Li W Z, Huang J A
Department of Gastroenterology, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Zhonghua Gan Zang Bing Za Zhi. 2021 Mar 20;29(3):275-278. doi: 10.3760/cma.j.cn501113-20190402-00105.
Pyogenic liver abscess (PLA) accompanied by occult malignant tumors is a rare kind of life-threatening disease. Studies have shown that it can predict the occurrence of cancer, especially hepatobiliary and colorectal cancer. The risk of combined occult primary liver cancer, cholangiocarcinoma, and gastrointestinal cancer is high in PLA patients. Malignant tumor-related PLA lacks specific symptoms and signs. The iodine concentration ratio between the energy spectrum CT lesions and normal liver tissue is of certain value in the differentiation of liver cancer and liver abscess. Computed tomography colonography has a dual role. It can screen patients with PLA for occult colorectal cancer and determine the treatment response of abscess lesions. Klebsiella pneumoniae and Escherichia coli is the main microorganism of PLA related to colorectal cancer, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma. PLA treatment related to hepatobiliary malignant tumor has high complications and mortality, and poor prognosis. Most occult colorectal cancers are in the early stage, and their early detection and prognosis are better than those of PLA patients combined with hepatobiliary malignancies.
伴有隐匿性恶性肿瘤的化脓性肝脓肿（PLA）是一种罕见的危及生命的疾病。研究表明，它可以预测癌症的发生，尤其是肝胆癌和结直肠癌。PLA患者合并隐匿性原发性肝癌、胆管癌和胃肠道癌的风险较高。恶性肿瘤相关的PLA缺乏特异性症状和体征。能谱CT病变与正常肝组织之间的碘浓度比值在肝癌和肝脓肿的鉴别诊断中具有一定价值。计算机断层结肠成像具有双重作用。它可以筛查PLA患者是否患有隐匿性结直肠癌，并确定脓肿病变的治疗反应。肺炎克雷伯菌和大肠埃希菌是与结直肠癌、肝细胞癌和肝内胆管癌相关的PLA的主要微生物。与肝胆恶性肿瘤相关的PLA治疗并发症多、死亡率高，预后差。大多数隐匿性结直肠癌处于早期阶段，其早期发现和预后优于合并肝胆恶性肿瘤的PLA患者。
