盘点:近期胆管癌重大研究进展汇总

2016-09-15 MedSci MedSci原创

胆管癌是指源于肝外胆管包括肝门区至胆总管下端的胆管的恶性肿瘤。其病因可能与胆管结石、原发性硬化性胆管炎等疾病有关。临床可采用手术治疗、放射治疗、化学治疗等方法,但预后较差。【1】Hepatology:极早期肝内胆管癌或许不再是肝移植禁忌硬变肝存在肝内胆管癌(iCCA)是肝移植的禁忌证(LT)。最近的调查表明,“极早期”的iCCA(单个肿瘤≤2厘米)或许可以进行LT。因此研究者进行了这项国际多中

胆管癌是指源于肝外胆管包括肝门区至胆总管下端的胆管的恶性肿瘤。其病因可能与胆管结石、原发性硬化性胆管炎等疾病有关。临床可采用手术治疗、放射治疗、化学治疗等方法,但预后较差。

【1】Hepatology:极早期肝内胆管癌或许不再是肝移植禁忌

硬变肝存在肝内胆管癌(iCCA)是肝移植的禁忌证(LT)。最近的调查表明,“极早期”的iCCA(单个肿瘤≤2厘米)或许可以进行LT。

因此研究者进行了这项国际多中心队列研究,评估是否如此。研究组包括因肝细胞癌(HCC)或失代偿性肝硬化进行移植,且组织病理学发现iCCA的患者,根据结果将其分为“极早期”iCCA和“晚期”iCCA(单个肿瘤>2 cm或多发病灶)。

在2000-1至2013-12月,81例发现iCCA,33例为iCCA和HCC,48例只有iCCA(研究组)。在研究组中,15/48 (31%)为“极早期”iCCA组,33/48 (69%)为“晚期”iCCA组。

结果表明,极早期iCCA或许不再是肝硬化患者进行LT的禁忌症,不过还需要前瞻性多中心临床试验进一步确认这些结果。(文章详见--Hepatology:极早期肝内胆管癌或许不再是肝移植禁忌

【2】JNCI:每天饮用含糖饮料≥2杯,肝胆管癌风险高79%

日前,发表在Journal of the National Cancer Institute杂志上的研究表明,大量饮用含糖饮料如苏打水和果汁会增加胆囊癌的风险。

该研究由瑞典卡罗林斯卡研究所的专家开展,为了探索苏打水和癌症风险之间的关系,他们分析了70000名成年人的饮食习惯调查数据,并对这些人进行了13年的随访调查,以了解他们的癌症诊断情况。

这些参与者在1997年完成了饮食问卷调查,包括回答在过去一周以及一年里消耗了多少苏打水或果汁饮料,参与者的平均年龄为61岁,大约有一半的人属于超重,25%是吸烟者,研究人员排除了过往被诊断出癌症或糖尿病的志愿者。

研究结果发现,与那些完全不接触含糖饮料的人相比,每天至少饮用两杯果汁或碳酸饮料的人患胆囊肿瘤的风险增加2倍以上,患肝胆管癌的风险高79%。他们也更容易超重,更倾向于食用高热量、高糖低蛋白的食物。(文章详见--JNCI:每天饮用含糖饮料≥2杯,肝胆管癌风险高79%

【3】EBioMedicine:科学家发现特殊细菌或与胆管癌直接相关

近日,来自新加坡A*STAR研究所的研究人员通过研究发现,胆管中的一种细菌或是引发胆管癌(Bile Duct Cancer)的一种潜在风险因素,胆管上皮癌(CCA)是一种罕见但非常恶性的胆管癌,这种癌症在早期并不会表现出任何症状。

文章中,研究者发现,胆管组织中包含了多种细菌群落,而且此前认为和胆管感染相关的寡养单胞菌(Stenotrophomonas)群落也被发现可以优先寄居到非意外感染的CCA患者机体的肿瘤组织中,这就揭示了细菌在CCA发病过程中的关键角色。相比非意外感染的CCA患者而言,意外感染CCA患者的机体组织包含有多种肠细菌,而这些肠细菌的代谢产物比如胆汁酸等都和致癌过程或癌症发生直接相关
总的来讲,本文研究结果揭示了单管组织微生物组在胆管上皮癌发生中的关键作用,相关研究刊登于EbioMedicine杂志上;研究者Nagarajan说道,截止到目前为止,我们对机体细菌群落和疾病发生的关系理解得并不深入,本文研究结果为阐明细菌在胆管癌发病中的角色提供了确凿的证据,我们希望该研究可以帮助我们加速寻找治疗胆管上皮癌的新型疗法。(文章详见--EBioMedicine:科学家发现特殊细菌或与胆管癌直接相关

【4】Am J Gastroenterol:炎症性肠病(IBD)与胆管癌风险增加有关

近期在线发表在The American Journal of Gastroenterology的研究称,长期患有炎症性肠病(Inflammatory Bowel Disease,IBD)和原发性硬化性胆管炎(PSC),会增加胆管癌风险增加。

该回顾性研究纳入了2005年1月-2013年5月就诊于Mayo诊所的399名PSC-IBD患者。其中有137名患者接受了结肠切除术。

研究数据显示,研究期间有123名患者发展为胆管癌。单因素Cox比例风险模型分析显示,校正年龄后,结肠切除术(HR=1.53;95% CI,1.05-2.22)和炎症性肠病持续时间(HR=1.37;95% CI,1.15-1.63)会增加胆管癌风险。随着年龄的增加,行结肠切除术的患者其胆管癌绝对风险高于没有行结肠切除术的患者(39% vs 27%)。

多变量分析显示,IBD持续时间仍与胆管癌相关(HR=1.33;95% CI,1.11-1.60)。结肠切除术后,IBD持续时间对胆管癌风险的影响没有改变。(文章详见--Am J Gastroenterol:炎症性肠病(IBD)与胆管癌风险增加有关

【5】Hepatology:阿司匹林可降低胆管癌风险

阿司匹林能预防胆管癌(CCA)吗?研究者对CCA患者进行了一项基于医院的病例对照研究,探究阿司匹林对CCA的影响,以及不同CCA类型的危险因素。

研究共纳入了2000-2014年梅奥诊所的2395名CCA患者,其中1169名为肝内CCA患者,995名为肝门部CCA患者,231名为远端CCA患者。根据年龄、性别、种族和居住地按2:1匹配了4769名对照组。

原发性硬化性胆管炎(PSC)与肝门部CCA相关性更大(aOR, 452.9; 95% CI, 104-999)(肝内CCA (aOR, 93.4; 95% CI, 27.1-322.2)、远端CCA (aOR, 34.0; 95% CI, 3.6-323.1))。糖尿病则与远端CCA关系更密切(aOR, 4.2; 95% CI, 2.5-7.0)(肝门部CCA (aOR 2.9, 95% CI, 2.2-3.8)、肝内CCA (aOR 2.5, 95% CI, 2.0-3.2))。非PSC相关的肝硬化与肝内和肝门部CCA的aOR相似,均为14。不伴PSC的孤立性炎症性小肠疾病与CCA无关。

研究结果表明,阿司匹林可降低2.7-3.6倍的CCA风险。同一危险因素对不同CCA类型具有不同影响。(文章详见--Hepatology:阿司匹林可降低胆管癌风险

【6】BMC Cancer:反复使用吡喹酮会增加胆管癌风险

在泰国肝吸虫、麝猫后睾吸虫感染仍然是一个重要的公共健康问题;泰国是世界上感染和随后胆管癌(CCA)发生率最高的地区;而吡喹酮(PZQ)是可供选择的驱虫药。先前关于仓鼠的研究表明,反复感染和PZQ治疗会导致CCA风险增高。不过关于PZQ的摄入频率增加CCA风险的人类流行病学证据不清楚,研究者进行了一项研究,探究PZQ重复治疗数量与CCA间的关系。

该病例对照研究共纳入了2012-2014年间210例经病理确诊的CCA和840例对照组(每个案例对于四个对照)。病例组和对照组分别在性别、年龄、入院日期上匹配。使用标准化的测试问卷,通过面对面的方式进行数据采集。研究者采用多变量条件逻辑回归分析法进行数据分析。

研究结果表明,重复使用PZQ治疗会增加CCA风险,与PZQ降低CCA的观念相反。不仅如此研究还表明反复治疗次数与生的淡水鱼摄入量有关,反复使用PZQ治疗可能提示吃生鱼的习惯。(文章详见--BMC Cancer:反复使用吡喹酮会增加胆管癌风险

【7】BMC Cancer:胆石症会大大增加肝内胆管癌风险

目前肝内胆管癌 (ICC) 病因并不明确,大部分认可肝内胆管结石会增加ICC风险,那么肝外胆道结石呢?目前众说纷纭,结论并不一致。研究者进行了荟萃分析,探究胆总管结石和胆囊结石与ICC风险间关系。

研究者检索了PubMed, Embase, Web of Science等数据库,关于胆总管结石和胆囊结石与ICC风险间关系的队列和病例对照研究。

最终该研究纳入了7篇病例对照研究,涉及123,771名参与者,其中4763 (3.85 %)为ICC患者,119,008 名为非癌症对照组患者。研究数据显示,预先存在的胆管结石(胆总管结石或胆总管结石伴肝内胆管结石)会增加ICC风险(OR17.64, 95%CI 11.14-27.95)。单独存在的胆总管结石也会大大增加ICC风险(OR11.79, 95%CI4.17-33.35)。胆囊结石会小幅度的增加ICC风险 (OR 2.00, 95 % CI 1.16-3.42),不过研究间异质性很大(I (2) = 78.5 %)。

研究结果表明,胆管结石包括胆总管结石,是肝内胆管癌的重要的危险因素,临床上应该对胆石症患者提高警惕,进行必要的监测。(文章详见--BMC Cancer:胆石症会大大增加肝内胆管癌风险

【8】Surgery:肝门部胆管癌患者不应常规行门静脉切除

对肝门部胆管癌(HCA)行肝切除术 (LR)依旧存在很多挑战,因为血管和胆管的侵犯是无法预料的。手术的目标之一是达到切缘无肿瘤浸润,而常规门静脉切除术(PVR) 对患者的利弊一直饱受争议。

研究者纳入了60例行了LR的HCA病例。其中有21(35.0%)名病人进行了LR+PVR,余下39(65.0%)名病人只行了LR。研究者通过单因素和多因素分析对数据进行处理。

研究结果显示,切除术主要针对的是Bismuth-Corlette III / IV型肿瘤(97.3%)。41(68.3%)名患者进行了肝三分法切除。切缘肿瘤状态RI定义为对生存的有不良预后因素(HR 3.61; P = .003)。PVR增加了围手术期发病率风险(P = .04)。两组患者术后90天的发病率相比无统计学差异(P = .70)。淋巴结清楚情况在两组中也差不多(P = .86)。研究者还发现,PVR并不会对长期预后产生有利的影响,两组5年生存率比较:LR  17.8% vs LR + PVR 20.0% (P = .89);无病存活率比较: LR 10.6% vs LR + PVR 21.4% (P = .63)。PVR不是肿瘤相关生存率或无病存活率的预测因子(HR 0.64; P = .26/HR 0.76; P = .47)。

研究结果表明,对肝门部胆管癌患者进行肝切除术同时行门静脉切除术,不会对患者的长期预后产生有利影响,并且会导致围手术期发病率增加。因此门静脉切除术不能作为常规手术选择。(文章详见--Surgery:肝门部胆管癌患者不应常规行门静脉切除

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1754983, encodeId=7afb1e549830e, content=<a href='/topic/show?id=ec5995e752e' target=_blank style='color:#2F92EE;'>#重大研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95775, encryptionId=ec5995e752e, topicName=重大研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eb4036811817, createdName=zz12341246, createdTime=Mon May 15 02:07:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153549, encodeId=dbe9153549cd, content=学习了‘, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Nov 05 08:29:36 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145284, encodeId=785014528431, content=很好,谢谢,很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Tue Oct 11 20:12:15 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380554, encodeId=7e7d1380554a9, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628275, encodeId=605516282e580, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128932, encodeId=4c24128932b5, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128933, encodeId=73da12893373, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128146, encodeId=d1cb12814641, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD4F3BA5C0C4129.jpg, createdBy=428e1946417, createdName=李亚锋, createdTime=Thu Sep 15 19:23:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
    2016-11-05 一个字-牛

    学习了‘

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1754983, encodeId=7afb1e549830e, content=<a href='/topic/show?id=ec5995e752e' target=_blank style='color:#2F92EE;'>#重大研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95775, encryptionId=ec5995e752e, topicName=重大研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eb4036811817, createdName=zz12341246, createdTime=Mon May 15 02:07:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153549, encodeId=dbe9153549cd, content=学习了‘, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Nov 05 08:29:36 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145284, encodeId=785014528431, content=很好,谢谢,很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Tue Oct 11 20:12:15 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380554, encodeId=7e7d1380554a9, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628275, encodeId=605516282e580, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128932, encodeId=4c24128932b5, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128933, encodeId=73da12893373, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128146, encodeId=d1cb12814641, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD4F3BA5C0C4129.jpg, createdBy=428e1946417, createdName=李亚锋, createdTime=Thu Sep 15 19:23:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
    2016-10-11 右脚梅西

    很好,谢谢,很有帮助。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1754983, encodeId=7afb1e549830e, content=<a href='/topic/show?id=ec5995e752e' target=_blank style='color:#2F92EE;'>#重大研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95775, encryptionId=ec5995e752e, topicName=重大研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eb4036811817, createdName=zz12341246, createdTime=Mon May 15 02:07:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153549, encodeId=dbe9153549cd, content=学习了‘, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Nov 05 08:29:36 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145284, encodeId=785014528431, content=很好,谢谢,很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Tue Oct 11 20:12:15 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380554, encodeId=7e7d1380554a9, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628275, encodeId=605516282e580, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128932, encodeId=4c24128932b5, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128933, encodeId=73da12893373, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128146, encodeId=d1cb12814641, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD4F3BA5C0C4129.jpg, createdBy=428e1946417, createdName=李亚锋, createdTime=Thu Sep 15 19:23:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1754983, encodeId=7afb1e549830e, content=<a href='/topic/show?id=ec5995e752e' target=_blank style='color:#2F92EE;'>#重大研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95775, encryptionId=ec5995e752e, topicName=重大研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eb4036811817, createdName=zz12341246, createdTime=Mon May 15 02:07:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153549, encodeId=dbe9153549cd, content=学习了‘, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Nov 05 08:29:36 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145284, encodeId=785014528431, content=很好,谢谢,很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Tue Oct 11 20:12:15 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380554, encodeId=7e7d1380554a9, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628275, encodeId=605516282e580, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128932, encodeId=4c24128932b5, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128933, encodeId=73da12893373, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128146, encodeId=d1cb12814641, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD4F3BA5C0C4129.jpg, createdBy=428e1946417, createdName=李亚锋, createdTime=Thu Sep 15 19:23:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1754983, encodeId=7afb1e549830e, content=<a href='/topic/show?id=ec5995e752e' target=_blank style='color:#2F92EE;'>#重大研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95775, encryptionId=ec5995e752e, topicName=重大研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eb4036811817, createdName=zz12341246, createdTime=Mon May 15 02:07:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153549, encodeId=dbe9153549cd, content=学习了‘, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Nov 05 08:29:36 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145284, encodeId=785014528431, content=很好,谢谢,很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Tue Oct 11 20:12:15 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380554, encodeId=7e7d1380554a9, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628275, encodeId=605516282e580, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128932, encodeId=4c24128932b5, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128933, encodeId=73da12893373, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128146, encodeId=d1cb12814641, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD4F3BA5C0C4129.jpg, createdBy=428e1946417, createdName=李亚锋, createdTime=Thu Sep 15 19:23:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
    2016-09-16 知难而进

    谢谢分享!

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1754983, encodeId=7afb1e549830e, content=<a href='/topic/show?id=ec5995e752e' target=_blank style='color:#2F92EE;'>#重大研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95775, encryptionId=ec5995e752e, topicName=重大研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eb4036811817, createdName=zz12341246, createdTime=Mon May 15 02:07:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153549, encodeId=dbe9153549cd, content=学习了‘, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Nov 05 08:29:36 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145284, encodeId=785014528431, content=很好,谢谢,很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Tue Oct 11 20:12:15 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380554, encodeId=7e7d1380554a9, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628275, encodeId=605516282e580, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128932, encodeId=4c24128932b5, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128933, encodeId=73da12893373, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128146, encodeId=d1cb12814641, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD4F3BA5C0C4129.jpg, createdBy=428e1946417, createdName=李亚锋, createdTime=Thu Sep 15 19:23:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
    2016-09-16 知难而进

    继续关注!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1754983, encodeId=7afb1e549830e, content=<a href='/topic/show?id=ec5995e752e' target=_blank style='color:#2F92EE;'>#重大研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95775, encryptionId=ec5995e752e, topicName=重大研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eb4036811817, createdName=zz12341246, createdTime=Mon May 15 02:07:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153549, encodeId=dbe9153549cd, content=学习了‘, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Sat Nov 05 08:29:36 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145284, encodeId=785014528431, content=很好,谢谢,很有帮助。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Tue Oct 11 20:12:15 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380554, encodeId=7e7d1380554a9, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628275, encodeId=605516282e580, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Sat Sep 17 09:07:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128932, encodeId=4c24128932b5, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128933, encodeId=73da12893373, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 22:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128146, encodeId=d1cb12814641, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD4F3BA5C0C4129.jpg, createdBy=428e1946417, createdName=李亚锋, createdTime=Thu Sep 15 19:23:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
    2016-09-15 李亚锋

    学习了谢谢

    0

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在泰国肝吸虫、麝后睾吸虫感染仍然是一个重要的公共健康问题;泰国是世界上感染和随后胆管癌(CCA)发生率最高的地区;而吡喹酮(PZQ)是可供选择的驱虫药。先前关于仓鼠的研究表明,反复感染和PZQ治疗会导致CCA风险增高。不过关于PZQ的摄入频率增加CCA风险的人类流行病学证据不清楚,研究者进行了一项研究,探究PZQ重复治疗数量与CCA间的关系。该病例对照研究共纳入了2012-2014年间210例经病

EBioMedicine:科学家发现特殊细菌或与胆管癌直接相关

近日,来自新加坡A*STAR研究所的研究人员通过研究发现,胆管中的一种细菌或是引发胆管癌(Bile Duct Cancer)的一种潜在风险因素,胆管上皮癌(CCA)是一种罕见但非常恶性的胆管癌,这种癌症在早期并不会表现出任何症状。胆管上皮癌的发病和多种风险因子有关,而这些因子的地理位置明显不同,胆管囊肿和原发性硬化性胆管炎被认为和西方人群患CCA直接相关,肝脏中感染寄生虫也会导致东南亚人群较高的C

Am J Clin Nutr:来瞅瞅硒与肝癌有啥关系

The American Journal of Clinical Nutrition最近的一项研究结果显示,在癌症发病之前,一个更高的硒水平与欧洲人群中的肝细胞癌的风险降低相关。硒是一种矿物微量元素,存在于肉、蛋、谷物、洋葱等物质中,是控制氧化过程与癌症发展的关键。爱尔兰皇家外科学院的David J. Hughes博士进行了一项巢式病例对照研究,探究硒在癌症发病前,是否与各种肝胆肿瘤相关。研究者测

Am J Gastroenterol:炎症性肠病(IBD)与胆管癌风险增加有关

近期在线发表在The American Journal of Gastroenterology的研究称,长期患有炎症性肠病(IBS)和原发性硬化性胆管炎(PSC),会增加胆管癌风险增加。该回顾性研究纳入了2005年1月-2013年5月就诊于Mayo诊所的399名PSC-IBD患者。其中有137名患者接受了结肠切除术。研究数据显示,研究期间有123名患者发展为胆管癌。单因素Cox比例风险模型分析显示

Hepatology:阿司匹林可降低胆管癌风险

阿司匹林能预防胆管癌(CCA)吗?研究者对CCA患者进行了一项基于医院的病例对照研究,探究阿司匹林对CCA的影响,以及不同CCA类型的危险因素。研究共纳入了2000-2014年梅约诊所的2395名CCA患者,其中1169名为肝内CCA患者,995名为肝门部CCA患者,231名为远端CCA患者。根据年龄、性别、种族和居住地按2:1匹配了4769名对照组。CCA组和对照组分别为591 (24.7%)名