Холангиоцеллюлярный рак (ХЦР) является относительно редким заболеванием, составляющим около 3% от всех злокачественных образований желудочно-кишечного тракта. Внутрипеченочный тип ХЦР (ВПХЦР) составляет от 5 до 10% всех ХЦР и в 90% случаев представляет собой аденокарциному. В процессах холангиокарциногенеза важную роль играет хроническое воспаление, которое активирует различные внутриклеточные патологические сигнальные пути, приводящие к нарушению клеточной пролиферации холангиоцитов. Несмотря на улучшение лабораторных и инструментальных методов диагностики ввиду поздних клинических проявлений болезни более 1/2 больных поступают на поздних стадиях, в то время как хирургическое лечение на ранней стадии заболевания является решающим в улучшении прогноза у этих больных. Несомненно, углубление знаний об изменениях на молекулярно-генетическом уровне у больных ВПХЦР позволит совершенствовать методы обследования таких пациентов, что может способствовать улучшению результатов лечения у больных ВПХЦР.
Cholangiocellular carcinoma (CCA) is a rare disease. In average it is 3% of all malignant tumors of the gastrointestinal tract. Intrahepatic type (iCCA) represents from 5 to 10% of the CCA. The chronic inflammation plays an important role in pathogenesis of CCA, against the background of what there is an activation of various cellular signaling pathways leading to disruption of cell proliferation of cholangiocytes. The majority of patients with iCCA develop symptoms only at an advanced stage of disease. Surgical treatment at an early stage is curative in improving the prognosis of these patients. Certainly, knowledge of changes at the molecular genetic level in patients with iCCA will improve the methods of examination of these patients, that elevate the diagnosis and treatment results.
1. Имянитов Е.Н. Эпидемиология и биология опухолей кожи. Практ. онкология. 2012; 13 (2): 61–8. / Imianitov E.N. Epidemiologiia i biologiia opukholei kozhi. Prakt. onkologiia. 2012; 13 (2): 61–8. [in Russian]
2. Майстренко Н.А., Шейко С.Б., Алентьев А.В., Азимов Ф.Х. Холангиоцеллюлярный рак (особенности диагностики и лечения). Практ. онкология. 2008; 9 (4): 229–36. / Maistrenko N.A., Sheiko S.B., Alent'ev A.V., Azimov F.Kh. Kholangiotselliuliarnyi rak (osobennosti diagnostiki i lecheniia). Prakt. onkologiia. 2008; 9 (4): 229–36. [in Russian]
3. American Joint Committee on Cancer. AJCC cancer staging manual. 6th ed. New York: Springer, 2002.
4. Anderson МА, Appalaneni V, Ben-Menachem T et al. The role of endoscopy in the evaluation and treatment of patients with biliary neoplasia. Gastrointest Endosc 2013; 77 (2): 167–74. doi: 10.1016/j.gie.2012.09.029.
5. Ariizumi Sh, Kotera Yo, Katagiri S, Nakano M et al. Long-term Survival of Patients with Cholangiolocellular Carcinoma After Curative Hepatectomy. Ann Surg Oncol 2014; 21: 451–8. doi: 10.1245/s10434-014-3582-0.
6. Blechacz B, Komuta M, Roskams T, Gores GJ. Clinical diagnosis and staging of cholangiocarcinoma. Nat Rev Gastroenterol Hepatol 2011; 8 (9): 512–22. doi: 10.1038/nrgastro.2011.131.
7. Bloom CM, Langer B, Wilson SR. Role of US in the detection, characterization, and staging of cholangiocarcinoma. Radiographics 1999; 19 (5): 1199–218.
8. Cardinale V, Bragazzi MC, Carpino G et al. Cholangiocarcinoma: increasing burden of classifications. Hepatobiliary Surgery Nutrition 2013; 2 (5): 272–80. doi: 10.3978/j.issn.2304-3881.2013.10.02.
9. Comoglio PM, Giordano S, Trusolino L. Drug development of MET inhibitors: targeting oncogene addiction and expedience. Nat Rev Drug Discov 2008; 7 (6): 504–16. doi: 10.1038/nrd2530.
10. DeOliveira ML. Liver transplantation for cholangiocarcinoma: current best practice. Curr Opin Org Transplant 2014; 19 (3): 245–52. doi: 10.1097/MOT.0000000000000087.
11. Farges O, Fuks D, Le Treut YP et al. AJCC 7th edition of TNM staging accurately discriminates outcomes of patients with resectable intrahepatic cholangiocarcinoma: By the AFC-IHCC-2009 study group. Cancer 2011; 117 (10): 2170–7. doi: 10.1002/cncr.25712.
12. Guglielmi A, Ruzzenente A, Campagnaro T et al. Intrahepatic cholangiocarcinoma: prognostic factors after surgical resection. World J Surg 2009; 33 (6): 1247–54. doi: 10.1007/s00268-009-9970-0.
13. Kiefer MV, Albert M, McNally M et al. Chemoembolization of intrahepatic cholangiocarcinoma with cisplatinum, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol: a 2-center study. Cancer 2011; 117 (7): 1498–505. doi: 10.1002/cncr.25625.
14. Kloeckner R, Ruckes C, Kronfeld K et al. Selective internal radiotherapy (SIRT) versus transarterial chemoembolization (TACE) for the treatment of intrahepatic cholangiocellular carcinoma (CCC): study protocol for a randomized controlled trial. Trials 2014; 15 (1): 311. doi: 10.1186/1745-6215-15-311.
15. Komuta M, Spee B, Borght SV et al. Clinicopathological Study on Cholangiolocellular Carcinoma Suggesting Hepatic Progenitor Cell Origin. Hepatology 2008; 47 (5): 1544–56. doi: 10.1002/hep.22238.
16. Lai GH, Radaeva S, Nakamura T et al. Unique epithelial cell production of hepatocyte growth factor/scatter factor by putative precancerous intestinal metaplasias and associated «intestinaltype» biliary cancer chemically induced in rat liver. Hepatology 2000; 31 (6): 1257–65.
17. Makuuchi M, Torzilli G, Minagawa M et al. Accurate preoperative evaluation of liver mass lesions without fine-needle biopsy. Hepatology 1999; 30 (4): 889–93.
18. Mavros MN, Economopoulos KP, Alexiou VG, Pawlik TM. Treatment and Prognosis for Patients with Intrahepatic Cholangiocarcinoma: Systematic Review and Meta-analysis. JAMA Surg 2014; 149 (6): 565–74. doi: 10.1001/jamasurg.2013.5137.
19. Miyamoto M, Ojima H, Iwasaki M et al. Prognostic significance of overexpression of c-Met oncoprotein in cholangiocarcinoma. Br J Cancer 2011; 105 (1): 131–8. doi: 10.1038/bjc.2011.199.
20. Nakanuma Y, Tsutsui A, Ren XS. What Are the Precursor and Early Lesions of Peripheral Intrahepatic Cholangiocarcinoma? Int J Hepatol 2014; 2014: 805973. doi: 10.1155/2014/805973.
21. Padden J, Megger DA, Bracht T et al. Identification of Novel Biomarker Candidates for the Immunohistochemical Diagnosis of Cholangiocellular Carcinoma. Mol Cell Proteomics 2014; 13 (10): 2661–72. doi: 10.1074/mcp.M113.034942.
22. Patel T. New insights into the molecular pathogenesis of intrahepatic cholangiocarcinoma. J Gastroenterol 2014; 49 (2): 165–72. doi: 10.1007/s00535-013-0894-y.
23. Rizvi S, Gores GJ. Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology 2013; 145 (6): 1215–29. doi: 10.1053/j.gastro.2013.10.013.
24. Sato Y, Harada K, Sasaki M, Nakanuma Y. Clinicopathological significance of S100 protein expression in cholangiocarcinoma. J Gastroenterol Hepatol 2013; 28 (8): 1422–9. doi: 10.1111/ jgh.12247.
25. Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis 2004; 24: 115–25.
26. Sia D, Hoshida Y, Villanueva A et al. Integrative molecular analysis of intrahepatic cholangiocarcinoma reveals 2 classes that have different outcomes. Gastroenterology 2013; 144 (4): 829–40. doi: 10.1053/j.gastro.2013.01.001.
27. Sia D, Tovar V, Moeini A, Llovet JM. Intrahepatic cholangiocarcinoma: pathogenesis and rationale for molecular therapies. Oncogene 2013; 32 (41): 4861–70. doi: 10.1038/onc.2012.617.
28. Vilana R, Forner A, Bianchi L et al. Intrahepatic peripheral cholangiocarcinoma in cirrhosis patients may display a vascular pattern similar to hepatocellular carcinoma on contrast-enhanced ultrasound. Hepatology 2010; 51 (6): 2020–9. doi: 10.1002/hep.23600.
29. Witjes CD, Karim-Kos HE, Visser O et al. Intrahepatic cholangiocarcinoma in a low endemic area: rising incidence and improved survival. HPB (Oxford) 2012; 14 (11): 777–81. doi: 10.1111/j.1477-2574.2012.00536.x.
30. Zechlinski JJ, Rilling WS. Transarterial therapies for the treatment of intrahepatic cholangiocarcinoma. Semin Intervent Radiol 2013; 30 (1): 21–7. doi: 10.1055/s-0033-1333650.
31. Zhang L, Frank R, Furth EE et al. Expression and diagnostic values of calretinin and CK5/6 in cholangiocarcinoma. Experiment Hematol Oncol 2014; 3: 12. doi: 10.1186/2162-3619-3-12.
32. Zhang W, Yan L. Perihilar cholangiocarcinoma: Current therapy. World J Gastrointestinal Pathophysiol 2014; 5 (3): 344–54. doi: 10.4291/wjgp.v5.i3.344.
________________________________________________
1. Imianitov E.N. Epidemiologiia i biologiia opukholei kozhi. Prakt. onkologiia. 2012; 13 (2): 61–8. [in Russian]
2. Maistrenko N.A., Sheiko S.B., Alent'ev A.V., Azimov F.Kh. Kholangiotselliuliarnyi rak (osobennosti diagnostiki i lecheniia). Prakt. onkologiia. 2008; 9 (4): 229–36. [in Russian]
3. American Joint Committee on Cancer. AJCC cancer staging manual. 6th ed. New York: Springer, 2002.
4. Anderson МА, Appalaneni V, Ben-Menachem T et al. The role of endoscopy in the evaluation and treatment of patients with biliary neoplasia. Gastrointest Endosc 2013; 77 (2): 167–74. doi: 10.1016/j.gie.2012.09.029.
5. Ariizumi Sh, Kotera Yo, Katagiri S, Nakano M et al. Long-term Survival of Patients with Cholangiolocellular Carcinoma After Curative Hepatectomy. Ann Surg Oncol 2014; 21: 451–8. doi: 10.1245/s10434-014-3582-0.
6. Blechacz B, Komuta M, Roskams T, Gores GJ. Clinical diagnosis and staging of cholangiocarcinoma. Nat Rev Gastroenterol Hepatol 2011; 8 (9): 512–22. doi: 10.1038/nrgastro.2011.131.
7. Bloom CM, Langer B, Wilson SR. Role of US in the detection, characterization, and staging of cholangiocarcinoma. Radiographics 1999; 19 (5): 1199–218.
8. Cardinale V, Bragazzi MC, Carpino G et al. Cholangiocarcinoma: increasing burden of classifications. Hepatobiliary Surgery Nutrition 2013; 2 (5): 272–80. doi: 10.3978/j.issn.2304-3881.2013.10.02.
9. Comoglio PM, Giordano S, Trusolino L. Drug development of MET inhibitors: targeting oncogene addiction and expedience. Nat Rev Drug Discov 2008; 7 (6): 504–16. doi: 10.1038/nrd2530.
10. DeOliveira ML. Liver transplantation for cholangiocarcinoma: current best practice. Curr Opin Org Transplant 2014; 19 (3): 245–52. doi: 10.1097/MOT.0000000000000087.
11. Farges O, Fuks D, Le Treut YP et al. AJCC 7th edition of TNM staging accurately discriminates outcomes of patients with resectable intrahepatic cholangiocarcinoma: By the AFC-IHCC-2009 study group. Cancer 2011; 117 (10): 2170–7. doi: 10.1002/cncr.25712.
12. Guglielmi A, Ruzzenente A, Campagnaro T et al. Intrahepatic cholangiocarcinoma: prognostic factors after surgical resection. World J Surg 2009; 33 (6): 1247–54. doi: 10.1007/s00268-009-9970-0.
13. Kiefer MV, Albert M, McNally M et al. Chemoembolization of intrahepatic cholangiocarcinoma with cisplatinum, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol: a 2-center study. Cancer 2011; 117 (7): 1498–505. doi: 10.1002/cncr.25625.
14. Kloeckner R, Ruckes C, Kronfeld K et al. Selective internal radiotherapy (SIRT) versus transarterial chemoembolization (TACE) for the treatment of intrahepatic cholangiocellular carcinoma (CCC): study protocol for a randomized controlled trial. Trials 2014; 15 (1): 311. doi: 10.1186/1745-6215-15-311.
15. Komuta M, Spee B, Borght SV et al. Clinicopathological Study on Cholangiolocellular Carcinoma Suggesting Hepatic Progenitor Cell Origin. Hepatology 2008; 47 (5): 1544–56. doi: 10.1002/hep.22238.
16. Lai GH, Radaeva S, Nakamura T et al. Unique epithelial cell production of hepatocyte growth factor/scatter factor by putative precancerous intestinal metaplasias and associated «intestinaltype» biliary cancer chemically induced in rat liver. Hepatology 2000; 31 (6): 1257–65.
17. Makuuchi M, Torzilli G, Minagawa M et al. Accurate preoperative evaluation of liver mass lesions without fine-needle biopsy. Hepatology 1999; 30 (4): 889–93.
18. Mavros MN, Economopoulos KP, Alexiou VG, Pawlik TM. Treatment and Prognosis for Patients with Intrahepatic Cholangiocarcinoma: Systematic Review and Meta-analysis. JAMA Surg 2014; 149 (6): 565–74. doi: 10.1001/jamasurg.2013.5137.
19. Miyamoto M, Ojima H, Iwasaki M et al. Prognostic significance of overexpression of c-Met oncoprotein in cholangiocarcinoma. Br J Cancer 2011; 105 (1): 131–8. doi: 10.1038/bjc.2011.199.
20. Nakanuma Y, Tsutsui A, Ren XS. What Are the Precursor and Early Lesions of Peripheral Intrahepatic Cholangiocarcinoma? Int J Hepatol 2014; 2014: 805973. doi: 10.1155/2014/805973.
21. Padden J, Megger DA, Bracht T et al. Identification of Novel Biomarker Candidates for the Immunohistochemical Diagnosis of Cholangiocellular Carcinoma. Mol Cell Proteomics 2014; 13 (10): 2661–72. doi: 10.1074/mcp.M113.034942.
22. Patel T. New insights into the molecular pathogenesis of intrahepatic cholangiocarcinoma. J Gastroenterol 2014; 49 (2): 165–72. doi: 10.1007/s00535-013-0894-y.
23. Rizvi S, Gores GJ. Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology 2013; 145 (6): 1215–29. doi: 10.1053/j.gastro.2013.10.013.
24. Sato Y, Harada K, Sasaki M, Nakanuma Y. Clinicopathological significance of S100 protein expression in cholangiocarcinoma. J Gastroenterol Hepatol 2013; 28 (8): 1422–9. doi: 10.1111/ jgh.12247.
25. Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis 2004; 24: 115–25.
26. Sia D, Hoshida Y, Villanueva A et al. Integrative molecular analysis of intrahepatic cholangiocarcinoma reveals 2 classes that have different outcomes. Gastroenterology 2013; 144 (4): 829–40. doi: 10.1053/j.gastro.2013.01.001.
27. Sia D, Tovar V, Moeini A, Llovet JM. Intrahepatic cholangiocarcinoma: pathogenesis and rationale for molecular therapies. Oncogene 2013; 32 (41): 4861–70. doi: 10.1038/onc.2012.617.
28. Vilana R, Forner A, Bianchi L et al. Intrahepatic peripheral cholangiocarcinoma in cirrhosis patients may display a vascular pattern similar to hepatocellular carcinoma on contrast-enhanced ultrasound. Hepatology 2010; 51 (6): 2020–9. doi: 10.1002/hep.23600.
29. Witjes CD, Karim-Kos HE, Visser O et al. Intrahepatic cholangiocarcinoma in a low endemic area: rising incidence and improved survival. HPB (Oxford) 2012; 14 (11): 777–81. doi: 10.1111/j.1477-2574.2012.00536.x.
30. Zechlinski JJ, Rilling WS. Transarterial therapies for the treatment of intrahepatic cholangiocarcinoma. Semin Intervent Radiol 2013; 30 (1): 21–7. doi: 10.1055/s-0033-1333650.
31. Zhang L, Frank R, Furth EE et al. Expression and diagnostic values of calretinin and CK5/6 in cholangiocarcinoma. Experiment Hematol Oncol 2014; 3: 12. doi: 10.1186/2162-3619-3-12.
32. Zhang W, Yan L. Perihilar cholangiocarcinoma: Current therapy. World J Gastrointestinal Pathophysiol 2014; 5 (3): 344–54. doi: 10.4291/wjgp.v5.i3.344.
Авторы
Ю.О.Жариков*, Т.В.Шевченко, А.В.Чжао
ФГБУ Институт хирургии им. А.В.Вишневского Минздрава России. 117997, Россия, Москва, ул. Большая Серпуховская, д. 27
*deadmaster_89@mail.ru
________________________________________________
Yu.O.Zharikov*, T.V.Shevchenko, A.V.Zhao
A.V.Vishnevsky Institute of Surgery of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Bol'shaia Serpukhovskaia, d. 27
*deadmaster_89@mail.ru