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异位肝脏与肝癌发生

Ectopic liver and hepatocarcinogenesis.

作者信息

Caygill Christine P J, Gatenby Piers A C

机构信息

UK National Barrett's Oesophagus Registry (UKBOR), University Department of Surgery, Royal Free Hospital, London, UK.

出版信息

Eur J Gastroenterol Hepatol. 2004 Aug;16(8):727-9. doi: 10.1097/01.meg.0000131037.92864.df.

Abstract

Hepatocellular carcinomata are relatively rare in the western hemisphere, but they are much more common in South-East Asia and sub-Saharan Africa due to high endogenous levels of hepatitis B and C. Ectopic liver tissue usually is found incidentally (frequently at cholecystectomy), but it may also be found due to neoplastic changes or compressive effects. Ectopic liver tissue has an increased neoplastic potential over orthotopic liver, which we postulate is due to compromised vascular supply and biliary drainage. These lesions may be susceptible to surgical resection, although long-term follow-up data are poor. Ectopic or accessory liver tissue is a rare condition. Most commonly, it is found incidentally, but it may also be found as a result of neoplasia or compressive effects. These lesions appear to have an increased potential for the development of hepatocellular carcinoma in the absence of malignancy in the mother liver. Due to their anatomical features, these carcinomata appear to be susceptible to curative resection, although long-term follow-up data are poor. These carcinomata have been reported more frequently from South-East Asia than from Western countries; however, the common risk factors for hepatocellular carcinoma, such as infection with hepatitis B or C and cirrhosis, appear to be less implicated than in carcinomata of the orthotopic liver. In ectopic or accessory liver tissue, development of hepatocellular carcinoma may be the result of compromised vascular supply or biliary drainage.

摘要

肝细胞癌在西半球相对少见,但在东南亚和撒哈拉以南非洲更为常见,这是由于乙型和丙型肝炎的内源性高水平感染。异位肝组织通常是偶然发现的(常在胆囊切除术时),但也可能因肿瘤性改变或压迫效应而被发现。与原位肝相比,异位肝组织发生肿瘤的可能性增加,我们推测这是由于血管供应和胆汁引流受损所致。这些病变可能适合手术切除,尽管长期随访数据较少。异位或副肝组织是一种罕见情况。最常见的是偶然发现,但也可能因肿瘤形成或压迫效应而被发现。在母肝无恶性病变的情况下,这些病变似乎发生肝细胞癌的可能性增加。由于其解剖学特征,这些癌似乎适合根治性切除,尽管长期随访数据较少。与西方国家相比,东南亚报道这些癌的频率更高;然而,肝细胞癌的常见危险因素,如乙型或丙型肝炎感染和肝硬化,在异位或副肝组织癌中的关联似乎比原位肝癌少。在异位或副肝组织中,肝细胞癌的发生可能是血管供应或胆汁引流受损的结果。

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