Kocjan Janusz, Rydel Mateusz, Adamek Mariusz
Diaphragm Concept Academy, Private Clinic Centre Specializing in Treating of Diaphragm Disorders, 32-300 Olkusz, Poland.
Department of Thoracic Surgery, Faculty of Medicine with Dentistry Division, Medical University of Silesia, 40-055 Katowice, Poland.
Cancers (Basel). 2024 Sep 4;16(17):3076. doi: 10.3390/cancers16173076.
The purpose of this study was to conduct a systematic review and meta-analysis of case reports presenting HCC spread to the diaphragm muscle and to determine possible risk factors for this condition. An extensive literature search was performed using the following electronic databases: MEDLINE, CINAHL, ScienceDirect, Google Scholar, and DOAJ. A total of 18 articles describing 27 hepatocellular carcinoma patients were included in this review. The presence of HCC cells in the superior liver segment is strongly associated with metastases to the diaphragm. Among the two types of diaphragm involvement by HCC cells, diaphragm infiltration occurs much more frequently than diaphragm adhesion. However, an HCC nodule in the 8th liver segment and a higher number of liver segments involved by HCC cells predispose patients to diaphragm adhesion. Hepatitis B is a risk factor for diaphragm metastases in recurrent HCC. The tumor diameter is not associated with HCC spread to the diaphragm muscle. We did not find specific symptoms reported by patients that could indicate HCC metastasis to the diaphragm muscle. The presence of hepatitis B and the localization of HCC cells in superior liver segments, especially in the 8th liver segment, should be take into consideration in the diagnostic process.
本研究的目的是对呈现肝癌扩散至膈肌的病例报告进行系统评价和荟萃分析，并确定这种情况的可能危险因素。使用以下电子数据库进行了广泛的文献检索：医学文献数据库（MEDLINE）、护理学与健康领域数据库（CINAHL）、科学Direct数据库、谷歌学术和开放获取期刊目录（DOAJ）。本评价纳入了共18篇描述27例肝细胞癌患者的文章。肝上段存在肝癌细胞与转移至膈肌密切相关。在肝癌细胞累及膈肌的两种类型中，膈肌浸润比膈肌粘连更为常见。然而，肝第8段的肝癌结节以及肝癌细胞累及的肝段数量较多使患者易发生膈肌粘连。乙型肝炎是复发性肝癌发生膈肌转移的危险因素。肿瘤直径与肝癌扩散至膈肌无关。我们未发现患者报告的可提示肝癌转移至膈肌的特定症状。在诊断过程中应考虑乙型肝炎的存在以及肝癌细胞在肝上段尤其是第8段的定位。
