臨床外科64巻1号

2009年01月発行

特集 外科診療上知っておきたい新たな予後予測因子・スコア

〔癌における新たな予後予測因子〕

胆道癌の予後予測因子・スコア

著者： 神谷尚彦¹ 宮﨑耕治¹

所属機関： ¹佐賀大学医学部一般・消化器外科

ページ範囲：P.21 - P.29

文献概要

要旨：胆道癌は早期診断が困難なため切除が不能な症例も多いが，長期生存が望める唯一の治療法は外科切除である．しかし，切除後の成績は必ずしも一定でなく，胆道癌においても数多くの臨床病理学的および分子生物学的な研究がなされ，いくつかの予後規定因子が報告されている．臨床病理学的因子ではリンパ節転移が最も重要な独立予後規定因子である．分子生物学的予後規定因子については様々な報告があるものの，エビデンスレベルの高いものは少ない．細胞周期関連遺伝子の報告が最も多いが，DNA修復遺伝子や細胞接着遺伝子も予後と関連する．そのほかに新規遺伝子もいくつか予後との相関が報告されており，今後の検討が必要である．また，抗癌剤関連遺伝子に関しても新しい知見が蓄積しつつあり，これらについても概説した．

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