隐源性肝癌的临床特点及病理特征分析

王国华; 丛乐乐; 赵曌; 王悦超; 戴晶; 赵平

doi:10.3969/j.issn.1001-5256.2016.04.025

隐源性肝癌的临床特点及病理特征分析

DOI: 10.3969/j.issn.1001-5256.2016.04.025

1. 吉林大学中日联谊医院消化内科
2. 吉林大学中日联谊医院神经内科

详细信息

中图分类号: R735.7
计量
- 文章访问数: 2556
- HTML全文浏览量: 36
- PDF下载量: 447
- 被引次数: 0
出版历程
- 出版日期: 2016-04-20

Clinical and pathological features of cryptogenic liver cancer

Department of Gastroenterology, China-Japan Union Hospital of Jilin University

摘要

摘要:
目的通过对隐源性肝癌临床特点及病理特征分析,进一步寻找其病因及发病机制。方法选择2010年1月-2015年12月于吉林大学中日联谊医院行手术治疗的隐源性肝癌患者22例,对其年龄、性别、临床表现、肝生化指标、肿瘤标志物、病理及免疫组化等资料进行分析。结果隐源性肝癌患者平均57岁,男女比例约为1.7∶1。伴有脂肪肝患者16例,占72.7%。有临床症状者13例,占59.1%,主要表现为腹痛、腹胀等。生化检查异常以ALP和（或）GGT升高为主,共14例,占63.6%。病理结果显示,以胆管细胞癌为主,共16例,占72.7%;肿瘤多为单发,共20例,占90.9%;肿瘤直径多<5 cm,共14例,占63.6%;伴局部浸润4例,占18.2%;伴脉管浸润2例,占9.1%。免疫组化结果显示,Ki67阳性患者为19例,CK17阳性13例,CK19阳性16例。结论通过对隐源性肝癌患者的临床及病理特点进行分析,可明确非酒精性脂肪性肝炎是隐源性肝癌的主要致病因素之一,且因其引起的肝癌多为单发腺癌。
- 肝肿瘤 /
- 脂肪肝 /
- 病理学,临床
Abstract:
Objective To investigate the clinical and pathological features of cryptogenic liver cancer,and to determine its etiology and pathogenesis. Methods A total of 22 patients with cryptogenic liver cancer who underwent surgical treatment in China- Japan Union Hospital of Jilin University from January 2010 to December 2015 were enrolled,and their clinical and pathological data were analyzed. Results The mean age of these patients was 57 years,and the male / female ratio was 1. 7 ∶ 1. Sixteen patients( 72. 7%) were complicated by fatty liver disease,and 13 patients( 59. 1%) had clinical symptoms such as abdominal pain and abdominal distension. The dominant abnormalities in biochemical examinations were increases in alkaline phosphatase and / or gamma- glutamyl transpeptidase,which occurred in 14 patients( 63. 6%). The results of pathological examination showed that 16 patients( 72. 7%) had cholangiocellular carcinoma,20( 90. 9%)had a single tumor,14( 63. 6%) had a tumor diameter of < 5 cm,4( 18. 2%) had local invasion,and 2( 9. 1%) had vessel invasion.The immunohistochemical results revealed 19 Ki67- positive patients,13 CK17- positive patients,and 16 CK19- positive patients. Conclusion The analyses of the clinical and pathological features of cryptogenic liver cancer confirm that nonalcoholic steatohepatitis( NASH)is one of the major pathogenic factors for cryptogenic liver cancer,and most liver cancer cases caused by NASH are single adenocarcinoma.
- liver neoplasms /
- fatty liver /
- pathology,clinical

HTML全文

参考文献(15)

[1]BOSETTI C,TURATI F,La VECCHIA C.Hepatocellular carcinoma epidemiology[J].Best Pract Res Clin Gastroenterol,2014,28(5):753-770.

[2]FERLAY J,SOERJOMATARAM I,DIKSHIT R,et al.Cancer incidence and mortality worldwide:sources,methods and major patterns in GLOBOCAN 2012[J].Int J Cancer,2015,136(5):e359-e386.

[3]HSU CY,LEE YH,LIU PH,et al.Decrypting cryptogenic hepatocellular carcinoma:clinical manifestations,prognostic factors and long-term survival by propensity score model[J].PLoS One,2014,9(2):e89373.

[4]YOSHITAKA T,KAZUHIRO N.Nonalcoholic steatohepatitis-associated hepatocellular carcinoma:our case series and literature review[J].World J Gastroenterol,2010,16(12):1436-1441.

[5]ERTLE J,DECHENE A,SOWA JP,et al.Non-alcoholic fatty liver disease progresses to hepatocellular carcinoma in the absence of apparent cirrhosis[J].Int J Cancer,2011,128(10):2436-2443.

[6]SIRIWARDANA RC,NIRIELLA MA,LIYANAGE CA,et al.Cryptogenic cirrhosis is the leading cause for listing for liver transplantation in Sri Lanka[J].Indian J Gastroenterol,2013,32(6):397-399.

[7]REDDY SK,STEEL JL,CHEN HW,et al.Outcomes of curative treatment for hepatocellular cancer in nonalcoholic steatohepatitis versus hepatitis C and alcoholic liver disease[J].Hepatology,2012,55(6):1809-1819.

[8]KOIKE K.Hepatitis B virus HBx gene and hepatocarcinogenesis[J].Intervirology,1995,38(3-4):134-142.

[9]NAGATA M,SUZUKI W,IIZUKA S,et al.Type 2 diabetes mellitus in obese mouse model induced by monosodium glutamate[J].Exp Anim,2006,55(2):109-115.

[10]ROSMORDUC O,FARTOUX L.HCC and NASH:how strong is the clinical demonstration?[J].Clin Res Hepatol Gastroenterol,2012,36(3):202-208.

[11]PAGE JM,HARRISON SA.NASH and HCC[J].Clin Liver Dis,2009,13(4):631-647.

[12]CHEN JG,LU JH,ZHU YR,et al.A thirty-one year prospective follow-up program on the HBsA g carrier state and primary liver cancer in Qidong,China[J].Chin J Epidemiol,2010,31(7):721-726.(in Chinese)陈建国,陆建华,朱源荣,等.乙型肝炎病毒感染与肝癌发生的31年随访研究[J].中华流行病学杂志,2010,31(7):721-726.

[13]SIRIWARDANA RC,NIRIELLA MA,DASSANAYAKE AS,et al.Clinical characteristics and outcome of hepatocellular carcinoma in alcohol related and cryptogenic cirrhosis:a prospective study[J].Hepatobiliary Pancreat Dis Int,2015,14(4):401-405.

[14]KAO WY,SU CW,CHAU GY,et al.A comparison of prognosis between patients with hepatitis B and C virus-related hepatocellular carcinoma undergoing resection surgery[J].World J Surg,2011,35(4):858-867.

[15]ARNDT W,YVONNE A,SANDRA K,et al.Treatment and survival of non-alcoholic steatohepatitis associated hepatocellular carcinoma[J].BMC Cancer,2015,15:210.

施引文献

资源附件(0)

访问统计