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肝内胆管囊腺瘤与囊腺癌:单中心经验

Hepatobiliary cystadenoma and cystadenocarcinoma: a single center experience.

作者信息

Li Xin, Zhang Jia-Lin, Wang Yong-Hong, Song Shao-Wei, Wang Feng-Shan, Shi Rui, Liu Yong-Feng

机构信息

Department of General Surgery, the First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.

出版信息

Tumori. 2013 Mar-Apr;99(2):261-5. doi: 10.1177/030089161309900223.

Abstract

AIMS AND BACKGROUND

Hepatobiliary cystadenoma and cystadenocarcinoma are rare cystic lesions of the liver. The aim of the study was to discuss the clinical features, diagnostic methods and surgical treatment of hepatobiliary cystadenoma and cystadenocarcinoma in our hospital.

METHODS

Six patients with hepatobiliary cystadenomas and four with hepatobiliary cystadenocarcinomas were evaluated. We collected detailed clinical data, and all patients were followed.

RESULTS

Three patients of the 6 with cystadenomas and 2 patients of the 4 with cystadenocarcinomas had marked elevation of CA19-9 (average, 707.0 U/ml and 1078.5 U/ml, respectively). CT scan with contrast revealed typical lesions in all 10 cases, i.e., cyst-occupying lesions with separations in the liver. All patients with hepatobiliary cystadenoma were treated by partial hepatectomy. None of them recurred at a mean follow-up of 40 months. Three patients with hepatobiliary cystadenocarcinoma underwent hepatectomy, without recurrence or metastasis at a mean follow-up of 32 months.

CONCLUSIONS

Tumor markers (CA19-9) and imaging findings may be helpful for an early diagnosis. Complete resection is still the best choice. Even for hepatobiliary cystadenocarcinoma, considering the low malignant grade, we suggest that for the best prognosis radical excision should be attempted.

摘要

目的与背景

肝胆管囊腺瘤和囊腺癌是肝脏罕见的囊性病变。本研究旨在探讨我院肝胆管囊腺瘤和囊腺癌的临床特征、诊断方法及手术治疗。

方法

对6例肝胆管囊腺瘤患者和4例肝胆管囊腺癌患者进行评估。我们收集了详细的临床资料,并对所有患者进行了随访。

结果

6例囊腺瘤患者中有3例,4例囊腺癌患者中有2例CA19-9显著升高(平均分别为707.0 U/ml和1078.5 U/ml)。增强CT扫描显示所有10例均有典型病变,即肝脏内有分隔的占位性囊性病变。所有肝胆管囊腺瘤患者均接受了肝部分切除术。平均随访40个月,无一例复发。3例肝胆管囊腺癌患者接受了肝切除术,平均随访32个月,无复发或转移。

结论

肿瘤标志物(CA19-9)和影像学表现可能有助于早期诊断。完整切除仍是最佳选择。即使对于肝胆管囊腺癌,考虑到其低恶性程度,我们建议为获得最佳预后应尝试根治性切除。

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