摘要
肝癌是恶性程度极高的肿瘤,淋巴结转移是影响患者治疗效果及生存期的一个重要因素。伴有淋巴结转移的患者预后都很差,经外科治疗中位生存期多数不到3个月。尤其是肝内胆管细胞癌,发生淋巴结转移可高达31.9%～58%,远远高于肝细胞癌,其发生隐匿、恶性度高、发展迅速。胆管细胞癌系源于胆管被覆上皮的一种原发性肝癌,临床又称肝内胆管细胞癌或外周型胆管癌,临床预后较肝细胞癌差,5年生存率为13%～42%。淋巴结转移是一个多因素多步骤的过程,大致过程为原发肿瘤增殖后,从原发灶脱离、粘附、降解基底膜向外浸润迁移,侵入微淋巴管随淋巴液到达局部淋巴结,肝癌细胞先聚集在边缘窦,以后累及整个淋巴结,使淋巴结肿大、变硬、融合;局部淋巴结发生转移后可继续转移至下一站的淋巴结。最后经胸导管进入血流,继发血道转移。肝胆管细胞癌以淋巴转移为主,其中以微淋巴管生成,胆管癌细胞的粘附和基质降解三个步骤最为重要,以下将从这几方面详细叙述肝内胆管细胞癌的研究进展。可为靶向治疗及生物治疗提供理论依据。
Liver cancer is a high-degree malignancy with a poor prognosis. Metastasis and recurrence of liver cancer are the main factors influencing the effects of treatment. Lymph node metastasis of liver cancer is the most important factor influencing patient survival. Liver cancer patients have a poor prognosis with an average survival time of less than 3 months after surgical treatment. The rate of lymph node metastasis of intrahepatic bile duct cell carcinoma is 31.9%-58%, much higher than that of hepatocellular carcinoma. Intrahepatic bile duct cell carcinoma has a poorer prognosis than that of primary liver cancer. The five-year survival rate of patients with intrahepatic bile duct cell carcinoma is 13%-42%. Lymph node metastasis is a process involving multiple factors and steps. The process of metastasis includes cancer cell proliferation, detachment, adhesion, degradation of basement membrane and outward infiltration to microlymphatic vessels and lymph nodes, resulting in enlarged, hardened and fused lymph nodes. Cancer cells then transfer into the lymphatic circulation through the thoracic duct and eventually end up in the blood circulation. At present, the metastasis of liver cancer focuses on hematogenous metastasis. Hepatocholangiocarcinoma metastasis involves the lymphatic system, a process that includes micro-lymphangiogenesis, cholangiocarcinoma cell adhesion and matrix degradation. We review the advances in the research on the mechanism of liver cancer metastasis in an effort to confirm the theoretical basis of targeted therapy and biological therapy for liver cancer.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第18期1076-1079,共4页
Chinese Journal of Clinical Oncology
关键词
肝癌
淋巴结转移
微淋巴管
黏附
降解
Liver cancer
Lymphatic metastasis
Micro-lymphatic vessel
Conglutination
Degradation
