of bile duct epithelial tumors, also known as high bile duct carcino-ma, proximal bile duct carcinoma, or Klatskin tumor. Radical resection remains the only way to achieve long-term survival. Some patients with early detection of Perihilar Cholangiocarcinoma can undergo radical resection. However, due to the strong metastatic ability of perineural invasion, the early symptoms of the patient are not obvious, and they are already in the middle and late stages of the disease at the time of treatment, resulting in a low resection rate of radical surgery, early post-operative recurrence, and short postoperative survival time. Perineural invasion often occurs in pa-tients with Perihilar Cholangiocarcinoma and is an important prognostic factor affecting postopera-tive survival. For patients with portal cholangiocarcinoma, accurate preoperative diagnosis of peri-neural invasion is crucial for evaluating the prognosis of patients with Perihilar Cholangiocarcino-ma.