本书中涉及的胆囊肿瘤及其癌前病变的中英文名称见表1-0-2。
表1-0-2 胆道肿瘤及其癌前病变中英文名称
依据肝脏Couinaud解剖分段法 [72,73] 及中华医学会外科学分会肝脏外科学组制订的肝切除手术命名法(2017年第1次修订,第2版) [74] ,在本书中对胆道肿瘤外科治疗涉及的肝切除术进行下述规范性命名:
(1)肝肿瘤剜除术(enucleation of hepatic tumor):
在肝实质中沿肿瘤包膜外分离,直至将肿瘤完整地剜除,最大限度保留肝实质,常用于肝血管瘤等肝内良性肿瘤。
肝内胆管癌、胆囊癌肝侵犯或肝内转移等胆道肿瘤外科治疗术式,不应采用肝内肿瘤剜除的术式。
(2)限制性肝切除术(limited hepatectomy):
通常是指为保留更多的肝实质,肝实质离断切缘距离肿瘤边界小于1cm。
胆道肿瘤外科治疗术式不建议常规应用限制性肝切除术。
(3)局部性肝切除术(local hepatectomy):
是在距肿瘤边缘≥1cm的正常肝组织处离断肝实质,以达到既能将肿瘤完全切除,又可以更多保留残肝组织的目的。
部分肝内胆管癌、胆囊癌肝侵犯或肝转移等适用于局部性肝切除术。
(4)其他特殊类型的非解剖性肝切除术
1)肝楔形切除术(wedge hepatectomy):
肝楔形切除术是肝部分切除术的一种类型,主要适用于肝边缘部肿瘤的切除。
对于T3期、无肝内广泛转移的胆囊癌,可行距胆囊床3cm的肝楔形切除术。
2)围肝门切除术:
围肝门区域是指第一肝门附近、包含血管及胆管的狭小空间解剖区域,随着肝脏外科临床实践及解剖的发展,在肝胆外科学界逐渐形成了这一约定俗成的称谓,其范围界定于肝脏脏面H形横沟区域内 [75] 。董家鸿等认为围肝门区域涵盖经过第一肝门的脉管及其周围组织结构,包括肝十二指肠韧带、尾状叶、肝脏4b段和5段、肝门板等 [76] 。围肝门切除术即指在围肝门区域内实施的肝切除术,也有人称之为中央型肝切除(central hepatectomy) [77] ,其本质是一种保留功能肝实质的肝切除术(parenchyma-preserving hepatectomy),主要应用于部分肝门部胆管癌及胆囊癌的手术方案中 [78,79] 。
(1)肝段切除术(hepatic segmentectomy):
将某一肝段全切除,称肝段切除术。
(2)半肝切除术(hemi-hepatectomy):
正常以肝正中裂为界将肝脏分为左、右两半,沿着正中裂切开肝包膜、离断肝实质,将左半肝或右半肝予以完全切除,称为半肝切除术。右半肝的完全切除(Ⅴ、Ⅵ、Ⅶ、Ⅷ肝段),称为右半肝切除术。左半肝的完全切除(Ⅱ、Ⅲ、Ⅳ肝段),称为左半肝切除术,Ⅰ肝段切除可独立命名为肝尾状叶切除术。
(3)肝三叶切除术(hepatic trilobectomy):
同时切除肝右后叶、右前叶及左内叶(Ⅳ、Ⅴ、Ⅵ、Ⅶ、Ⅷ段),称肝右三叶切除术;同时切除肝左外叶、左内叶及右前叶(Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅷ肝段),称肝左三叶切除术。
(1)肝部分切除术(partial resection):
指仅切部分肝脏,包括解剖性和非解剖性肝切除,可分为小范围肝切除和大范围肝切除两种。
(2)小范围肝切除(minor hepatectomy):
<3个肝段的肝切除。
(3)大范围肝切除(major hepatectomy):
≥3个肝段的肝切除。国内也有“大部肝切除”的称谓,在本书中统一为表述“大范围肝切除”。
[1]PARADIS V,FUKAYMA M,PARK Y N,et al.WHO Classification of Tumours Editorial Board.Tumours of the liver and intrahepatic bile ducts[M]//World Health Organization.WHO Classification of Tumours-Digestive System Tumours.5th ed.Lyon:International Agency for Research on Cancer,2018:216.
[2]KLIMSTRA D S,LAM A K,PARADIS V,et al.WHO Classification of Tumours Editorial Board.Tumours of the gallbladder and extrahepatic bile ducts[M]//World Health Organization.WHO Classification of Tumours-Digestive System Tumours.5th ed.Lyon:International Agency for Research on Cancer,2018:266.
[3]DEOLIVEIRA M L,CUNNINGHAM S C,CAMERON J L,et al.Cholangiocarcinoma:thirty-one-year experience with 564 patients at a single institution[J].Ann Surg,2007,245(5):755-762.
[4]CHARBEL H,AL-KAWAS F H.Cholangiocarcinoma:epidemiology,risk factors,pathogenesis,and diagnosis[J].Curr Gastroenterol Rep,2011,13(2):182-187.
[5]赫捷,陈万青.2017中国肿瘤登记年报[M].北京:人民卫生出版社,2018:113.
[6]HUSSAIN S P,HARRIS C C.Inflammation and cancer:an ancient link with novel potentials[J].Int J Cancer,2007,121(11):2373-2380.
[7]OKADA F.Inflammation-related carcinogenesis:current findings in epidemiological trends,causes and mechanisms[J].Yonago Acta Med,2014,57(2):65-72.
[8]WU Y,ANTONY S,MEITZLER J L,et al.Molecular mechanisms underlying chronic inflammation-associatedcancers[J].Cancer Lett,2014,345(2):164-173.
[9]ZHANG R,KANG K A,KIM K C,et al.Oxidative stress causes epigenetic alteration of CDX1 expression incolorectal cancer cells[J].Gene,2013,524(2):214-219.
[10]CHIBA T,MARUSAWA H,USHIJIMA T.Inflammation-associated cancer development in digestive organs:mechanisms and roles for genetic andepigenetic modulation[J].Gastroenterology,2012,143(3):550-563.
[11]COLOTTA F,ALLAVENA P,SICA A,et al.Cancer-related in flammation,the seventh hallmark of cancer:links to genetic instability.Carcinogenesis,2009,30(7):1073-1081.
[12]WU Y,WANG T,YE S,et al.Detection of hepatitis B virus DNA in paraffin-embedded intrahepatic and extrahepatic cholangiocarcinoma tissue in the northern Chinese population[J].Hum Pathol,2012,43(1):56-61.
[13]FUJII T,ZEN Y,NAKANUMA Y.Perihilar cholangiocarcinoma arising in hepatitis C virus-related liver cirrhosis with hepatocellular carcinoma [J].J Gastroenterol,2007,42(8):698-702.
[14]ZENG B,LI Z,CHEN R,et al.Epigenetic regulation of miR-124 by hepatitis C virus core protein promotes migration and invasion of intrahepatic cholangiocarcinoma cells by targeting SMYD3[J].FEBS Lett,2012,586(19):3271-3278.
[15]LIU W,CHEN J R,HSU C H,et al.A zebrafish model of intrahepatic cholangiocarcinoma by dual expression of hepatitis B virus X and hepatitis C virus core protein in liver[J].Hepatology,2012,56(6):2268-2276.
[16]ZHOU H,WANG H,ZHOU D,et al.Hepatitis B virus-associated intrahepatic cholangiocarcinoma and hepatocellular carcinoma may hold common disease process for carcinogenesis[J].Eur J Cancer,2010,46(6):1056-1061.
[17]FWU C W,CHIEN Y C,YOU S L,et al.Hepatitis B virus infection and risk of intrahepatic cholangiocarcinoma and non-Hodgkin lymphoma:a cohort study of parous women in Taiwan[J].Hepatology,2011,53(4):1217-1225.
[18]ARZUMANYAN A,REIS H M,FEITELSON M A.Pathogenic mechanisms in HBV- and HCV-associated hepatocellular carcinoma[J].Nat Rev Cancer,2013,13(2):123-135.
[19]BOONSTRA A,WOLTMAN A M,Janssen H L.Immunology of hepatitis B and hepatitis C virus infections[J].Best Pract Res Clin Gastroenterol,2008,22(6):1049-1061.
[20]TAROCCHI M,POLVANI S,MARRONCINI G,et al.Molecular mechanism of hepatitis B virus-induced hepatocarcinogenesis[J].World J Gastroenterol,2014,20(33):11630-11640.
[21]READ S A,DOUGLAS M W.Virus induced inflammation and cancer development[J].Cancer Letters,2014,345(2):174-181.
[22]LIN C C,LIN P Y,CHEN Y L.Comparison of concomitant and subsequent cholangiocarcinomas associated with hepatolithiasis:Clinical implications[J].World J Gastroenterol,2013,19(3):375-380.
[23]MATHUR S K,DUHAN A,SIBGH S,et al.Correlation of gallstone characteristics with mucosal changes in gall bladder[J].Trop Gastroenterol,2012,33(1):39-44.
[24]TEWARI M.Contribution of silent gallstones in gallbladder cancer[J].J Surg Oncol,2006,93(8):629-632.
[25]LI Y,ZHANG J,MA H.Chronic inflammation and gallbladder cancer[J].Cancer Lett,2014,345(2):242-248.
[26]RANDI G,FRANCESCHI S,LA V C.Gallbladder cancer worldwide:geographical distribution and risk factors[J].Int J Cancer,2006,118(7):1591-1602.
[27]SHRIKHANDE S V,BARRETO S G,SINGH S,et al.Cholelithiasis in gallbladder cancer:coincidence,cofactor,or cause![J].Eur J Surg Oncol,2010,36(6):514-519.
[28]HUNDAL R,SHAFFER E A.Gallbladder cancer:epidemiology and outcome[J].Clin Epidemiol,2014,6:99-109.
[29]MAEMURA K,NATSUGOE S,TAKAO S.Molecular mechanism of cholangiocarcinoma carcinogenesis[J].J Hepatobiliary Pancreat Sci,2014,21(10):754-760.
[30]HOU P C.The relationship between primary carcinoma of the live and infestation with Clonorchis sinensis[J].J Pathol Bacterio1,1956,72(1):239-246.
[31]HONJO S,SRIVATANAKUL P,SRIPLUNG H,et al.Genetic and environmental determinants of risk for cholangiocarcinoma via Opisthorchis viverrini in a densely infested area in Nakhon Phanom,northeast Thailand[J].Int J Cancer,2005,117(5):854-860.
[32]SRIPA B,KAEWKES S.Localisation of parasite antigens and inflammatory responses in experimental opisthorchiasis[J].Int J Parasitol,2000,30(6):735-740.
[33]OHSHIMA H,TATEMICHI M,SAWA T.Chemical basis of inflammation-induced carcinogenesis[J].Arch Biochem Biophys,2003,417(1):3-11.
[34]SRIPA B,KAEWKES S,SITHITHAWORN P,et al.Liver fluke induces cholangiocarcinoma[J].PLoS Med,2007,4(7):1148-1155.
[35]NINLAWAN K,O'HARA S P,SPLINTER P L,et al.Opisthorchis viverrini excretory/secretory products induce toll-like receptor 4 upregulation and production of interleukin 6 and 8 in cholangiocyte[J].Parasitol Int,2010,59(4):616-621.
[36]LANZONI A,FAUSTINELLI I,CRISTOFORI P,et al.Localization of Helicobacter sppin the fundic mucosa of laboratory Beagle dogs:an ultrastructural study[J].Vet Res,2011,42:42.
[37]MARINI R P,MUTHUPALANI S,SHEN Z,et al.Persistent infection of rhesus monkeys with‘Helicobacter macacae’and its isolation from an animal with intestinal adenocarcinoma[J].J Med Microbiol,2010,59:961-969.
[38]SJÖDIN S,TROWALD-WIGH G,FREDRIKSSON M.Identification of Helicobacter DNA in feline pancreas,liver,stomach,and duodenum:comparison between findings in fresh and formalin-fixed paraffin-embedded tissue samples[J].Res Vet Sci,2011,91(3):28-30.
[39]HAMADA T,YOKOTA K,AYADA K,et al.Detection of Helicobacter hepaticus in human bile samples of patients with biliary disease[J].Helicobacter,2009,14(6):545-551.
[40]PARK M J,HYUN M H,YANG J P,et al.Effects of the interleukin-1β-511 C/T gene polymorphism on the risk of gastric cancer in the context of the relationship between race and H.pylori infection:a meta-analysis of 20,000 subjects[J].Mol Biol Rep,2015,42(1):119-134.
[41]DE KORWIN J D.Epidemiology of Helicobacter pylori infection and gastric cancer[J].Rev Prat,2014,64(2):189-193.
[42]OSWALD E,TAIEB F,SUGAI M,et al.Bacterial toxins that modulate host cell-cycle progression[J].Curr Opin Microbiol,2005,8(1):83-91.
[43]SHENKER B J,DEMUTH D R,ZEKAVAT A.Exposure of lymphocytes to high doses of Actinobacillus actinomycetemcomitans cytolethal distending toxin induces rapid onset of apoptosis-mediated DNA fragmentation[J].Infect lmmun,2006,74(4):2080-2092.
[44]LIYANAGE N P,MANTHEY K C,DASSANAYAKE R P,et al.Helicobacter hepaticus cytolethal distending toxin causes cell death in intestinal epithelial cells via mitochondrial apoptotic pathway[J].Helicobacter,2010,15(2):98-107.
[45]NAGARAJA V,ESLICK G D.Systematic review with meta-analysis:the relationship between chronic Salmonella typhi carrier status and gall-bladder cancer[J].Aliment Pharmacol Ther,2014,39(8):745-750.
[46]BOONYANUGOMOL W,CHOMVARIN C,SRIPA B,et al.Helicobacter pylori in Thai patients with cholangiocarcinoma and its association with biliary inflammation and proliferation.HPB(Oxford),2012,14(3):177-184.
[47]SHIMOYAMA T,TAKAHASHI R,ABE D,et al.Serological analysis of Helicobacter hepaticus infection in patients with biliary and pancreatic diseases[J].J Gastroenterol Hepatol,2010,25(Suppl.1):86-89.
[48]MISHRA R R,TEWARI M,SHUKLA H S.Helicobacter pylori and pathogenesis of gallbladder cancer[J].J Gastroenterol Hepatol,2011,26(2):260-266.
[49]VIVEKANANDAN P,TORBENSON M.Low frequency of Helicobacter DNA in benign and malignant liver tissues from Baltimore,United States[J].Hum Pathol,2008,39(2):213-216.
[50]LIU Z,RAMER-TAIT A E,HENDERSON A L,et al.Helicobacter bilis colonization enhances susceptibility to Typhlocolitis following an inflammatory trigger[J].Dig Dis Sci,2011,56(10):2838-2848.
[51]HARADA K,OHIRA S,ISSE K,et al.Lipopolysaccharide activates nuclear factor-kappa B through toll like receptors and related molecules in cultured biliary epithelial cells[J].Lab Invest,2003,83:1657-1667.
[52]KEPLINGER K M,BLOOMSTON M.Anatomy and embryology of the biliary tract[J].Surg Clin North Am,2014,94(2):203-217.
[53]MORINE Y,SHIMADA M,TAKAMATSU H,et al.Clinical features of pancreaticobiliary maljunction:update analysis of 2nd Japan-nationwide survey[J].J Hepatobiliary Pancreat Sci,2013,20(5):472-480.
[54]FUNABIKI T,MATSUBARA T,MIYAKAWA S,et al.Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy[J].Langenbecks Arch Surg,2009,394(1):159-169.
[55]YAMAGUCHI J,SASAKI M,HARADA K,et al.Papillary hyperplasia of the gallbladder in pancreaticobiliary maljunctionrepresents a senescence-related lesion induced by lysolecithin[J].Lab Invest,2009,89(9):1018-1031.
[56]DENG Y L,CHENG N S,LIN Y X,et al.Relationship between pancreaticobiliary maljunction and gallbladdercarcinoma:meta-analysis[J].Hepatobiliary Pancreat Dis Int,2011,10(6):570-580.
[57]KAMISAWA T,TU Y,KUWATA G,et al.Biliary carcinoma risk in patients with Pancreaticobiliary maljunction and the degree of extrahepatic bile duct dilatation[J].Hepatogastroenterology,2006,53(72):816-818.
[58]TAZUMA S,KANNO K,SUGIYAMA A,et al.Nutritional factors(nutritional aspects)in biliary disorders-bile acid and lipid metabolism in gallstone diseases and pancreaticobiliary maljunction[J].J Gastroenterol Hepatol,2013,28(Suppl.4):103-107.
[59]XU Y,YU J,ZHANG R,et al.The Perinatal Infection of Cytomegalovirus Is an Important Etiology for Biliary Atresia in China[J].Clin Pediatr(Phila),2012,51(2):109-113.
[60]YARUR A J,CZUL F,LEVY C.Hepatobiliary manifestations of inflammatory bowel disease[J].Inflamm Bowel Dis,2014,20(9):1655-1667.
[61]BOONSTRA K,WEERSMA R K,VAN ERPECUM K J,et al.Population-based epidemiology,malignancy risk,and outcome of primary sclerosing cholangitis[J].Hepatology,2013,58(6):2045-2055.
[62]EATON J E,TALWALKAR J A,LAZARIDIS K N,et al.Pathogenesis of primary sclerosing cholangitis and advances in diagnosis and management[J].Gastroenterology,2013,145(3):521-536.
[63]KOSHIOL J,GAO Y T,DEAN M,et al.Association of aflatoxin and gallbladder cancer[J].Gastroenterology,2017,153(2):488-494.e1.
[64]SONGSERM N,PROMTHET S,PIENTONG C,et al.Gene-environment interaction involved in cholangiocarcinoma in the Thai population:polymorphisms of DNA repair genes,smoking and use of alcohol[J].BMJ Open,2014,4(10):e005447.
[65]TYSON G L,EL-SERAG H B.Risk factors for cholangiocarcinoma[J].Hepatology,2011,54(1):173-184.
[66]GIOVANNUCCI E,HARLAN D M,ARCHER M C,et al.Diabetesand cancer:a consensus report[J].Diabetes Care,2010,33(7):1674-1685.
[67]CHAITEERAKIJ R,YANG J D,HARMSEN W S,et al.Risk Factors for Intrahepatic Cholangiocarcinoma:Associationbetween Metformin use and Reduced Cancer Risk[J].Hepatology,2013,52(2):648-655.
[68]MARTIN-CASTILLO B,VAZQUEZ-MARTIN A,OLIVERAS-FERRAROS C,et al.Metformin and cancer:doses,mechanisms and the dandelion and hormetic phenomena[J].Cell Cycle,2010,9(6):1057-1064.
[69]KORSSE S E,PEPPELENBOSCH M P,VAN VEELEN W.Targeting LKB1 signaling in cancer[J].Biochim Biophys Acta,2013,1835(2):194-210.
[70]WANG J,ZHANG K,WANG J,et al.Underexpression of LKB1 tumor suppressor is associated with enhanced Wnt signaling and malignant characteristics of human intrahepatic cholangiocarcinoma[J].Oncotarget,2015,6(22):18905-18920.
[71]HU M T,WANG J H,YU Y,et al.Tumor suppressor LKB1 inhibits the progression of gallbladder carcinoma and predicts the prognosis of patients with this malignancy[J].Int J Oncol,2018,53(3):1215-1226.
[72]COUINAUD C.Definition of hepatic anatomical regions and their value during hepatectomy(author's transl)[J].Chirurgie,1980,106(2):103-108.
[73]COUINAUD C.Liver anatomy:portal(and suprahepatic)or biliary segmentation.Liver anatomy:portal(and suprahepatic)or biliary segmentation[J].Dig Surg,1999,16(6):459-467.
[74]中华医学会外科学分会肝脏外科学组.肝脏解剖和肝切除手术命名及肝切除术中控制出血方法和选择原则(2017年第1次修订,第2版)[J].腹部外科,2017,30(2):75-78.
[75]黄志强,黄晓强,周宁新.围肝门外科:概念与实践[J].消化外科,2002,1(3):153-159.
[76]董家鸿,杨世忠,冯晓彬.论围肝门外科[J].中国实用外科杂志,2019,39(2):110-112.
[77]NAGINO M,NIMURA Y,KAMIYA J,et al.A cholangiocellular carcinoma radically resected by central hepatic bisegmentectomy with en bloc resection of the caudate lobe and extrahepatic bile duct[J].J Hep Bil Pancr Surg,1995,2:72-76.
[78]KAWARADA Y,ISAJI S,TAOKA H,et al.S4a + S5 with caudate lobe(S1)resection using the Taj Mahal liver parenchymal resection for carcinoma of the biliary tract[J].J Gastrointest Surg,1999,3(4):369-373.
[79]MIYAZAKI M,ITO H,NAKAGAWA K,et al.Parenchyma-preserving hepatectomy in the surgical treatment of hilar cholangiocarcinoma[J].J Am Coll Surg,1999,189(6):575-583.