Guedj Nathalie, Bedossa Pierre, Paradis Valérie
Hôpital Beaujon, Clichy, France.
Ann Pathol. 2010 Dec;30(6):455-63. doi: 10.1016/j.annpat.2010.10.004. Epub 2010 Nov 27.
Cholangiocarcinomas (CC) are tumors that arise from the epithelial cell of the biliary tract. They represent the second most frequent primitive liver malignancy after hepatocellular carcinoma. Recent epidemiological data show an increase incidence of CC independently of the increased incidence of cirrhosis. According to their location in the biliary tract, we distinguish intrahepatic, hilar (Klastkin tumors) and extrahepatic CC. In literature, confusion exists around hilar CC that are included, according series, to intrahepatic or extrahepatic CC. However, hilar CC share common clinical, morphological and therapeutic features with extrahepatic CC. So, OMS classification of digestive tumors defined two groups of CC: intrahepatic or peripheral CC which develop from small intrahepatic biliary duct beyond the second segmentation, and extrahepatic CC comprising hilar CC and tumors from common hepatic bile duct. In this chapter, we will describe the different gross features and histological characteristic of CC and will detail the major histopronostic criteria of these tumors.
胆管癌(CC)是起源于胆道上皮细胞的肿瘤。它们是继肝细胞癌之后第二常见的原发性肝脏恶性肿瘤。最近的流行病学数据显示,胆管癌的发病率有所上升,且与肝硬化发病率的增加无关。根据其在胆道中的位置,我们可区分肝内胆管癌、肝门部胆管癌(克拉斯金瘤)和肝外胆管癌。在文献中,对于肝门部胆管癌存在混淆,根据不同系列,它们被归入肝内胆管癌或肝外胆管癌。然而,肝门部胆管癌与肝外胆管癌具有共同的临床、形态学和治疗特征。因此,世界卫生组织消化系统肿瘤分类将胆管癌分为两组:肝内或周围型胆管癌,由第二段以外的肝内小胆管发展而来;肝外胆管癌,包括肝门部胆管癌和肝总管肿瘤。在本章中,我们将描述胆管癌的不同大体特征和组织学特征,并详细阐述这些肿瘤的主要组织学预后标准。