Okuda K, Musha H, Kanno H, Igarashi M, Nakano M
Cancer. 1976 Apr;37(4):1965-72. doi: 10.1002/1097-0142(197604)37:4<1965::aid-cncr2820370448>3.0.co;2-p.
Six cases of hepatocellular carcinoma (HCC) and one case of metastatic liver carcinoma in which SGOT, SGPT, and SLDH were suddenly and markedly elevated immediately before death are described. All had a large blood loss and systemic hypotension in the preterminal period; autopsy disclosed irregularly shaped, patchy necrotic areas or infarcts, often clearly demarcated by hemorrhagic rims, in the noncancerous liver parenchyma. Tumor growths in the intrahepatic portal branches were extensive in all six cases with HCC; in the metastatic case, invasion and narrowing of the portal branches were extensive. The incidence of this terminal catastrophe was 3.3% (6 of 184 cases) for HCC and 1.15% (1 of 87) for metastatic carcinoma. The terminal liver necrosis was probably a result of sudden reduction in portal perfusion which had been inadequate because of tumor thrombosis, combined with hypotension of hepatic arteries.
本文描述了6例肝细胞癌（HCC）和1例转移性肝癌病例，这些病例在死亡前血清谷草转氨酶（SGOT）、血清谷丙转氨酶（SGPT）和血清乳酸脱氢酶（SLDH）突然显著升高。所有病例在临终前均有大量失血和全身性低血压；尸检发现，在非癌性肝实质中存在形状不规则的斑片状坏死区域或梗死灶，通常由出血边缘清晰界定。在所有6例HCC病例中，肝内门静脉分支的肿瘤生长广泛；在转移性肝癌病例中，门静脉分支的浸润和狭窄广泛。这种终末期灾难的发生率在HCC中为3.3%（184例中的6例），在转移性肝癌中为1.15%（87例中的1例）。终末期肝坏死可能是由于肿瘤血栓形成导致门静脉灌注突然减少，再加上肝动脉低血压所致，而门静脉灌注不足。
