肝内胆管癌淋巴结清扫的研究热点、焦点与难点
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作者单位:

1.福建医科大学孟超肝胆医院 肝胆胰外科,福建 福州 350007;2.福建省肝胆医学中心,福建 福州 350007

作者简介:

曾永毅,福建医科大学孟超肝胆医院主任医师,主要从事肝胆胰恶性肿瘤外科治疗方面的研究。

基金项目:

国家自然科学基金面上基金资助项目(62275050);福建省科技创新联合基金资金项目(2019Y9108);福建省卫健委中青年科研重大基金资助项目(2021ZQNZD013)。


Research hotspots, focus, and challenges of lymph node dissection in intrahepatic cholangiocarcinoma
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Affiliation:

1.Department of Hepatobiliary and Pancreatic Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350007, China;2.Hepatobiliary Medical Center of Fujian Province, Fuzhou 350007, China

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    摘要:

    肝内胆管癌(ICC)是一种高度侵袭性的恶性肿瘤,淋巴结转移是ICC患者预后不良的最重要因素之一。淋巴结清扫在ICC淋巴结分期、预后指导及辅助治疗等方面具有重要价值。近年来,国内外学者围绕ICC淋巴结转移及淋巴结清扫开展了深入研究,但国内外不同研究结果和共识对ICC淋巴结清扫尚存在不同的认识和推荐,同时淋巴结清扫范围、清扫数量及清扫方法各不相同,相应研究结果也略有差异。本文结合近期研究成果对淋巴结清扫范围、清扫数量、清扫方式、临床价值、适宜人群和前瞻性临床研究等ICC淋巴结清扫相关问题作一概述,以期明确本领域研究热点、焦点和难点,为提高ICC综合整治水平助力。

    Abstract:

    Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive malignant tumor, and lymph node metastasis is one of the most important adverse prognostic factors for ICC patients. Lymph node dissection has important value in lymph node staging, prognostic guidance, and adjuvant therapy for ICC. In recent years, domestic and foreign scholars have conducted in-depth research on ICC lymph node metastasis and dissection. However, there are still different understandings and recommendations regarding ICC lymph node dissection based on different research results and consensus at home and abroad. At the same time, the scope, number, and methods of lymph node dissection vary, leading to slight differences in corresponding research results. This article provides an overview of issues related to ICC lymph node dissection, including the scope, number, method, clinical value, appropriate population, and prospective clinical research based on recent research findings, aiming to clarify the research hotspots, focus, and difficulties in this field, and to help improve the comprehensive treatment level of ICC.

    图1 淋巴结清扫范围示意图 A:左肝ICC,NCCN指南建议清扫肝门区淋巴结(12组),原发性肝癌诊疗指南之ICC诊治专家共识建议清扫12、1、3、7、8组淋巴结;B:右肝ICC,NCCN指南建议清扫肝门区淋巴结(12组),原发性肝癌诊疗指南之ICC诊治专家共识建议清扫12、8、13组淋巴结Fig.1 Diagram illustrating the scope of lymph node dissection A: For left liver ICC, NCCN guidelines suggest clearing hilar lymph nodes (No. 12), while the expert consensus on the diagnosis and treatment of primary liver cancer recommends clearing No. 12, 1, 3, 7, and 8 lymph nodes; B: For right liver ICC, NCCN guidelines recommend clearing hilar lymph nodes (No. 12), while the expert consensus on the diagnosis and treatment of primary liver cancer suggests clearing No. 12, 8, and 13 lymph nodes
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刘红枝,曾永毅.肝内胆管癌淋巴结清扫的研究热点、焦点与难点[J].中国普通外科杂志,2024,33(2):168-175.
DOI:10.7659/j. issn.1005-6947.2024.02.002

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  • 收稿日期:2024-01-03
  • 最后修改日期:2024-01-31
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  • 在线发布日期: 2024-03-09