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摘要:
目的 探讨肝肉瘤样癌的临床特征，提高对本病诊断与治疗的认识。 方法 回顾性分析天津医科大学附属肿瘤医院2009年1月至2014年4月收治的8例肝肉瘤样癌患者临床资料，并进行随访。 结果 患者发病年龄平均为56.6岁，男女之比为3：1，患者术前CT或MRI有一定特征，术后病理免疫组织化学检查均表达上皮样表型。8例患者的肿瘤局部侵袭性较强，淋巴结转移率较高。所有患者均接受了手术为主的治疗，中位生存期为10.8个月（3~35个月）。 结论 肝肉瘤样癌的诊断主要依靠术后病理，免疫组织化学对其诊断及鉴别诊断很有帮助。手术切除是唯一能够延长患者生存时间的治疗手段，但总体预后较差。 Abstract:Objective To discusse the clinical features of sarcomatoid hepatocellular carcinoma to improve the understanding of diagnosis and treatment for sarcomatoid hepatocellular carcinoma. Methods Data including clinical features and follow-up from 8 patients admitted in Tianjin Medical University Cancer Institute and Hospital from January 2009 to April 2014 were retrospectively analyzed. Results The average age of all patients was 56.6 years old, and the male-to-female ratio was 3:1. Preoperative CT or MRI showed specific characteristics but it was difficult to confirm diagnosis. Pathological and immunohistochemical examination revealed an expressed epithelial-like phenotype. All 8 patients had advanced local tumor invasion and high lymph node metastasis rates. These patients received surgery, and the median survival time was 10.8 months (3 months to 35 months). Conclusion Diagnosis of sarcomatoid hepatocellular carcinoma mainly depended on postoperative pathological examination. Immunohistochemistry was beneficial for sarcomatoid hepatocellular carcinoma diagnosis and differential diagnosis. Surgical treatment prolonged survival time, but the overall prognosis remained poor. -
Key words:
- sarcomatoid hepatocellular carcinoma /
- treatment /
- prognosis
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表 1 8例肝肉瘤样癌患者的临床特征
Table 1. Clinical features of 8 sarcomatoid hepatocellular carcinoma patients
表 2 8例肝肉瘤样癌患者的TNM分期及病理特征
Table 2. TNM staging and pathological features of 8 sarcomatoid hepatocellular carcinoma patients
表 3 8例肝肉瘤样癌患者随访结果
Table 3. Follow-up results of 8 sarcomatoid hepatocellular carcinoma patients
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