Nagasue N, Yukaya H, Chang Y C, Kimura N, Ota N, Nakamura T
Department of Surgery, Hiroshima Red Cross Hospital, Japan.
Br J Surg. 1988 Nov;75(11):1124-8. doi: 10.1002/bjs.1800751124.
During a recent 6-year period we have encountered 10 patients with 'hepatocellular pseudotumour in the cirrhotic liver' (regenerating hyperplastic nodule). The patients were all male, aged 40-82 years. Seven were chronic alcohol consumers. None was positive for HBs-Ag but seven had either anti-HBs or anti-HBc. Serum AFP level ranged from 4 to 28 ng/ml in six patients who did not have hepatocellular carcinoma at the time of the diagnosis of the pseudotumour. The lesions were depicted by ultrasonography in seven, by computed tomography in two, and by angiography in one case. Liver scan was negative in all five cases investigated. The pre-operative diagnosis was definitely or highly suspicious of hepatocellular carcinoma in three, of pseudotumour in the cirrhotic liver in three, and of recurrent carcinoma in one. In another three patients, pseudotumour was coincidentally discovered in resected specimens with hepatocellular carcinoma. The histopathological and follow-up studies demonstrated synchronous or metachronous development of carcinoma in seven patients. Whether or not these lesions in the cirrhotic liver are premalignant remains to be elucidated.
在最近6年期间，我们遇到了10例“肝硬化肝脏中的肝细胞假瘤”（再生性增生结节）患者。患者均为男性，年龄在40至82岁之间。7例为慢性酒精饮用者。无一例HBs - Ag阳性，但7例有抗 - HBs或抗 - HBc。在诊断假瘤时无肝细胞癌的6例患者中，血清甲胎蛋白水平为4至28 ng/ml。7例病变通过超声检查显示，2例通过计算机断层扫描显示，1例通过血管造影显示。在所有5例接受检查的病例中，肝脏扫描均为阴性。术前诊断为肝细胞癌明确或高度可疑的有3例，肝硬化肝脏假瘤的有3例，复发性癌的有1例。另外3例患者在切除的肝细胞癌标本中偶然发现了假瘤。组织病理学和随访研究表明，7例患者出现了同步或异时性癌。这些肝硬化肝脏中的病变是否为癌前病变仍有待阐明。
