侵犯肝中静脉的肝内胆管癌转化治疗的难点与策略

The challenges and strategies of conversion therapy for intrahepatic cholangiocarcinoma with middle hepatic vein invasion

摘要:

肝内胆管癌（ICC）是一种起病隐匿、致死率极高的恶性肿瘤，常因血管侵犯和转移，导致无法进行根治性手术。肝中静脉（MHV）毗邻左右肝静脉和第二肝门，是肝脏血管系统的重要组成部分，ICC侵犯MHV的患者在治疗上面临较大的挑战，且相关治疗决策常存在较多争议。转化治疗为最初不可切除的ICC患者带来了新的治疗希望，尤其对于ICC侵犯MHV的患者而言，转化治疗的需求尤为迫切。本文将结合相关研究成果和笔者团队的临床经验，探讨ICC伴MHV侵犯在转化治疗中存在的若干难点问题，旨在为此类患者的临床治疗提供参考。

Abstract:

Intrahepatic cholangiocarcinoma (ICC) is a malignancy with an insidious onset and extremely high mortality, often resulting in the inability to perform radical surgery due to vascular invasion and metastasis. The middle hepatic vein (MHV), located adjacent to the left and right hepatic veins and the second hepatic hilum, is an essential component of the hepatic vascular system. Patients with ICC involving the MHV face significant treatment challenges, and there is considerable debate regarding the optimal treatment decisions. Conversion therapy has provided new hope for patients with initially unresectable ICC, particularly for those with MHV invasion, who have an urgent need for such treatment. This article combines relevant research findings and clinical experience of the authors' team to discuss several challenges in conversion therapy for ICC with MHV invasion, aiming to provide reference for the clinical management of these patients.