肝移植治疗肝内胆管癌的研究进展

摘要: 肝内胆管癌（ICC）是仅次于肝细胞癌的肝脏原发性恶性肿瘤，其发病率在全球范围内呈上升趋势。肝切除术一直是ICC患者外科治疗的首选，而ICC肝移植过去由于高肿瘤复发率和较差的生存结果，被视为肝移植禁忌证。目前，ICC肝移植治疗已经取得了诸多重要进展，对于严格选择的ICC患者，肝移植或在新辅助治疗后肝移植取得了令人鼓舞的生存结果。同时，随着ICC肝移植治疗预后风险分层的完善，也将进一步优化ICC肝移植候选者的选择标准。此外，ICC现代多模式综合治疗的发展，也将进一步指导ICC肝移植术前新辅助治疗方案的选择。ICC肝移植前应用免疫检查点抑制剂也是未来重要的研究方向。本文从ICC肝移植治疗的预后、ICC肝移植的预后风险因素及候选者选择标准、正在进行的试验和挑战进行总结，以期为肝移植治疗ICC提供参考。
- 肝内胆管癌 /
- 肝移植 /
- 肝细胞癌 /
- 肝切除 /
- 新辅助治疗 /
- 复发 /
- 化学药物治疗 /
- 免疫治疗
Abstract: Intrahepatic cholangiocarcinoma (ICC) is a primary malignant tumor of the liver, secondary to hepatocellular carcinoma, and its incidence tends to elevate worldwide. Hepatectomy is the optimal surgical regimen for ICC patients. ICC is considered as a contraindication for liver transplantation due to high tumor recurrence rate and poor survival outcome. At present, multiple significant progresses have been made in liver transplantation for ICC. For strictly-selected ICC patients, liver transplantation or liver transplantation after neoadjuvant therapy has achieved encouraging survival outcomes. Meantime, with the improvement of prognostic risk stratification of liver transplantation for ICC, the inclusion criteria of ICC candidates undergoing liver transplantation will be further optimized. In addition, the advancement of modern multi-mode comprehensive treatment of ICC will further guide the selection of neoadjuvant therapy before liver transplantation for ICC. The application of immune checkpoint inhibitors in ICC before liver transplantation is also an important research direction in the future. In this article, clinical prognosis of liver transplantation for ICC, prognostic risk factors and inclusion criteria of ICC candidates undergoing liver transplantation, and the ongoing trials and existing challenges were summarized, aiming to provide reference for liver transplantation for ICC.
- Intrahepatic cholangiocarcinoma /
- Liver transplantation /
- Hepatocellular carcinoma /
- Hepatectomy /
- Neoadjuvant therapy /
- Recurrence /
- Chemotherapy /
- Immunotherapy

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