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通过重复肝脏扫描和重复穿刺活检研究肝叶切除术后人类肝脏的再生

Regeneration of human liver after hepatic lobectomy studied by repeated liver scanning and repeated needle biopsy.

作者信息

Lin T Y, Lee C S, Chen C C, Liau K Y, Lin W S

出版信息

Ann Surg. 1979 Jul;190(1):48-53. doi: 10.1097/00000658-197907000-00011.

Abstract

Regeneration of the residual lobe of the liver after hepatic lobectomy in humans was studied by repeated liver scanning in seven noncirrhotic and three cirrhotic patients. Each patient was studied for several months during the study which lasted from 1-12 years. Regeneration was apparent in noncirrhotic liver remnants following hepatic lobectomy. In the case of a long standing, space occupying lesions such as benign giant cysts, the liver remnant would complete its regeneration process rather early, usually within a few months of hepatic lobectomy. In hepatoma cases, however, regeneration of the residual lobe after hepatic resection usually took five or six months for completion. On the contrary, no definite increase in the size of the liver remnant was seen on repeated liver scanning in cirrhotic patients. Histologic study of the residual lobe was repeated on needle biopsy specimens in two noncirrhotic and four cirrhotic patients. Regenerative hyperplasia of liver cells with large hyperchromatic, or double nuclei never seen in the preresection liver appeared in the liver remnant five, 11, and 27 days after hepatic lobectomy in noncirrhotic patients. In cirrhotics, however, there were no histologic changes between the preresection liver and the postresection remnant studied three, five, 15, 40 days or even two years and 8 months after hepatic lobectomy.

摘要

通过对7例非肝硬化患者和3例肝硬化患者进行反复肝脏扫描,研究了人类肝叶切除术后肝脏残余叶的再生情况。在为期1至12年的研究中,对每位患者进行了数月的观察。肝叶切除术后,非肝硬化肝脏残余的再生明显。对于长期存在的占位性病变,如良性巨大囊肿,肝脏残余通常会在肝叶切除术后数月内较早完成再生过程。然而,在肝癌病例中,肝切除术后残余叶的再生通常需要五六个月才能完成。相反,在肝硬化患者中,反复肝脏扫描未发现肝脏残余大小有明确增加。对2例非肝硬化患者和4例肝硬化患者的针吸活检标本进行了残余叶的组织学研究。非肝硬化患者在肝叶切除术后5天、11天和27天,肝脏残余中出现了术前肝脏中未见的大的深染或双核肝细胞再生性增生。然而,在肝硬化患者中,术前肝脏与肝叶切除术后3天、5天、15天、40天甚至两年零8个月研究的切除后残余之间没有组织学变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7766/1344456/fe0a4645a9cc/annsurg00233-0063-a.jpg

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