Preview

Медицинская визуализация

Расширенный поиск

Современные методы диагностики холангиоцеллюлярного рака

Полный текст:

Аннотация

Цель: представить особенности современной диагностики холангиоцеллюлярного рака (ХЦР). Основные положения. В статье описана классификация, частота встречаемости, факторы риска развития ХЦР. Рассмотрены диагностические возможности трансабдоминального, эндоскопического и внутрипротокового УЗИ, а также РКТ, МРТ, ПЭТ и холангиографии в обнаружении внутри- и внепеченочной формы ХЦР, локорегионарного распространения опухоли. Расширение желчного протока на ультразвуковых томограммах - важный признак для ранней диагностики рака желчного протока и повод для проведения более масштабного обследования с применением других информативных методов. УЗИ - метод выбора при проведении интервенционных процедур, таких как чрескожная чреспеченочная холангиография и дренирование перибилиарных абсцессов. Разработка новых методов исследования желчных протоков привела к использованию УЗИ при проведении эндоскопии - эндоскопического УЗИ и при проведении холангиопанкреатографии-транспапиллярного внутрипротокового УЗИ. Выводы. Большинство авторов считают, что диагностические методы для карциномы желчных протоков без желтухи включают УЗИ, МРХПГ, ЭУЗИ, ЭРХПГ и внутри-протоковое УЗИ, ас желтухой УЗИ, РКТ или МРТ, пункцию под контролем ЭУЗИ, ЭРХПГ. ПЭТ с успехом справляется с диагностикой внутрипеченочной формы ХЦР, но имеет низкие показатели информативности в обнаружении внепеченочного ХЦР. Ее роль заключается в выявлении отдаленных метастазов и оценке эффективности лечения.

Об авторах

Татьяна Юрьевна Данзанова
ФГБУ "Российский онкологический центр им. Н.Н. Блохина" РАМН
Россия


Галина Тимофеевна Синюкова
ФГБУ "Российский онкологический центр им. Н.Н. Блохина" РАМН
Россия


Павел Иванович Лепэдату
ФГБУ "Российский онкологический центр им. Н.Н. Блохина" РАМН
Россия


Список литературы

1. Everhart J.E., Ruhl C.E. Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas. Gastroenterology. 2009; 136: 1134-1144.

2. Blechacz B., Komuta M., Roskams T. et al. Clinical diagnosis and staging of cholangiocarcinoma. Nat. Rev. Gastroenterol. Hepatol. 2011; 8 (9): 512-522.

3. DeOliveira M.L., Schulick R.D., Nimura Y. et al. New staging system and a registry for perihilar cholangiocarcinoma. Hepatology. 2011; 53: 1363-1371.

4. Ito Y., Tajima Y., Fujita F. et al. Solitary recurrence of hilar cholangiocarcinoma in a mediastinal lymph node two years after curative resection. Wld J. Gastroenterol. 2007; 13: 2243-2246.

5. Tao L.Y., He X.D., Qu Q. et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: a case-control study in China. Liver Int. 2010; 30: 215-221.

6. Morana G., Dorigo A. Imaging of cholangiocarcinoma. Cancer Imaging. 2011; 11 Spec No A: S72-S73.

7. Friman S. Cholangiocarcinoma - current treatment options. Scand. J. Surg. 2011; 100 (1): 30-34.

8. Eckel F., Brunner T., Jelic S. Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2010; 21, Suppl. 5: v65-v69.

9. Miyakawa S., Ishihara S., Horiguchi A. et al. Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan. J. Hepatobil. Pancreat. Surg. 2009; 16: 1-7.

10. Tamada K., Ushio J., Sugano K. Endoscopic diagnosis of extrahepatic bile duct carcinoma: Advances and current limitations. Wld J. Clin. Oncol. 2011; 2 (5): 203-216.

11. Zabron A., Edwards R.J., Khan S.A. The challenge of cholangiocarcinoma: dissecting the molecular mechanisms of an insidious cancer. Dis. Model. Mech. 2013; 6 (2): 281-292.

12. Хамидуллин Р.И., Аглуллин И.Р., Рахманин Ю.А. и др. Паразитарный фактор и рак. Гиг. и сан. 2011; 6: 8-11.

13. Razumilava N., Gores G.J. Classification, diagnosis, and management of cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2013; 11 (1):13-21.

14. Nathan H., Aloia T.A., Vauthey J.N. et al. A proposed staging system for intrahepatic cholangiocarcinoma. Ann. Surg. Oncol. 2009; 16: 14-22.

15. Shimada K., Sano T., Sakamoto Y. et al. Surgical outcomes of the mass-forming plus periductal infiltrating types of intrahepatic cholangiocarcinoma: a comparative study with the typical mass-forming type of intrahepatic cholangiocarcinoma. Wld J. Surg. 2007; 31: 2016-2022.

16. Yamamoto Y., Shimada K., Sakamoto Y. et al. Clinicopathological characteristics of intrahepatic cholangiocellular carcinoma presenting intrahepatic bile duct growth. J. Surg. Oncol. 2009; 99: 161-165.

17. Wiedmann M., Schoppmeyer K., Witzigmann H. et al. Current diagnostics and therapy for carcinomas of the biliary tree and gallbladder. J. Gastroenterol. 2005; 43 (3): 305-315.

18. Chung Y.J., Choi D.W., Choi S.H. et al. Prognostic factors following surgical resection of distal bile duct cancer. J. Korean. Surg. Soc. 2013; 85 (5): 212-218.

19. Minami Y., Kudo M. Hepatic malignancies: Correlation between sonographic findings and pathological features. Wld J. Radiol. 2010; 2 (7): 249-256.

20. Измайлова Л.Г., Приходько А.Г., Андреев А.В. и др. Ультразвуковая диагностика гилюсной холангиокарциномы. Мед. виз. 2011; 6: 9-12.

21. Aljiffry M., Walsh M.J., Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009. Wld J. Gastroenterol. 2009; 15 (34): 4240-4262.

22. D'Onofrio M., Vecchiato F., Cantisani V. et al. Intrahepatic peripheral cholangiocarcinoma (IPCC): comparison between perfusion ultrasound and CT imaging. Radiol. Med. 2008; 113 (1): 76-86.

23. Chen L.D., Xu H.X., Xie X.Y. et al. Enhancement patterns of intrahepatic cholangiocarcinoma: comparison between contrast-enhanced ultrasound and contrast-enhanced CT. Br. J. Radiol. 2008; 81 (971): 881-889.

24. Xu H.X. Contrast-enhanced ultrasound in the biliary system: Potential uses and indications. Wld J. Radiol. 2009; 1 (1): 37-44.

25. Foley W.D., Quiroz F.A. The role of sonography in imaging of the biliary tract. Ultrasound Q. 2007; 23 (2): 123-135.

26. Zhimin G., Noor H., Jian-Bo Z. et al. Advances in diagnosis and treatment of hilar cholangiocarcinoma - a review. Med. Sci Monit. 2013; 19: 648-556.

27. Asayama Y., Yoshimitsu K., Irie H. et al. Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. Radiology. 2006; 238: 150-155.

28. Okumoto T., Sato A., Yamada T. et al. Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four-channel multidetector-row computed tomography. Tohoku J. Exp. Med. 2009; 217 (1): 1-8.

29. Watadani T., Akahane M., Yoshikawa T. et al. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT: correlation with histopathological findings. Radiat. Med. 2008; 26: 402-407.

30. Seo H., Lee J.M., Kim I.H. et al. Evaluation of the gross type and longitudinal extent of extrahepatic cholangiocarcinomas on contrast-enhanced multidetector row computed tomography. J. Comput. Assist. Tomogr. 2009; 33: 376-382.

31. Blechacz B., Gores G.J. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment. Hepatology. 2008; 48 (1): 308-321.

32. Lee H.Y., Kim S.H., Lee J.M. et al. Preoperative assessment of resectability of hepatic hilar cholangiocarcinoma: combined CT and cholangiography with revised criteria. Radiology. 2006; 239: 113-121.

33. Khan S.A., Miras A., Pelling M. et al. Cholangiocarcinoma and its management. Gut. 2007; 56: 1755-1756.

34. Masselli G., Gualdi G. Hilar cholangiocarcinoma: MRI/MRCP in staging and treatment planning. Abdom. Imaging. 2008; 33 (4): 444-451.

35. Майстренко Н.А., Шейко С.В., Алентьев А.В. и др. Холангиоцеллюлярный рак (особенности диагностики и лечения). Практ. онкол. 2008; 9 (4): 229-236.

36. Valero V. 3rd, Cosgrove D., Herman J.M. et al. Management of perihilar cholangiocarcinoma in the era of multimodal therapy. Expert. Rev. Gastroenterol. Hepatol. 2012; 6 (4): 481-495.

37. Gorycki T., Studniarek M. Bile Duct Strictures Caused by Solid Masses: MR in Differential Diagnosis and as a Prognostic Tool to Plan the Endoscopic Treatment. Gastroenterol. Res. Pract. 2013; 2013, Article ID 729279: 7.

38. Gore R.M., Shelhamer R.P. Biliary tract neoplasms: diagnosis and staging. Cancer Imaging. 2007; 7 Spec No A: S15-S23.

39. Vilgrain V. Staging cholangiocarcinoma by imaging studies. HPB (Oxford). 2008; 10 (2): 106-109.

40. Lee M.G., Park K.B., Shin Y.M. et al. Preoperative evaluation of hilar cholangiocarcinoma with contrast-enhanced three-dimensional fast imaging with steady-state precession magnetic resonance angiography: comparison with intraarterial digital subtraction angiography. Wld J. Surg. 2003; 27: 278-283.

41. Hanninen E.L., Pech M., Jonas S. et al. Magnetic resonance imaging including magnetic resonance cholangiopancreatography for tumor localization and therapy planning in malignant hilar obstructions. Acta Radiol. 2005; 46: 462-470.

42. Masselli G., Manfredi R., Vecchioli A. et al. MR imaging and MR cholangiopancreatography in the preoperative evaluation of hilar cholangiocarcinoma: correlation with surgical and pathologic findings. Eur. Radiol. 2008; 18: 2213-2221.

43. Larghi A., Lecca P.G., Ardito F. et al. Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience. Gastrointest. Endosc. 2009; 69: 356-360.

44. Назыров Ф.Г., Икрамов А.И., Акбаров М.М. и др. Диагностика и тактика хирургического лечения больных опухолями проксимальных отделов внепеченочных желчных протоков. Хирургия. Журн. им. Н.И. Пирогова. 2010; 6: 36-39.

45. Lee T.H. Technical tips and issues of biliary stenting, focusing on malignant hilar obstruction. Clin. Endosc. 2013; 46 (3): 260-266.

46. Akamatsu N., Sugawara Y., Hashimoto D. Surgical strategy for bile duct cancer: Advances and current limitations. Wld J. Clin. Oncol. 2011; 2 (2): 94-107.

47. Lazaridis K.N., Gores G.J. Cholangiocarcinoma. Gastroenterology. 2005; 128: 1655-1667.

48. Domagk D., Poremba C., Dietl K.H. et al. Endoscopic transpapillary biopsies and intraductal ultrasonography in the diagnostics of bile duct strictures: a prospective study. Gut. 2002; 51: 240-244.

49. Hattori M., Nagino M., Ebata T. et al. Prospective study of biliary cytology in suspected perihilar cholangiocarcinoma. Br. J. Surg. 2011; 98: 704-709.

50. Halling K.C., Kipp B.R. Fluorescence in situ hybridization in diagnostic cytology. Hum. Pathol. 2007; 38: 1137-1144.

51. Baskin-Bey E.S., Moreno Luna L.E., Gores G.J. Diagnosis of cholangiocarcinoma in patients with PSC: a sight on cytology. J. Hepatol. 2006; 45: 476-479.

52. Topazian M. Clin Endoscopic ultrasonography in the evaluation of indeterminate biliary strictures. Endoscopy. 2012; 45 (3): 328-330.

53. Brugge W.R. Advances in the endoscopic management of patients with pancreatic and biliary malignancies. South. Med. J. 2006; 99: 1358-1366.

54. Heimbach J.K., Sanchez W., Rosen C.B. et al. Trans-peritoneal fine needle aspiration biopsy of hilar cholangiocarcinoma is associated with disease dissemination. HPB (Oxford). 2011; 13: 356-360.

55. Eloubeidi M.A., Chen V.K., Jhala N.C. et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2004; 2: 209-213.

56. Levy M.J., Heimbach J.K., Gores G.J. Endoscopic ultrasound staging of cholangiocarcinoma. Curr. Opin. Gastroenterol. 2012; 28 (3): 244-252.

57. Varadarajulu S., Eloubeidi M.A., Wilcox C.M. Prospective evaluation of indeterminate ERCP findings by intraductal ultrasound. J. Gastroenterol. Hepatol. 2007; 22: 2086-2092.

58. Levy M.J., Baron T.H., Clayton A.C. et al. Prospective evaluation of advanced molecular markers and imaging techniques in patients with indeterminate bile duct strictures. Am. J. Gastroenterol. 2008; 103: 1263-1273.

59. Brugge W.R. Endoscopic techniques to diagnose and manage biliary tumors. J. Clin. Oncol. 2005; 23: 4561-4565.

60. Meister T., Heinzow H.S., Woestmeyer C. et al. Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology. Wld J. Gastroenterol. 2013; 19 (6): 874-881.

61. Stavropoulos S., Larghi A., Verna E. et al. Intraductal ultrasound for the evaluation of patients with biliary strictures and no abdominal mass on computed tomography. Endoscopy. 2005; 37: 715-721.

62. Kapoor V., McCook B.M., Torok F.S. An introduction to PET-CT imaging. Radiographics. 2004; 24: 523-543.

63. Iglehart J.K. The new era of medical imaging - progress and pitfalls. N. Engl. J. Med. 2006; 354: 2822-2828.

64. Wakabayashi H., Akamoto S., Yachida S. et al. Significance of fluorodeoxyglucose PET imaging in the diagnosis of malignancies in patients with biliary stricture. Eur. J. Surg. Oncol. 2005; 31: 1175-1179.

65. Anderson C.D., Rice M.H., Pinson C.W. et al. Fluorodeoxyglucose PET imaging in the evaluation of gallbladder carcinoma and cholangiocarcinoma. J. Gastrointest. Surg. 2004; 8: 90-97.

66. Lan B.Y., Kwee S.A., Wong L.L. Positron emission tomography in hepatobiliary and pancreatic malignancies: a review. Am. J. Surg. 2012; 204 (2): 232-241.

67. Li J., Kuehl H., Grabellus F. et al. Preoperative assessment of hilar cholangiocarcinoma by dual-modality PET/CT. J. Surg. Oncol. 2008; 98: 438-443.

68. Petrowsky H., Wildbrett P., Husarik D.B. et al. Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinoma. J. Hepatol. 2006; 45: 43-50.

69. Chikamoto A., Tsuji T., Takamori H. et al. The diagnostic efficacy of FDG-PET in the local recurrence of hilar bile duct cancer. J. Hepatobil. Pancreat. Surg. 2006; 13: 403-408.

70. Brock K.K. Imaging and image-guided radiation therapy in liver cancer. Semin. Radiat. Oncol. 2011; 21(4): 247-255.

71. Rimola J., Forner A., Reig M. et al. Cholangiocarcinoma in cirrhosis: absence of contrast washout in delayed phases by magnetic resonance imaging avoids misdiagnosis of hepatocellular carcinoma. Hepatology. 2009; 50: 791-798.

72. Corvera C.U., Blumgart L.H., Akhurst T. et al. 18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer. J. Am. Coll. Surg. 2008; 206: 57-65.

73. Moon C.M., Bang S., Chung J.B. et al. Usefulness of 18F-fluorodeoxyglucose positron emission tomography in differential diagnosis and staging of cholangiocarcinomas. J. Gastroenterol. Hepatol. 2008; 23 (5): 759-765.

74. Xu J., Igarashi S., Sasaki M. et al. Intrahepatic cholangiocarcinomas in cirrhosis are hypervascular in comparison with those in normal livers. Liver Int. 2012; 32 (7): 1156-1164.

75. Савельева Т.В., Кащенко В.А. Возможности многослойной спиральной компьютерной томографии в выявлении опухолевых поражений внепеченочных желчных протоков. Луч. диагн. и тер. 2010; 3: 54-60.

76. Valls C., Ruiz S., Martinez L. et al. Radiological diagnosis and staging of hilar cholangiocarcinoma. Wld J. Gastrointest. Oncol. 2013; 5 (7): 115-126.

77. Aloia T.A., Charnsangavej C., Faria S. et al. High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma. Am. J. Surg. 2007; 193: 702-706.

78. Ustundag Y., Bayraktar Y. Cholangiocarcinoma: a compact review of the literature. Wld J. Gastroenterol. 2008; 14 (42): 6458-6466.

79. Murakami K. FDG-PET for hepatobiliary and pancreatic cancer: Advances and current limitations.Wld. J. Clin. Oncol. 2011; 2 (5): 229-236.

80. Vogl T.J., Schwarz W.O., Heller M. et al. Staging of Klatskin tumours (hilar cholangiocarcinomas): comparison of MR cholangiography, MR imaging, and endoscopic retrograde cholangiography. Eur. Radiol. 2006; 16: 2317-2325.

81. Manfredi R., Barbaro B., Masselli G. et al. Magnetic resonance imaging of cholangiocarcinoma. Semin. Liver. Dis. 2004; 24: 155-164.

82. Гришина Е.В. Магнитно-резонансная холангиопанкреатография в диагностике патологии гепатопанкреатодуоденальной области: Автореф.. дис. канд. мед. наук. М., 2004. 22 с.

83. Fernandez-Esparrach G., Gines A., Sanchez M. et al. Comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the diagnosis of pancreatobiliary diseases: a prospective study. Am. J. Gastroenterol. 2007; 102: 1632-1639.

84. Sai J.K., Suyama M., Kubokawa Y. et al. Early detection of extrahepatic bile-duct carcinomas in the nonicteric stage by using MRCP followed by EUS. Gastrointest. Endosc. 2009; 70: 29-36.

85. Ruys A.T., van Beem B.E., Engelbrecht M.R. et al. Radiological staging in patients with hilar cholangiocarcinoma: a systematic review and meta-analysis. Br. J. Radiol. 2012; 85: 1255-1262.

86. Sacks A., Peller P.J., Surasi D.S. et al. Value of PET/CT in the Management of Liver Metastases, Part 2. Am. J. Roentgenol. 2011; 197: W256-W259.

87. Iwaki K., Shibata K., Ohta M. et al. Adenomyomatous hyperplasia of the common bile duct: report of a case. Surg. Today. 2008; 38: 85-89.

88. Gamblin T.C., Krasinskas A.M., Slivka A.S. et al. Fibroinflammatory biliary stricture: a rare bile duct lesion masquerading as cholangiocarcinoma. J. Gastrointest. Surg. 2009; 13: 713-721.

89. Pavey D.A., Gress F.G. The role of EUS-guided FNA for the evaluation of biliary strictures. Gastrointest. Endosc. 2006; 64: 334-337.

90. Pollack M.J., Gholam P.M., Chak A. EUS-FNA in unresectable cholangiocarcinoma: a novel indication. Gastrointest. Endosc. 2008; 67: 444-445.

91. DeWitt J., Misra V.L., Leblanc J.K. et al. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest. Endosc. 2006; 64: 325-333.

92. Бурдюков М.С., Нечипай А.М., Юричев И.Н. и др. Тонкоигольная пункция под контролем эндоскопической ультрасонографии в диагностике опухолей билиопанкреатодуоденальной зоны. Анн. хир. гепатол. 2010; 2: 66-71.

93. Weber A., Schmid R.M., Prinz C. Diagnostic approaches for cholangiocarcinoma. Wld J. Gastroenterol. 2008; 14 (26): 4131-4136.

94. Victor D.W., Sherman S., Karakan T. et al. Current endoscopic approach to indeterminate biliary strictures. Wld J. Gastroenterol. 2012; 18 (43): 6197-6205.

95. Yamao K., Bhatia V., Mizuno N. et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in patients with malignant biliary obstruction: results of long-term follow-up. Endoscopy. 2008; 40 (4): 340-342.

96. Saifuku Y., Yamagata M., Koike T. et al. Endoscopic ultrasonography can diagnose distal biliary strictures without a mass on computed tomography. Wld J. Gastroenterol. 2010; 16: 237-244.

97. Kim H.M., Park J.Y., Kim K.S. et al. Intraductal ultrasonography combined with percutaneous transhepatic cholangioscopy for the preoperative evaluation of longitudinal tumor extent in hilar cholangiocarcinoma. J. Gastroenterol. Hepatol. 2010; 25: 286-292.

98. Inoue H. Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis. Diagn. Ther Endosc. 2001; 7: 159-164.

99. Fujita N., Noda Y., Kobayashi G. et al. Staging of bile duct carcinoma by EUS and IDUS. Endoscopy. 1998; 30, Suppl. 1: A132-A134.

100. Duda S.H., Huppert P.E., Schott U. et al. Percutaneous transhepatic intraductal biliary sonography for lymph node staging at 12.5 MHz in malignant bile duct obstruction: work in progress. Cardiovasc. Intervent. Radiol. 1997; 20: 133-138.

101. Malhi H., Gores G.J. Cholangiocarcinoma: modern advances in understanding a deadly old disease. J. Hepatol. 2006; 45: 856-867.

102. Shen W.F., Zhong W., Xu F. et al. Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma. Wld J. Gastroenterol. 2009; 15 (47): 5976-5982.

103. Gores G.J., Nagorney D.M., Rosen C.B. Cholangiocarcinoma: Is transplantation an option? For whom? J. Hepatol. 2007; 47: 455-459.

104. Вишневский В.А., Ефанов М.Г., Икрамов Р.З. и др. Отдаленные результаты радикальных и условно радикальных резекций при воротной холангиокарциноме. Анн. хир. гепатол. 2013; 2: 9-20.

105. Meza-Junco J., Montano-Loza A.J., Ma M. et al. Cholangiocarcinoma: has there been any progress? Can. J. Gastroenterol. 2010; 24 (1): 52-57.


Для цитирования:


Данзанова Т.Ю., Синюкова Г.Т., Лепэдату П.И. Современные методы диагностики холангиоцеллюлярного рака. Медицинская визуализация. 2014;(1):22-36.

For citation:


Danzanova T.Y., Sinyukova G.T., Lepedatu P.I. Modern Diagnostic Methods of Cholangiocarcinoma. Medical Visualization. 2014;(1):22-36. (In Russ.)

Просмотров: 301


ISSN 1607-0763 (Print)
ISSN 2408-9516 (Online)