概述

胆管癌是一种在输送消化液胆汁的细长管道(胆管)中形成的癌症。胆管连接着肝脏、胆囊和小肠。

胆管癌也称为胆道癌,虽然可能发生在任何年龄段,但主要发生在 50 岁以上的人群中。

医生根据胆管癌在胆管中的发生部位,将其分为不同的类型:

  • 肝内胆管癌发生在肝内胆管各部分,有时也归类为一种肝癌。
  • 肝门部胆管癌只发生在肝外胆管内。这种也叫做肝门周围胆管癌。
  • 远端胆管癌发生在最接近小肠的胆管内部。这种类型的胆管癌也叫做肝外胆管癌。

胆管癌通常在晚期才诊断出,因此治疗难以成功。

Types

症状

胆管癌的体征和症状包括:

  • 皮肤和眼白发黄(黄疸)
  • 皮肤剧烈瘙痒
  • 白色大便
  • 疲劳
  • 右侧肋骨下方腹痛
  • 体重意外下降
  • 发热
  • 盗汗
  • 尿色深

何时就诊

如果您出现持续的疲劳、腹痛、黄疸或其他困扰您的体征和症状,请就医。医生可能会将您转诊给消化系统疾病专科医生(肠胃科医生)。

病因

当胆管细胞的 DNA 发生变化时,就有可能发展成胆管癌。细胞的 DNA 包含指示细胞该如何做的指令。DNA 变化会让细胞失控增殖,形成细胞团块(肿瘤),侵入并破坏正常身体组织。导致胆管癌的 DNA 变化的诱因尚不清楚。

风险因素

增加患胆管癌风险的因素包括:

  • 原发性硬化性胆管炎。这种疾病会引起胆管硬化和瘢痕形成。
  • 慢性肝病。由慢性肝病引起的肝脏瘢痕形成会增加患胆管癌的风险。
  • 出生即存在的胆管问题。出生时就有胆总管囊肿(该疾病会导致胆管扩张和不规则)的人患胆管癌的风险会更高。
  • 肝脏寄生虫。在东南亚地区,胆管癌通常和肝吸虫感染有关。吃生鱼或未煮熟的鱼都可能发生这种感染。
  • 年龄较大。胆管癌常见于 50 岁以上的人群。
  • 抽烟。抽烟与患胆管癌的风险增加相关。
  • 糖尿病。1 型或 2 型糖尿病患者患胆管癌的风险增加。
  • 某些遗传病。一些由父母遗传给孩子的 DNA 变化会导致医疗状况,增加胆管癌风险。这些病症包括囊性纤维化和林奇综合征。

预防

为降低患胆管癌的风险,可采取的措施有:

  • 戒烟。抽烟与患胆管癌的风险增加有关。如果您抽烟,请戒烟。如果您过去曾尝试戒烟但没有成功,请向医生咨询有助于您戒烟的策略。
  • 降低患肝病的风险。慢性肝病与患胆管癌的风险增加有关。有些肝病的病因无法预防,但另一些则可以预防。尽您所能做好肝脏护理。

    例如,为了降低出现肝脏发炎(肝硬化)的风险,如要饮酒,请适度。对于健康成人,女性每天最多喝一杯,男性每天最多喝两杯。保持健康的体重。使用化学品时,要遵守安全说明。

在 Mayo Clinic 治疗

June 06, 2023

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