摘要
目的 探讨混合细胞性肝癌 (MHC)的临床特征、诊断及外科治疗效果。方法 对我院近 30年来病理学检查证实的 14例MHC临床资料进行回顾性分析研究。结果 本组男性 9例 ,女性 5例。发病年龄 33～ 6 2岁 (平均 5 0岁 )。 10例 (71% )伴有乙型肝炎病史。 9例 (6 4% )合并肝硬化。血清甲胎蛋白 (AFP)升高 9例 ,阳性率 6 4%。全组病例手术切除率为 86 % (12 14) ,总的 1、3、5年生存率分别为 71% (10 14)、43 % (6 14)、2 9% (4 14) ,其中切除癌灶病例的 1、3、5年生存率分别为 83%(10 12 )、5 0 % (6 12 )、33 % (4 12 )。结论 本病缺乏特异性临床表现 ,术前明确诊断较为困难。最终诊断有赖于病理学检查。根治性手术切除是MHC的有效治疗手段。癌灶内胆管细胞癌成分可能是影响预后的关键因素。
Objective To study the clinical feature, diagnosis and surgical treatment of mixed hepatocellular and cholangiocellular carcinoma(MHC).Methods The clinical materials of 14 surgically treated patients with MHC were retrospectively analyzed.Results There were nine males and five females, with age ranging from 33 to 62 years (mean 50 years). Some patients had a history of hepatitis B(71%), and cirrhosis(64%). Elevation of serum alpha-fetaprotein(AFP) was observed in nine patients(64%). The resection rate was 86%(12/14), and postoperative overall 1-, 3-, 5-year survival rates were 71%(10/14)?43%(6/14)?and 29%(4/14), respectively. In the tumor-resected patients, the 1-, 3-, 5-year survival rates were 83%(10/12)?50%(6/12)?and 33%(4/12),respectively. Conclusions MHC patients lack typical clinical manifestations. Radical surgery is an effective treatment for this disease. The cholangiocellular carcinoma component appears to determine the prognosis.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第2期90-92,共3页
Chinese Journal of General Surgery
