胆管癌诊断与治疗.pptVIP

胆管癌的诊断与治疗 流行病学 尸检资料显示胆管癌的发病率约为0.01%～0.2% 美国胆管癌的年发病率约为十万分之一～二 肝门部胆管癌占其中的40%～60% 胆管癌的发病率逐年升高 (1)真实发病率上升 (2)诊断水平提高 男性多于女性 3:2 组织病理 95%以上是腺癌，鳞癌、腺鳞癌和类癌罕见。腺癌中以高分化为主，低分化、未分化癌较少且多发生在肝门部胆管。 影像学表现：超声内镜 TNM分期(cTNM、pTNM) Primary Tumor (T) TX Primary tumor cannot be assessed T0 No evidence of primary tumor Tis Carcinoma in situ T1 Tumor confined to the bile duct histologically T2 Tumor invades beyond the wall of the bile duct T3 Tumor invades the liver, gallbladder, pancreas, and/or ipsilateral branches of the portal vein (right or left) or hepatic artery (right or left) T4 Tumor invades any o