【求助】父亲肝门部胆管细胞癌，求靶点

父亲肝门部胆管细胞癌，IIIA型，手术完后切片发现有淋巴转移
现在恢复期，后期化疗+靶向药会不会延长生存期？

另外免疫组化如下
AFP(-),β-catenin(++),CD34(-),CEA(++),CK7(+++),CK19(+++),GS(-),GPC3(-),HBsAg(-),Hepatocyte(-),HSP70(++),KI-67(+)40%

以上能否看出靶点，或者还需要做什么检查才能知道？
请各位不吝指导，谢谢

突然发现免疫组化跟别人查出来的差好多，是不是要去检查中心指定要求做一个癌细胞表达？

先泼个凉水，胆管癌是没有针对的靶向药，有基因检测和免疫化组，可以针对相对应的靶点选择靶向药。

看靶点要去做基因检测和针对靶点的免疫组化，不过如果不是没有路可走了，胆管癌的基因检测意义真不大。可以做一下免疫组化。

lh唐朝 发表于 2016-6-27 12:59
看靶点要去做基因检测和针对靶点的免疫组化，不过如果不是没有路可走了，胆管癌的基因检测意义真不大。可以 ...

唐朝您好，感谢您的回复。
我父亲现在目测是R0切除，但是切片有淋巴转移。后期防止复发或者延迟复发，采用预防性化疗+中药调理的方法是否可行？
或者预防性化疗+靶向清理？
不吝指教，谢谢

根治术后不要急着上靶向，可以化疗1—2次巩固下成果，然后观察。中药可以上，但一定要找个靠谱的。

lh唐朝 发表于 2016-6-27 17:35
根治术后不要急着上靶向，可以化疗1—2次巩固下成果，然后观察。中药可以上，但一定要找个靠谱的。

谢谢指导。

正在看老美的一个胆管癌手册，关于新方法中提到的靶向药。

Targeted therapy
Newer drugs are being developed that work differently from standard chemo drugs. These drugs target specific parts of cancer cells or their surrounding environments.One target of several newer drugs is tumor blood vessels. Bile duct tumors need new blood vessels to grow beyond a certain size.
Sorafenib (Nexavar®), bevacizumab (Avastin®),pazopanib (Votrient®), and regorafenib (Stivarga®) are examples of drugs that target blood vessel growth and are being studied against bile duct cancer.
Other new drugs have different targets. For example, EGFR, a protein that helps cells grow,is found in high amounts on some cancer cells. Drugs that target EGFR have shown somebenefit against several types of cancer. Some of these drugs, such as cetuximab (Erbitux®)and panitumumab (Vectibix®) are now being studied for use in people with bile duct cancer,usually in combination with chemotherapy or other targeted drugs.Drugs known as MEK inhibitors, such as trametinib (Mekinist®), are also being studied for use against bile duct cancer.

可能有效果的有这三类
tumor blood vessels（英文不行）
索拉非尼、贝伐单抗、帕唑帕尼、瑞戈非尼
EGFR, a protein that helps cells grow靶向
西妥昔单抗、帕尼单抗
MEK抑制剂
曲美替尼

对应坛子里面的各种药名还不太清楚，希望对大家有点用。
原文PDF

手册推荐的化疗药物共有5种，建议2种混合使用
Drugs used to treat bile duct cancer Several drugs can be used to treat bile duct cancer. In some cases, 2 or more of these drugs may be combined to try to make them more effective. The drugs used most often to treat bile duct cancer include:
• 5-fluorouracil (5-FU)5-氟尿嘧啶
• Gemcitabine (Gemzar®)吉西他滨
• Cisplatin顺铂
• Capecitabine (Xeloda®)卡培他滨
• Oxaliplatin (Eloxatin®) 奥沙利铂

国内目前比较公认吉西他滨+顺铂/奥沙利铂

老美的手册能否发来看看，想了解曲美替尼。