胆管癌
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2019/06/18 15:07:02」(JST)
[Wiki ja表示]
CCC
- カルチュア・コンビニエンス・クラブ株式会社の略称 (Culture Convenience Club Co., Ltd.)
- CCC (企業) - その子会社としてかつて存在していた企業
- CCCチーム - プロ最高カテゴリーのUCIワールドチームに所属する自転車ロードレースのチーム。
- 著作権クリアランスセンター (Copyright Clearance Center)
- CCC制度（中国強制製品認証制度） (China Compulsory Certification)
- キャッシュ・コンヴァージョン・サイクル（英語版） - 経済用語
- CCC自然・文化創造会議/工場 (Creative Conservation Club) - 環境NPO法人
- キャンパス・クルセード・フォー・クライスト (Campus Crusade for Christ) - プロテスタント系キリスト教宣教団体
- 市民保全部隊 (Civilian Conservation Corps) - 1930年代のアメリカ合衆国で行われた失業対策プログラム。
- 中国地区高専コンピュータクラブコミュニティ
- カオス・コンピュータ・クラブ (Chaos Computer Club) - ドイツのハッカー集団
- Catalyst Control Center - AMD（旧ATI）が開発したグラフィックチップ (GPU) 製品「RADEON」、「ATI FirePro」向けのデバイスドライバ及びにコントロールパネルであるAMD Catalystの旧称。
- C♥C♥C (ちゅちゅちゅ) - 中島椿の漫画作品
- カプコン クラシックス コレクション - カプコンのゲームソフト
- Fate/EXTRA CCC - TYPE-MOON・マーベラスAQLのゲームソフト
- シー・シー・シー(C-C-C) - ザ・タイガースの楽曲。
- CCC-CHALLENGE COVER COLLECTION- - 音楽グループAAAのカバーアルバム
- あなたが選ぶカー・オブ・ザ・イヤー (Consumer's Choice Award-Car of the Year)
- C・C・C カークラッシュクラブ - TBS系列の深夜番組
- サイバークリーンセンター (Cyber Clean Center) - 総務省・経済産業省によるボット駆除を支援する連携プロジェクト
- Clickclickclick.com - クリック数を競うゲームを行っているイギリスのサイト
- ローマ数字の300
- デカルト閉圏 (Cartesian closed category)
- カトリック教会のカテキズム (Catechismo della Chiesa Cattolica)
- 可算鎖条件 (countable chain condition)
- Chaos Communication Congress（英語版）
- カニクリームコロッケ (crab cream croquette)
- コーンクリームコロッケ (corn cream croquette)
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- カートンクリスマスクラブ（Carton.Christmas.Club）-学生活動団体
[Wiki en表示]
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Look up CCC in Wiktionary, the free dictionary. |
CCC may refer to:
Arts and entertainment
- Canada's Capital Cappies, the Critics and Awards Program in Ottawa, Ontario, Canada
- Capcom Classics Collection, a 2005 compilation of arcade games for the PlayStation 2 and Xbox
- CCC, the production code for the 1970 Doctor Who serial The Ambassadors of Death
Music
- Canadian Chamber Choir, a national choral ensemble for Canadian singers, conductors and composers
- "Candy Cane Children", a single by The White Stripes
- The Color Changin' Click, a rap group which was started by rapper Chamillionaire
Christianity
- Calvinist Cadet Corps, Christian mentoring organization
- Campus Crusade for Christ, an interdenominational Christian organization
- Canadian Council of Churches, an ecumenical Christian forum of churches in Canada
- Catechism of the Catholic Church, an official exposition (catechism) of the teachings of the Roman Catholic Church
- Celestial Church of Christ, an independent African Church
- Central Congregational Church (Providence, Rhode Island), a United Church of Christ congregation
- China Christian Council, a government-approved Christian organization in the People's Republic of China
- Christian City Churches, an evangelical, Pentecostal church movement founded by Pastors Phil Pringle and Chris Pringle
- Christian Cultural Center, a New York City-based church pastored by Dr. A. R. Bernard
- Church of Christ in China, one of the Chinese Independent Churches
- Clearwater Christian College, a four-year non-denominational Christian College
- Colorado Community Church, an interdenominational church in Denver, Colorado, U.S.
- Community Christian College, a two-year college based in Redlands, California, U.S.
Companies
- Canadian Commercial Corporation, a Canadian corporation responsible for facilitating international contracts
- Canterbury of New Zealand, a New Zealand-based sports apparel company
- CCC Film, a film production company in Germany, formally known as Central Cinema Compagnie-Film GmbH
- Color Climax Corporation, a Danish pornography company
- Comcast Cable Communications, a cable television, internet and telephone service provider in the United States
- Commodity Credit Corporation, United States owned corporation which funds USDA programs
- Consolidated Contractors Company, a large Middle Eastern and International EPC Contractor
- Cooper Cameron Corporation, now Cameron International Corporation
- Copyright Clearance Center, a U.S. copyright collection company
- Crane Carrier Company, a U.S. truck manufacturer
- Cwmni Cyfyngedig Cyhoeddus, a Welsh form of public limited company
Education
In the U.S.
- California Community Colleges System, combined districts of California's community colleges
- Camden County College, Camden County, New Jersey
- Cascadia Community College, Bothell, Washington, now known as Cascadia College
- Cayuga Community College, 2-year SUNY college in Cayuga County, New York
- Center for Computational Chemistry, research center in the department of Chemistry at the University of Georgia
- Central Community College (Nebraska)
- Chemeketa Community College, Salem, Oregon
- City Colleges of Chicago, a system of seven community colleges for Chicago residents
- Clackamas Community College, Oregon City, Oregon
- Clatsop Community College, Clatsop County, Oregon
- Clearwater Central Catholic High School, college preparatory school in Clearwater, Florida
- Cleveland Chiropractic College, chiropractic school in Overland Park, Kansas
- Cleveland Community College, Shelby, North Carolina
- Clinton Community College (Iowa), Clinton, Iowa
- Clovis Community College (New Mexico), Clovis, New Mexico
- Coahoma Community College, unincorporated Coahoma County, Mississippi, near Clarksdale
- Coconino County Community College, Flagstaff, Arizona
- Compton Community College, near Los Angeles, California
- Contra Costa College, San Pablo, California
- Corning Community College, another SUNY 2-year college
- Cross-cultural center, a department at various universities
- Cumberland County College, Cumberland County, New Jersey
- Cuyahoga Community College, Cuyahoga County, Ohio
In other places
- Canadian Computing Competition, a national programming competition for secondary school students in Canada
- Castleknock Community College, public secondary school in Carpenterstown, Dublin, Ireland
- Central Coast Campuses, three education campuses on the Central Coast of New South Wales
- Central Commerce Collegiate, high school in Toronto, Ontario, Canada
- Centro de Capacitación Cinematográfica, film school in Mexico City
- Chenab College, Chiniot, Institute in Pakistan
- Chessington Community College, secondary school and sixth form college in the Royal Borough of Kingston upon Thames
- City College of Calamba, public college in the Philippines
- Cooloola Christian College, Gympie, Queensland, Australia
- Corpus Christi College (disambiguation), the name of several colleges
- Countesthorpe Community College, Leicestershire, Countesthorpe, Great Britain
Law
- California Coastal Commission
- Central Criminal Court (disambiguation)
- China Compulsory Certificate, a compulsory safety mark for many products sold on the Chinese market
- Citizens' Committee for Children
- Civil Constitution of the Clergy, a law
- Constitutio Criminalis Carolina, the first body of German criminal law
- Convention on Cybercrime by the Council of Europe
- Corruption and Crime Commission of Western Australia
- Cox's Criminal Cases, a series of law reports
- Crime and Corruption Commission, independent entity of Queensland, Australia, created to combat major crime
Civil authorities
- Cambridge City Council (disambiguation)
- Cardiff City Council, the governing body for Cardiff
- Carmarthenshire County Council, the administrative authority for the county of Carmarthenshire, Wales
- Casino control commission, a variation of a gaming control board in the U.S.
- Central Communications Command, the command-and-control system for London's police services
- Chittagong City Corporation, a governing organisation in southeastern Bangladesh
- Christchurch City Council, New Zealand
Organizations and organizing
Conservation
- 2009 United Nations Climate Change Conference, held at the Bella Center in Copenhagen, Denmark
- California Conservation Corps, a state agency modelled after the Civilian Conservation Corps of the 1930s
- Cetacean Conservation Center, a Chilean organization dedicated to the conservation of cetaceans and other marine mammals
- Civilian Conservation Corps, a major New Deal program in the U.S. for young men, 1933–42
Politics
- Center for Community Change, a progressive community organizing group in the United States
- Climate Change Coalition, Australian political party
- Command of Communist Hunting, a Brazilian paramilitary terrorist group of the 1960s known as Comando de Caça aos Comunistas
- Committee on Climate Change, an independent body established by the UK Government to advise on climate change policy
- Communist Combatant Cells, a Belgian terrorist organization of the 1980s committed to a Communist ideology
- Communist Committee of Cabinda, a separatist group in the Cabinda exclave of Angola
- Council of Conservative Citizens, a United States paleoconservative white separatist political organization
- Customs Cooperation Council, an intergovernmental organization that helps Members communicate and cooperate on customs issues
Science and technology
- Comb ceramic culture
- Climatic climax community, a biological community of plants and animals which has reached a steady state
- Conformal cyclic cosmology, a cosmological model in which the universe undergoes a repeated cycle of death and rebirth
- Countercurrent chromatography, a chromatographic separations-science technique
- Cryogenic current comparator, electronic test equipment
Computing
- Catalyst Control Center, control panel for AMD Catalyst drivers
- Chaos Computer Club, one of the biggest and most influential hacker organisations
- Chaos Communication Congress, an annual meeting of computer hackers organized by the Chaos Computer Club
- Chaos Communication Camp, a quadrennial international meeting of hackers organized by the Chaos Computer Club
- Citizen Cyberscience Centre, Switzerland-based volunteer computing organisation
- Computational Complexity Conference, academic conference in the field of theoretical computer science
- Corsham Computer Centre, an underground British government installation near RAF Corsham and RAF Rudloe Manor in the heavily tunneled Corsham area of Wiltshire
- Cray Computer Corporation, a defunct computer company
- Color Cell Compression, an algorithm developed to compress digital color images
Mathematics
- Cartesian closed category, a concept in category theory
- CCC, Roman numeral for 300
- Countable chain condition, a condition in order theory and topology
- Cube-connected cycles, a graph used as a communications network topology
Medicine
- Capsulorhexis or capsulorrhexis, also known as continuous curvilinear capsulorhexis, a type of cataract surgery
- Clinical Care Classification System, a nursing terminology consisting of nursing diagnoses, nursing interventions, and nursing action types that assist in documenting the nursing process
- Convenient care clinic, a health care clinic located in neighborhoods
Sport
- CAF Confederation Cup, the annual international football competition held in the CAF region
- Cascade Cycling Classic, a competitive multi-stage bicycle road race, held every July in Bend, Oregon
- CCC Pro Team, a UCI WorldTeam cycling team based in Poland
- Central Connecticut Conference, an interscholastic athletic conference in greater Hartford, Connecticut, U.S.
- Charlottetown Civic Centre, an indoor ice hockey venue in Canada
- Colombo Cricket Club, a cricket club in Colombo, Sri Lanka
- Commonwealth Coast Conference A NCAA Division III conference in New England.
- Compton Cricket Club, a California exhibition cricket club
- County cricket club, any of the clubs participating in the County Championship or the Minor Counties Championship
- Cross Country Canada, The governing body for cross country skiing in Canada
Other uses
- California Correctional Center, a state prison in the United States
- Carly Colón (born 1979), also known as Carlito Caribbean Cool, a Puerto Rican professional wrestler
- Cash Conversion Cycle, a cost accounting term that refers to the liquidity risk posed by growth
- Certified Chef de Cuisine, a professional title
- Chapman code or Chapman County Code, a set of 3-letter codes used in genealogy to identify administrative divisions in the UK, Ireland, the Isle of Man and the Channel Islands
- Colorado Cryptologic Center, a U.S. National Security Agency facility
- Command, control, and communications, a concept in military doctrine
- Country calling code
- Crescent City Connection, twin cantilever bridges
- Jardines del Rey Airport, Cuba, by IATA code
See also
- Triple C's, popular nickname for the rap group Carol City Cartel
- CC (disambiguation)
- C3 (disambiguation)
- CCCC (disambiguation)
UpToDate Contents
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- 1. シャーガス心臓病：治療および予後chagas heart disease treatment and prognosis [show details]
…determined by NYHA class, was significantly more frequent in the non-CCC groups compared to the CCC group (DCM 74.0 and ICM 73.9 versus CCC 56.5 percent), and no improvement in echocardiographic indices of …
- 2. シャーガス心臓病：臨床症状および診断chagas heart disease clinical manifestations and diagnosis [show details]
…feature of CCC. Endomyocardial biopsy is not generally performed in patients with CCC. In uncertain cases it may be rarely performed to exclude other causes of cardiomyopathy. In patients with CCC who undergo …
- 3. B型肝炎ウイルスの特性および感染の病因characteristics of the hepatitis b virus and pathogenesis of infection [show details]
…HBV DNA can reenter the hepatocyte nucleus to produce more ccc DNA or be secreted as complete virions after coating with envelope proteins. The ccc DNA appears to have a long half-life and is not inhibited …
- 4. 新生児におけるカンジダ感染の治療treatment of candida infection in neonates [show details]
…can be treated with oral fluconazole. Neonates with CCC are at risk for dissemination to the bloodstream, urine, or cerebrospinal fluid (CSF). CCC occurs most commonly in low birth weight preterm infants …
- 5. 悪性肝腫瘍の病理pathology of malignant liver tumors [show details]
…types that can be encountered are the trabecular and hilar types and cholangiolocellular carcinoma (CCC). The trabecular type of intrahepatic CC is characterized by polygonal cells with eosinophilic cytoplasm …
English Journal
- Antioxidant activity and the isolation of polyphenols and new iridoids from Chilean Gaultheria phillyreifolia and G. poeppigii berries.
- Mieres-Castro D, Schmeda-Hirschmann G, Theoduloz C, Gómez-Alonso S, Pérez-Navarro J, Márquez K, Jiménez-Aspee F.
- Food chemistry. 2019 Sep;291()167-179.
- The berries from the native Chilean Gaultheria phillyreifolia and G. poeppigii are appreciated for their sweet taste and aroma. Fruits from both species were investigated for their secondary metabolite composition and antioxidant activity. The extracts were submitted to membrane chromatography to se
- PMID 31006456
- Anterior insular cortex is a bottleneck of cognitive control.
- Wu T, Wang X, Wu Q, Spagna A, Yang J, Yuan C, Wu Y, Gao Z, Hof PR, Fan J.
- NeuroImage. 2019 Jul;195()490-504.
- Cognitive control, with a limited capacity, is a core process in human cognition for the coordination of thoughts and actions. Although the regions involved in cognitive control have been identified as the cognitive control network (CCN), it is still unclear whether a specific region of the CCN serv
- PMID 30798012
- Improving the resolution of overlapping peaks by heartcut two-dimensional countercurrent chromatography with the same solvent system in both dimensions.
- Müller M, Murić M, Glanz L, Vetter W.
- Journal of chromatography. A. 2019 Jul;1596()142-151.
- The countercurrent chromatographic (CCC) isolation of structurally related compounds with high chemical purity can be challenging, especially in the field of lipids, were the range of biphasic solvent systems is limited. In the past, special elution modes like recycling CCC or re-injection of pooled
- PMID 30922718
Japanese Journal
- Life/style MOVIES 人類史を書き換えるゴジラの世界へ : 映画
- Life/style MUSICAL ポッドキャストでロックオペラを : カルチャー
- Life/style TOURISM 次の旅行はチェルノブイリへ? : トラベル
Related Links
- CCCは「カルチュア・インフラを、つくっていくカンパニー。」をブランド・ステートメントに掲げ、TSUTAYA事業を中心としたエンタテインメント事業、Tポイントを中心としたデータベース・マーケティング事業のほか数々のネット ...
- CCC（=Cash Conversion Cycle:キャッシュ・コンバージョン・サイクル）とは、企業が原材料や商品仕入などへ現金を投入してから最終的に現金化されるまでの日数を示し、資金効率を見るための指標です。CCCは小さい方ほど資金効率
- -3- 1．CCCとは 「CCC」とは中国強制製品認証制度のことでChina Compulsory Certificationの略です。 「中華人民共和国国家品質監督検験検疫総局( AQSIQ ) 」及び「中国国家認証認定監督管理 委員会( CNCA )」より新しい認証 ...
Related Pictures
★リンクテーブル★
[★]
- 英
- hepatocellular carcinoma, HCC, hepatocarcinoma, liver cell carcinoma
- 同
- ヘパトーム hepatoma
- 関
- 肝腫瘍、肝癌
特徴
- 外科的治癒切除を行っても、5年以内の再発率は約70%以上 ← 他の癌より高い。3年で50-60%とも
- リンパ節転移は少なく、肝内転移が多い ← 経門脈
- 多中心発癌が多い
- 肝細胞癌の約70-80%に肝硬変、10%前後に慢性肝炎を合併
疫学
- 原発性肝癌のうち肝細胞癌は95%を占める
- 男女比は3-4:1
- 死因では男性では3位、女性では4位である。
- 原発性肝癌の90%以上が肝炎ウイルス陽性である。
- 原発性肝癌の解検例の84%に肝硬変を合併している。
- 肝細胞癌の70-80%に肝硬変が認められ、10%前後に慢性肝炎の合併が見られる。
- 肝硬変から肝癌が発生する年間発生率はB型肝炎で3%、C型肝炎で7%である。
病因
- 病因の90%が肝炎ウイルスである。
- HCV(+) 75%、HBV(+) 15%、HBV(+)&HCV(+) 3%、TTV(+) 1-3%、アルコール性 3-4% (YN)
- その他
病理
- 肝細胞類似の細胞からなる上皮性の悪性腫瘍。多くが皮膜を有する。(SSUR.595)
- 多発性、多中心性
- 胆汁のために肉眼的に緑色に見える
- 壊死、出血しやすい。 → hemoperitoneum
病態
転移
症状
検査
超音波エコー
[show details]
造影CT
- ダイナミック造影CTでは動脈相で不均一な造影効果、門脈相、平衡相になるにつれ造影効果が低下する。(RNT.209) ⇔ 肝血管腫：造影効果が持続
- [show details]
- 被膜がある腫瘍に対しては造影効果が残存。(RNT.209)
前癌病変の造影CT
- SRA.479
- 肝細胞癌は多段階発癌により発生するという説が唱えられている。
- 腺腫様過形成(adenomatous hyperplasia AH)は肝癌とは異なる結節病変を形成するものである。
- 多段階発癌次の順に肝細胞癌に至るという；異型腺腫様過形成 → 肝細胞癌を内包する異型腺腫様過形成 → 高分化肝癌 → 中～低分化肝細胞癌(古典的肝癌)
- 多段階発癌の初期には門脈血の支配が多いが次第に肝動脈からの新生血管により支配されるようになる。
- すなわち、中～低分化肝細胞癌は肝動脈で支配される多血性肝細胞癌であり、高分化肝細胞癌は肝動脈の支配が比較的少ない。
- 造影CTにおいてもこれを反映し、高分化細胞癌では動脈相では造影効果が弱い(文献によっては乏血性で濃染しないとも)が、中～低分化細胞癌では高い造影効果が認められることになる。
MRI
- T1：等信号 低～高信号(YN.B-50)
- T2：高信号 ⇔ 肝血管腫のような著しい高信号は呈しない？
血管造影
腫瘍マーカー
- PIVKA-II：≦2cmの陽性率は25-30%
- AFP：≦2cmの陽性率は30%。肝細胞癌、卵黄嚢腫瘍、肝芽腫の腫瘍マーカー、炎症性肝疾患における肝再生の指標
診断
- 病歴、身体所見、血液検査所見(肝炎ウイルスマーカー、腫瘍マーカー、肝機能検査)、画像検査に基づいて判断する。
- 画像で確定診断される場合は組織診断を行わないように勧められている。 → 針生検に伴う重篤な合併症として，針穿刺経路播種（needle tract seeding）と出血がある。前者の発生頻度は1.6～3.4％とされている(ガイドライン1)
治療
。
治療アルゴリズム
- 肝癌診療ガイドライン 2017年版
- http://www.jsh.or.jp/medical/guidelines/jsh_guidlines/examination_jp_2017
局所療法
手術療法
- 肝機能A,Bであって、腫瘍の数が1,2個の場合は腫瘍切除が適応となる。
- 再発肝癌であっても肝切除が標準治療となる(ガイドライン1 CQ19 再発肝細胞癌に対する有効な治療は？)
推奨
- ガイドライン1
- TA（C）EはOkuda分類I、II、Child A、Bの進行肝細胞癌（手術不能で、かつ経皮的凝固療法の対象とならないもの）に対する治療として推奨される。
- 化学塞栓される非癌部肝容積の非癌部全肝容積に占める割合と残肝予備能を考慮したTACEが推奨される。
- 高ビリルビン血症のない肝細胞癌破裂症例の治療には救急TA（C）Eは有効な治療法である。
禁忌
- ガイドライン1
化学療法
- 肝癌は抗癌剤に対する抵抗性が高い。肝癌患者は肝機能の低下が存在するため十分量の抗癌剤治療はできない。このようなこともあり、肝癌に有効な抗がん薬は少ない。
日本で使用できる薬剤
- ガイドライン1
肝移植
- 肝硬変に肝細胞癌を合併する場合は、多発最大径3cm・3個まで、単発5cmまで、遠隔転移・リンパ節転移・脈管侵襲なし
- ミラノ基準によれば、他の両性疾患と同程度の移植成績
- 肝機能不良でミラノ基準を満たすものは肝移植を考慮。
ガイドライン
- http://minds.jcqhc.or.jp/stc/0018/0018_ContentsTop.html
国試
原発性肝細胞癌
- 英
- primary hepatocellular carcinoma
- 関
- [[]]
[★]
- 英
- liver tumor, hepatic tumor, hepatic neoplasm, liver neoplasm, tumor of the liver
- 関
- 肝癌、肝臓癌
分類
- SRA.472
-
-
肝細胞癌の鑑別疾患となる良性腫瘍
- SSUR.594
検査
- 超音波エコー：(肝細胞癌)線維性被膜を有する境界明瞭な腫瘤でモザイクパターンを呈する。(転移性肝癌)低エコーの結節病変の中心に高エコーを有するbull's eye signを認める。
参考
- 1. Fat-containing lesions of the liver: radiologic-pathologic correlation.
- Prasad SR, Wang H, Rosas H, Menias CO, Narra VR, Middleton WD, Heiken JP.SourceDepartment of Radiology, University of Texas Health Science Center at San Antonio, USA.
- Radiographics : a review publication of the Radiological Society of North America, Inc.Radiographics.2005 Mar-Apr;25(2):321-31.
- Fat-containing tumors of the liver are a heterogeneous group of tumors with characteristic histologic features, variable biologic profiles, and variable imaging findings. Benign liver lesions that contain fat include focal or geographic fatty change (steatosis), pseudolesions due to postoperative pa
- PMID 15798052
- 脂肪を含む肝腫瘍は画像検査で鑑別診断を狭めることが可能である。
[★]
- 英
- cholangiocarcinoma CCC, bile duct cancer, bile duct carcinoma, cancer of the bile duct
- 同
- 胆管細胞癌 cholangiocellular carcinoma, primary cholangiocellular carcinoma
- ラ
- cholangioma
- 関
- 肝内胆管癌、胆道癌
概念
- 胆管に発生する癌腫の総称
- 胆管癌とは通常肝外胆管癌のことであり、肝内胆管細胞癌とは区別される。
部位による分類
- 肝門部胆管癌
- 上部胆管癌：肝外胆管中枢側と下部胆管中枢側を二等分したときの、その中枢側？
- 中部胆管癌：肝外胆管中枢側と下部胆管中枢側を二等分したときの、その末梢側？
- 下部胆管癌：膵臓内の胆管？
早期癌
早期胆管癌：組織学的深達度が粘膜(m)・線維筋層(fm)にとどまるもの。リンパ節転移の有無は問わない。
疫学
- 高齢男性
- 男女比=2:1。50歳代、60歳代に好発し60歳代が最多 (⇔胆嚢癌)
リスク因子
- 膵胆管合流異常、原発性硬化性胆管炎、炎症性腸疾患、肝吸虫症
症状
- 初発症状は黄疸(31%)、腹痛(13%)、全身倦怠感(11%)、食思不振(9%)、暗色尿(8%)、発熱(5%)、掻痒感(4%)、背部痛(4%)、嘔気・嘔吐(3%)、体重減少(2%)
検査
- 肝門部胆管癌
[show details]
治療
手術療法(ガイドラインより)
胆道癌の肝，肺，腹膜転移，遠隔リンパ節（大動脈周囲リンパ節，腹腔外リンパ節など）転移は切除不能
ガイドライン
資料
国試
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- 英
- intrahepatic bile duct cancer, intrahepatic cholangiocarcinoma
- 同
- 胆管細胞癌 cholangiocellular carcinoma CCC
- 関
- 肝癌、肝腫瘍
概念
- 原発性肝癌の約5%を占める
- 肝内胆管に由来する上皮性悪性腫瘍。
検査
- 単純CT：低吸収
- 造影CT：(動脈相)周辺がわずかに濃染、(平衡相以降)中心の線維性壊死が比較的高濃度、周辺部の腫瘍を含む領域は低吸収となる。(SRA.479)
- MRI：T2境界不明瞭な高信号、造影 ← 正常胆管はT1低信号、T2高信号(SRA.504)
- 腫瘍マーカー
- 早期癌には上昇しない
参考
- 1. 肝内胆管癌(胆管細胞癌) - こもんの日々つれづれ - Yahoo!ブログ
- 出典明記なく信頼度は不明
- http://blogs.yahoo.co.jp/comoson2000/43691821.html
- http://www.ncbi.nlm.nih.gov/books/NBK13176/
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- 英
- liver cancer, cancer of liver, hepatoma
- 関
- 肝腫瘍、肝細胞癌
分類 (肝腫瘍より引用)
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- 関
- 精巣腫瘍
|
|
nonseminoma
|
seminoma
|
| GOOD PROGNOSIS
|
Testis/retroperitoneal primary and
|
Any primary site and
|
| No nonpulmonary visceral metastases and
|
No nonpulmonary
|
| Good markers ? all of:
|
Normal AFP, any hCG, any LDH
|
| AFP < 1000 ng/ml and
|
|
| hCG < 5000 iu/l
|
| LDH < 1.5 × upper limit of normal
|
| 56% of nonseminomas
|
90% of seminomas
|
| 5-year PFS 89%
|
5-year PFS 82%
|
| 5-year survival 92%
|
5-year survival 86%
|
| INTERMEDIATE PROGNOSIS
|
Testis/retroperitoneal primary and
|
Any primary site and
|
| No nonpulmonary visceral metastases and
|
Nonpulmonary visceral metastases and
|
| Intermediate markers ? any of:
|
Normal AFP, any hCG, any LDH
|
| AFP ? 1000 and ? 50,000 iu/l or
|
|
| hCG ? 5000 iu/l and ? 50 000 iu/l
|
| LDH ? 1.5 × N and ? 10 × N
|
| 28% of nonseminomas
|
10% of seminomas
|
| 5-year PFS 75%
|
5-year PFS 67%
|
| 5-year survival 80%
|
5-year survival 72%
|
| POOR PROGNOSIS
|
Mediastinal primary or
|
No patients classified and poor prognosis
|
| Nonpulmonary visceral metastases or
|
|
| Poor markers ? any of:
|
| AFP > 10,000 ng/mL or
|
| hCG > 50,000 IU/L (10000ng/mL) or
|
| LDH > 10 × upper limit of normal
|
| 16% of nonseminomas
|
| 5-year PFS 41%
|
| 5-year survival 48%
|
[★]
カルボニルシアニドm-クロロフェニルヒドラゾン
- 関
- carbonyl cyanide m-chlorophenyl hydrazone
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