胆道肿瘤专题研究(Monographic Study of Biliary Tract Neoplasms)

肝内胆管癌与肝细胞癌临床特征的比较研究

Published at: 2015年第24卷第2期

杭轶 1 , 杨小勇 2 , 李文美 2
1 徐州医学院研究生学院,江苏 徐州 221000
2 徐州医学院附属医院 普通外科,江苏 徐州 221002
通讯作者 文美 李 Email: L5748036@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.02.004
基金:

摘要

目的:探讨肝内胆管癌(ICC)的临床特征,以加深对该疾病的认识,减少临床误诊、误治。方法:回顾性分析2005年1月—2013年12月间收治的42例经病理证实的ICC患者(ICC组)及80例肝细胞癌(HCC)患者(HCC组)的临床资料。结果:与HCC组比较,ICC组组内无性别差异(HCC组男性多于女性);既往或现有合并胆石症的例数增加,且结石与瘤灶多位于同一侧肝脏;HBsAg与AFP阳性率及检测值均明显降低,但CA19-9阳性率与γ-GT增高比率及检测值均明显升高;影像学检查更多显示有腹腔淋巴结肿大、胆管结石、肿 瘤周围胆管扩张及肝包膜凹陷征或肝叶萎缩的特点;术前误诊率较高、组织学上细胞分化较差、腹腔 淋巴结转移率较高;手术方式更多采用肝脏病灶切除加腹腔淋巴结清扫,以上差异均有统计学意义(均P<0.05)。结论:ICC 具有一定的不同于HCC 的临床特征,通过提高对ICC的认识,可减少其误诊、误治。


Comparative study of clinical features between intrahepatic cholangiocarcinoma and hepatocellular carcinoma

Abstract

Objective: To investigate the clinical features of intrahepatic cholangiocarcinoma (ICC), for increasing the understanding of this disease, and reducing its misdiagnosis and inappropriate treatment. Methods: The clinical date of 42 ICC patients (ICC group) and 80 hepatocellular carcinoma (HCC) patients (HCC group) with pathological confirmation, admitted from January 2005 to December 2013, were retrospectively analyzed. Results: In ICC group compared with HCC group, there was no gender difference (number of male cases was more than female cases in HCC group); the number of cases with past or present cholelithiasis was increased, and most stones were on the same side of the tumors; the positive rate of HbsAg and AFP as well as their detection values were decreased, while the positive rate of CA19-9 and proportion of cases with high γ-GT level as well as their detection values were increased; the imaging profiles were more characterized by enlargement of abdominal lymph nodes, bile duct stones, peritumoral bile duct dilation and liver capsule retraction or lobe atrophy; the preoperative misdiagnosis rate was high, tumor cells showed histologically poor differentiation, and abdominal lymph node metastasis rate was increased; liver tumor resection plus abdominal lymphadenectomy was the most adopted procedure. All the difference had statistical significance (all P<0.05). Conclusion: ICC has some clinical features different from those of HCC, and a better understanding of ICC may reduce its misdiagnosis and wrong treatment.


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引用

引用本文: 轶 杭, 小勇 杨, 文美 李. 肝内胆管癌与肝细胞癌临床特征的比较研究[J]. 中国普通外科杂志, 2015, 24(2): 175-179.
Cite this article as: HANG Yi, YANG Xiaoyong, LI Wenmei . Comparative study of clinical features between intrahepatic cholangiocarcinoma and hepatocellular carcinoma[J]. Chin J Gen Surg, 2015, 24(2): 175-179.