摘要
目的:探讨肝腺瘤的临床特点、诊断及目前治疗方法。方法:对7例经病理检查确诊为肝腺瘤患者的临床资料进行分析总结。结果:7例中男5例、女2例,年龄22～71岁,中位年龄41岁。7例中3例有右上腹胀不适,4例无明显症状,3例合并乙型病毒性肝炎。7例均为单发肿瘤。术前5例诊断为肝细胞肝癌(HCC),2例诊断为肝腺瘤。7例中5例患者行彩色多普勒超声检查,4例考虑为HCC,1例考虑为肝脓肿;4例行MRI,2例考虑为HCC,2例考虑肝腺瘤;3例行CT,均考虑为HCC;2例行超声造影检查均考虑为肝腺瘤。全部患者行手术切除,均于第一次手术将肿瘤完整切除,切缘未见肿瘤残留。术后均无相关并发症,顺利出院,无围手术期死亡患者。术后7例均有随访,随访时间1～148个月。随访内容包括,抽血检查肝肾功能、甲胎蛋白以及行腹部彩超检查等,6例患者存活,且无复发,1例死亡,该患者为术后1年恶变为肝癌再次手术切除。结论:肝腺瘤无特殊临床表现,术前诊断有一定难度,MRI结合超声造影检查可提高术前诊断率,同时肝腺瘤具有恶变倾向,手术切除肿瘤效果确切。
Objective ： To explore the clinical characteristics, diagnosis and treatment of hepatocellular adeno- ma （HA）. Methods： Seven HA cases diagnosed by pathologist were studied retrospectively. Results： Of seven patients, five were male and two were female with median age of 41 years. Four patients were asymptomatic, three of them had abdominal distension, and three of them were infected with HBV. All patients presented with solitary tumor. Five patients were diagnosed as hepatocellular carcinoma （ HCC ）, and the other two were diagnosed HA preoperatively. Five underwent color ultrasound, four of whom were considered to be HCC, the other one hepata- postema. Four underwent Magnatic Resonance Imaging （ MRI）, two of whom were diagnosed as HCC, the other two HA. Three underwent Computed tomography, all of whom were diagnosed as HCC. Two underwent contrast-en- hanced uhrasonography and were diagnosed as HA. All patients underwent surgical resection and the resection mar- gin were negative. None of them was dead during perioperative period. All discharged without complication. All patients went through follow-up visit, from 1 month to 148 months. In our follow-up visit, the liver function, AFP, abdominal ultrasound were tested. Six patients were alive, one was dead, which transformed to HCC 1 year after a second operation. Conclusions： HA had no specific clinic characteristic. The preoperative diagnosis of HA was difficult. Contrast-enhanced uhrasonographic and magnetic resonance imaging could increase correct preoperative diagnostic rate. HA had a tendency to malignancy, and surgical resection was recommended.
出处
《新医学》
2012年第12期834-837,共4页
Journal of New Medicine
关键词
肝腺瘤
诊断
治疗
Hepatocellular adenoma
Diagnosis
Therapy
