罕见肝细胞肿瘤的前沿磁共振成像：纤维板层型肝细胞癌和肝细胞胆管癌合并症
State-of-the-art MR Imaging of Uncommon Hepatocellular Tumours: Fibrolamellar Hepatocellular Carcinoma and Combined Hepatocellularcholangiocarcinoma.
作者信息
Anysz-Grodzicka Agnieszka, Podgorska Joanna, Cieszanowski Andrzej
机构信息
Department of Radiology, Maria Sklodowska-Curie Memorial Cancer Centre, Institute of Oncology, Warsaw, Poland.
Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
出版信息
Curr Med Imaging Rev. 2019;15(3):269-280. doi: 10.2174/1573405614666180927113622.
BACKGROUND
Fibrolamellar Carcinoma (FLC) and Combined Hepatocellular- Cholangiocarcinoma (CHC) are rare primary liver tumours, which are related to different clinical settings. In both tumours, correlation with clinical data and laboratory tests are extremely important.
DISCUSSION
Typically, FLC is diagnosed in young patients without any chronic disease and with normal biochemical tests, whereas CHC arises in cirrhotic patients with elevated tumour markers: AFP and/or CA 19-9. The review describes epidemiology, aetiology, pathogenesis, radiological features and treatment of these tumours. Imaging features typical for FLC are: The presence of central scar, calcifications, the large size, heterogeneous and early contrast-enhancement.
CONCLUSION
The diagnosis of CHC may be suggested in case of elevation of both AFP and CA 19- 9 or inconsistency between elevated tumour markers and imaging findings (i.e., elevated CA 19-9 and radiological features of HCC, or elevated AFP with imaging findings characteristic of ICC).
背景
纤维板层癌（FLC）和肝细胞-胆管细胞癌（CHC）是罕见的原发性肝肿瘤，与不同的临床情况相关。在这两种肿瘤中，与临床数据和实验室检查的相关性极为重要。
讨论
通常，FLC在无任何慢性病且生化检查正常的年轻患者中被诊断出来，而CHC则发生在肿瘤标志物（甲胎蛋白和/或CA 19-9）升高的肝硬化患者中。该综述描述了这些肿瘤的流行病学、病因、发病机制、放射学特征及治疗方法。FLC典型的影像学特征为：存在中央瘢痕、钙化、体积大、不均匀及早期强化。
结论
当甲胎蛋白和CA 19-9均升高，或肿瘤标志物升高与影像学表现不一致（即CA 19-9升高且有肝癌的影像学特征，或甲胎蛋白升高并有肝内胆管癌的影像学表现）时，可能提示CHC的诊断。
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