Huang Jee-Fu, Wang Liang-Yen, Lin Zu-Yau, Chen Shinn-Chern, Hsieh Ming-Yuh, Chuang Wan-Long, Yu Ming-Yuh, Lu Sheng-Nan, Wang Jing-Houng, Yeung Kwok-Wan, Chang Wen-Yu
Department of Internal Medicine, Foo-Yin Institute of Technology Hospital, Pingtung, Taiwan.
J Gastroenterol Hepatol. 2002 Feb;17(2):190-5. doi: 10.1046/j.1440-1746.2002.02677.x.
To elucidate the incidence of the rare cases of icteric type hepatocellular carcinoma (IHCC), we conducted a retrospective study. The clinical outcomes of IHCC cases were also analyzed.
From January 1986 to December 1997, newly diagnosed HCC cases were evaluated and reviewed from an admission registration database in a medical center. Patients who had HCC tumors which were located within biliary tracts, and caused obstructive jaundice as the initial clinical manifestation of HCC, were defined as cases of IHCC. Besides clinical manifestations, the outcomes and survival times of various treatment strategies among the IHCC cases were compared retrospectively.
The incidence of IHCC was 0.53% (10/1897). The median age of the 10 IHCC patients (seven men, three women) was 56.1 years (range = 41-72 years). Most primary HCC lesions (80%) were of expansive type: either single nodular type or multinodular type. All the patients eventually died of cholangitis and sepsis. Besides biliary drainage, seven patients of moderate to good liver reserve function received transarterial chemoembolization (TACE) for palliative treatment, and three of these received additional radiotherapy (R/T) because of the limited effect of TACE (total dosage ranged from 1600 to 5000 cGy). One patient received only radiotherapy (total dosage 1600 cGy) because of having a single tumor and poor liver reserve function. The median survival time among those eight patients who received palliative treatment was 13.4 months (range = 8-26 months), which was significantly longer than for the other two patients without treatment (2 and 4 months).
Icteric type hepatocellular carcinoma (IHCC) is a rare presentation of HCC. Palliative treatment strategies, including TACE and/or R/T showed a beneficial effect in improving the survival time.
为阐明黄疸型肝细胞癌（IHCC）罕见病例的发生率，我们进行了一项回顾性研究。同时分析了IHCC病例的临床结局。
从1986年1月至1997年12月，对某医疗中心入院登记数据库中新诊断的肝癌病例进行评估和回顾。将肝癌肿瘤位于胆管内且以梗阻性黄疸为肝癌初始临床表现的患者定义为IHCC病例。除临床表现外，对IHCC病例中各种治疗策略的结局和生存时间进行回顾性比较。
IHCC的发生率为0.53%（10/1897）。10例IHCC患者（7例男性，3例女性）的中位年龄为56.1岁（范围=41 - 72岁）。大多数原发性肝癌病灶（80%）为膨胀型：单结节型或多结节型。所有患者最终均死于胆管炎和败血症。除胆管引流外，7例肝功能储备中等至良好的患者接受了经动脉化疗栓塞术（TACE）进行姑息治疗，其中3例因TACE效果有限接受了额外的放疗（R/T）（总剂量范围为1600至5000 cGy）。1例患者因肿瘤单一且肝功能储备差仅接受了放疗（总剂量1600 cGy）。接受姑息治疗的8例患者的中位生存时间为13.4个月（范围=8 - 26个月），明显长于未接受治疗的另外2例患者（2个月和4个月）。
黄疸型肝细胞癌（IHCC）是肝癌的一种罕见表现形式。包括TACE和/或R/T在内的姑息治疗策略在改善生存时间方面显示出有益效果。
