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0.8%～1.2%，但是它是胆道系统恶性肿瘤中的最常见类型。",[83,89,94,99,104],{"key":84,"title":85,"html":86,"icon":87,"updatedAt":88},"overview","疾病概述","\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆囊癌是起源于胆囊的恶性肿瘤，其发病率较低，占全部恶性肿瘤的 0.8%～1.2%，但是它是胆道系统恶性肿瘤中的最常见类型。好发年龄为 60～70 岁，女性患者多于男性，男女之比为 1:1.98。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆囊癌是一种疾病的总称，其又可分为不同的病理类型。不同的病理类型可预示患者的生存时间、可能出现的症状、甚至可以指导治疗方式的选择。87% 的胆囊癌为腺癌。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">其他类型有：未分化癌、腺鳞癌、鳞癌、肉瘤、神经内分泌癌、透明细胞癌等等。其中未分化癌和神经内分泌癌恶性程度高，易发生远处转移，生存期较短。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","⚕️","2026-08-03",{"key":90,"title":91,"html":92,"icon":93,"updatedAt":88},"Symptoms","症状表现","\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">尽管胆囊癌因早期症状不明显而使得多数患者就诊时已处于疾病的中晚期，但是，警惕可疑症状，及时就诊仍非常重要。以下为胆囊癌常见典型症状：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（1）黄疸；\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（2）腹痛；\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（3）恶心、呕吐；\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（4）胆囊肿大（体检或其他检查发现）；\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（5）其他症状：发热、柏油样大便、不明原因的腹部隆起、食欲不振、严重皮肤瘙痒、体重减轻等。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">晚期胆囊癌患者除了会出现疼痛、腹水、消瘦、等常见的晚期癌症症状，还会出现胆囊癌相关的特征性症状。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">即胆道梗阻所致的黄疸、顽固性呕吐等，严重影响患者的生活质量。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">医生会通过植入支架、胆道引流、姑息性手术、介入化疗、姑息性放疗等手段，以期解除或缓解症状。但是，效果往往不佳。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","📋",{"key":95,"title":96,"html":97,"icon":98,"updatedAt":88},"causes","病因分析","\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆囊癌的具体发病原因还不明确，目前已知可以增加胆囊癌的发病风险的因素有：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆结石：胆结石是目前公认的胆囊癌的高危因素，单个结石直径 >3 cm 的导致胆囊癌发生的重要原因。90% 以上的胆囊癌患者合并有胆结石。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆囊息肉、瓷化胆囊（是一种较为少见的疾病，特征是胆囊壁的广泛钙化，临床以胆绞痛和胆囊炎为主要表现）\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">年龄：70 岁以上人群发病风险明显升高\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">吸烟、肥胖、高碳水化合物饮食\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">性别：女性发病风险高于男性\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">地域差异：中国陕西、河南两省发病率高于其他省份\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆囊癌家族史\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆道寄生虫与胆囊癌发病率的相关性目前无足够流行病学依据，与胆管癌发病相关\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","🧬",{"key":100,"title":101,"html":102,"icon":103,"updatedAt":88},"diagnosis","诊断检查","\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">1、发现疑似胆囊癌症状该怎么办？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">无论你是否具备胆囊癌发病的高危因素，一旦出现疑似胆囊癌的症状，请及就医。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">截止目前，实验室诊断（即抽血检验）在胆囊癌诊断中的作用十分有限，但是研究发现 CA19-9 和 CEA 在半数以上的胆囊癌患者中均有升高。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">医生为安排你做一些影像学检查，最后确诊依赖于病理诊断，即获取胆囊组织，由病理医生制成标本，在显微镜下发现癌细胞方可确诊。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">2、胆囊癌怎么确诊？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">首先医生会安排一个 B 超筛查，对于 B 超发现的可疑团块需进行进一步的检查，如 CT、磁共振等。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">对于 CT、磁共振检查提示高度怀疑胆囊癌的患者，需要进行疾病分期，对于有手术机会的患者，在排除手术禁忌证后，应立即手术。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">对于伴有黄疸的患者，还应进行 ERCP（内窥镜逆行胰胆管造影术）或 PTC（经皮肝胆管造影术）进一步明确病情、肿瘤分期等。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">近年来，腹腔镜技术日益成熟，即可作为检查手段，获取组织标本以便病理检查，又可作为无远处转移的胆囊癌患者的治疗手段。\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">无论是体检发现，还是出现可疑症状后就医发现的胆囊息肉，如息肉≥1 cm，其癌变几率高，建议手术切除。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","🩺",{"key":105,"title":106,"html":107,"icon":108,"updatedAt":88},"treatment","治疗方式","\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">1、胆囊癌怎么治疗？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">手术是唯一能够根治胆囊癌的治疗方法。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">外科医生会综合考虑患者的年龄、基础健康状况、肿瘤的分期、是否伴随有黄疸症状来选择不同的手术方式（开腹手术或腹腔镜手术）和手术切除范围。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">因此，术前全面检查非常重要，可选择创伤最小的手术方式，最大程度的切除肿瘤病灶。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">除了极少数分期较早的患者，术后仅仅需要定期复查，绝大多数均需要接受放化疗。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">2、胆囊癌的手术方式有几种？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">胆囊癌的手术方式分为以下四种：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（1）单纯胆囊切除术：适用于 TNM 分期为 I 期患者。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（2）胆囊癌根治切除术：使用 II 期患者。通常需切除部分肝脏。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（3）胆囊癌扩大根治术：使用于 III 期和部分 IV 期患者。手术范围大，需同时切除大部分肝脏、胰十二指肠、以及肝脏的部分血管。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（4）姑息性手术：此类手术以缓解症状为目的。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">3、胆囊癌化疗需注意什么？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">大多数手术切除后的胆囊癌患者，以及所有丧失手术机会的患者，均需要接受放化疗。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">尽管胆囊癌的化疗效果不如其他类型癌症好，但仍可一定程度上延长患者的生存期。胆囊癌常用的化疗药物有：氟尿嘧啶、阿霉素和丝裂霉素等。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">大多数患者在化疗过程中不可避免地出现化疗相关毒副反应，如：脱发、恶性呕吐、腹泻便秘、白细胞减少、皮疹、周围神经毒性等等。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">然而，如同我们不能因为害怕车祸就拒绝出门一样，当专业的肿瘤内科医生评估化疗对你来说利大于弊，那就勇敢的接受化疗，并且积极配合医生的治疗，最大程度的预防毒副反应的出现，如果出现，尽早、尽可能的对症治疗。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">绝大多数患者均可以顺利、安全的渡过化疗期。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">4、胆囊癌放疗有哪些作用？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">放射治疗与化疗联合应用可延长胆囊癌患者的生存期。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">对于手术切除后需要进行进一步治疗的患者，放疗科医生及肿瘤内科医生会共同商讨，根据患者的具体病情制定合适的治疗方案。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">此外，由于放射治疗为局部治疗手段，对全身的毒副反应较化疗轻，对于胆道梗阻严重的、身体健康状况差的晚期患者，姑息性放疗可缓解症状，提高患者的生活质量。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">5、胆囊癌的介入治疗是什么？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">介入治疗也属于局部治疗手段之一。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">对于无法手术切除的晚期胆囊癌患者，介入治疗具有杀死肿瘤细胞、缓解症状的效果，同时又避免了静脉化疗的全身毒副反应。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">具体方法是通过腹腔动脉造影技术，插入一根导管至肝总动脉，往导管内注入化疗药物，药物顺着导管直接到达肿瘤组织。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">该方法对于局限于胆囊壁的肿瘤效果良好，而对于肿瘤侵犯胆囊壁以外组织时，疗效大大下降。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","💊",{"author":110,"reviewedBy":110,"lastReviewed":110,"datePublished":110,"citations":111,"disclaimer":110},"",[112,114,115],{"title":113},"郝希山，魏于全.肿瘤学[M].北京:人民卫生出版社，2010.",{"title":113},{"title":116}," 李少林，周琦.实用临床肿瘤学[M].北京:科学出版社，2019.",false,1789384125670]