摘要
目的探讨以发热为首发症状伴肝区胀痛为主要临床表现的肝内胆管细胞癌病例的临床表现、实验室检查、影像学及病理学特征,以提高临床医师对类似临床表现的肝内胆管细胞癌的认识。方法回顾性分析兰州大学第一医院2013年7月至2014年10月期间4例经病理学活检确诊为肝内胆管细胞癌患者的既往病史、临床表现、实验室检查、影像学表现、病理学检查及治疗情况。结果 4例肝内胆管细胞癌患者均以发热为首发症状,伴有不同程度的肝区胀痛。4例患者均存在慢性HBV感染,3例患者入院时白细胞、中性粒细胞百分比及降钙素原升高。3例患者血生化提示ALP和GGT升高,其中1例患者血清AFP明显升高,2例患者血清CA19-9轻度升高,2例患者铁蛋白明显升高,4例患者上腹部CT均提示肝脏单发或多发占位性病变,4例患者肝脏病理活检结果均支持肝内胆管细胞癌。结论对于慢性乙肝基础上发生肝脏占位性病变且以发热伴肝区胀痛为首发症状的病例,应警惕肝内胆管细胞癌。
Objective To discuss clinical manifestation, laboratory examination, imaging and pathological features of intrahepatic cholangiocellular carcinoma （ICC） patients with fever as initial symptom accompanied with liver area pain, in order to improve the clinicians＇ acquaintance for ICC under similar circumstances. Method The case informations including medical history, clinical manifestation, laboratory examination, imaging finding, pathological examination, and treatment of 4 patients diagnosed with ICC by pathological biopsy from July 2013 to October 2014 in the First Hospital of Lanzhou University were analyzed retrospectively. Results All of four cases showed the fever as the initial symptom accompanied with the liver area pain. All of them had got chronic HBV infection. The WBC, neutrophil percentage, and procalcitonin were increased on admission in 3 cases. The levels of serum ALP and GGT were elevated in 3 patients. The AFP was obviously increased in 1 patient. The serum CA19-9 had moderately elevated in 2 patients. The ferroprotein was obviously increased in 2 patients. All the patients were confirmed under the abdominal CT scans and the liver pathological biopsy. Conclusion Patients with fever and liver area pain as intial symptoms, and with chronic hepatitis B and space-occupying lesions, who should be alert for ICC.
出处
《中国普外基础与临床杂志》
CAS
2015年第12期1501-1506,共6页
Chinese Journal of Bases and Clinics In General Surgery
关键词
肝内胆管细胞癌
发热
肝区胀痛
乙型肝炎
病理活检
Intrahepatic cholangiocellular carcinoma
Fever
Liver area pain
Hepatitis B
Pathological biopsy
