中国普外基础与临床杂志

中国普外基础与临床杂志

2 例肝细胞癌伴胆管癌栓的 MDT 讨论

查看全文

目的 讨论肝细胞癌伴胆管癌栓(hepatocellular carcinoma with bile duct tumor thrombus,HCCBDT)的临床及影像学特点、诊断及治疗方法,以提高对该病的诊疗水平。 方法 回顾性分析西南医科大学附属医院分别于 2016 年 3 月和 7 月收治的 2 例 HCCBDTT 患者的临床资料,并结合相关文献进行总结。 结果 2 例 HCCBDTT 患者术前均误诊为肝门部胆管癌,行手术治疗,术后病理学检查证实为 HCCBDTT。术后 2 例患者分别获访 20 个月和 13 个月,随访期间均存活。 结论 临床诊断 HCCBDTT 时,应综合分析患者的临床资料,避免误诊。积极的外科治疗能有效地提高 HCCBDTT 患者的生活质量,延长生存期。

Objective To discuss the clinical characteristics, radiological characteristics, diagnosis, and treatment of hepatocellular carcinoma with bile duct tumor thrombus (HCCBDTT), and to improve the level of diagnosis and treatment for it. Methods Clinical data of 2 cases of HCCBDTT admitted in March 2016 and July 2016 in our hospital were analyzed retrospectively, and the related literatures were reviewed. Results Two cases of HCCBDTT were misdiag- nosed as hilar cholangiocarcinoma before operation, and then proved to be HCCBDTT after operation. The 2 cases were both alive during the follow-up period (20 months and 13 months respectively). Conclusions HCCBDTT patients should be comprehensively analyzed basing on the clinical data for diagnosis, and avoiding misdiagnosis. Active surgical treatment can effectively improve the quality of life in HCCBDTT patients, and prolong the survival time.

关键词: 肝细胞癌伴胆管癌栓; 诊断; 治疗; 文献复习

Key words: hepatocellular carcinoma with bile duct tumor thrombus; diagnosis; treatment; literature review

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. Kim JM, Kwon CH, Joh JW, et al. Incidental microscopic bile duct tumor thrombi in hepatocellular carcinoma after curative hepatectomy: a matched study. Medicine (Baltimore), 2015, 94(6): e450.
2. Xiangji L, Weifeng T, Bin Y, et al. Surgery of hepatocellular carcinoma complicated with cancer thrombi in bile duct: efficacy for criteria for different therapy modalities. Langenbecks Arch Surg, 2009, 394(6): 1033-1039.
3. Lin TY, Chen KM, Chen YR, et al. Icteric type hepatoma. Med Chir Dig, 1975, 4(5-6): 267-270.
4. Hu J, Pi Z, Yu MY, et al. Obstructive jaundice caused by tumor emboli from hepatocellular carcinoma. Am Surg, 1999, 65(5): 406-410.
5. 李江, 侯宇, 刘斌, 等. 肝细胞癌合并胆管癌栓的诊疗现状与展望. 中华肝胆外科杂志, 2005, 11(12): 857-859.
6. Pang YB, Zhong JH, Luo XL, et al. Clinicopathological characteristics and liver stem cell marker expression in hepatocellular carcinoma involving bile duct tumor thrombi. Tumour Biol, 2016, 37(5): 5879-5884.
7. Ueda M, Takeuchi T, Takayasu T, et al. Classification and surgical treatment of hepatocellular carcinoma (HCC) with bile duct thrombi. Hepatogastroenterology, 1994, 41(4): 349-354.
8. Satoh S, Ikai I, Honda G, et al. Clinicopathologic evaluation of hepatocellular carcinoma with bile duct thrombi. Surgery, 2000, 128(5): 779-783.
9. Chen MF, Jan YY, Jeng LB, et al. Obstructive jaundice secondary to ruptured hepatocellular carcinoma into the common bile duct. Surgical experiences of 20 cases. Cancer, 1994, 73(5): 1335-1340.
10. 崔宏, 高琴琴, 黄长山, 等. 肝癌伴胆管癌栓 148 例分析. 中国误诊学杂志, 2006, 6(23): 4629.
11. 谭蔚锋, 冉荣征, 杨昊玉, 等. 原发性肝癌伴胆管癌栓误诊分析. 第二军医大学学报, 2013, 34(4): 411-415.
12. Qin LX, Ma ZC, Wu ZQ, et al. Diagnosis and surgical treatments of hepatocellular carcinoma with tumor thrombosis in bile duct: experience of 34 patients. World J Gastroenterol, 2004, 10(10): 1397-1401.
13. Qiao W, Yu F, Wu L, et al. Surgical outcomes of hepatocellular carcinoma with biliary tumor thrombus: a systematic review. BMC Gastroenterol, 2016, 16: 11.
14. Orimo T, Kamiyama T, Yokoo H, et al. Hepatectomy for hepatocellular carcinoma with bile duct tumor thrombus, including cases with obstructive jaundice. Ann Surg Oncol, 2016, 23(8): 2627-2634.
15. 王庆新, 严以群, 吴孟超. 肝细胞性肝癌伴胆管癌栓的手术治疗. 中华肝胆外科杂志, 2009, 15(5): 385-386.
16. Yu XH, Xu LB, Liu C, et al. Clinicopathological characteristics of 20 cases of hepatocellular carcinoma with bile duct tumor thrombi. Dig Dis Sci, 2011, 56(1): 252-259.
17. Hwang S, Moon DB, Lee SG. Liver transplantation and conventional surgery for advanced hepatocellular carcinoma. Transpl Int, 2010, 23(7): 723-727.
18. 苏昆仑, 吴育连, 李晔, 等. 肝癌伴胆管癌栓的临床病理及预后分析. 中华肝胆外科杂志, 2009, 15(5): 371-373.
19. 曾弘, 文剑明, 张锐, 等. 肝细胞癌胆管癌栓的病理学特点及其对手术治疗预后的影响. 中华肝脏外科手术学电子杂志, 2014, 3(1): 8-11.
20. 龚彪, 吴介元, 周岱云, 等. 胆道癌栓的非手术治疗. 中华消化内镜杂志, 2000, 17(5): 301-302.
21. Peng SY, Wang JW, Liu YB, et al. Hepatocellular carcinoma with bile duct thrombi: analysis of surgical treatment. Hepatogastroenterology, 2004, 51(57): 801-804.
22. Kim JM, Kwon CH, Joh JW, et al. The effect of hepatocellular carcinoma bile duct tumor thrombi in liver transplantation. Hepatogastroenterology, 2014, 61(134): 1673-1676.
23. Ikenaga N, Chijiiwa K, Otani K, et al. Clinicopathologic characteristics of hepatocellular carcinoma with bile duct invasion. J Gastrointest Surg, 2009, 13(3): 492-497.
24. Shen Y, Li P, Cui K, et al. Neoadjuvant transcatheter arterial chemoembolization for biliary tumor thrombosis: a retrospective study. Int J Technol Assess Health Care, 2016, 32(4): 212-217.
25. Navadgi S, Chang CC, Bartlett A, et al. Systematic review and meta-analysis of outcomes after liver resection in patients with hepatocellular carcinoma (HCC) with and without bile duct thrombus. HPB (Oxford), 2016, 18(4): 312-316.
26. Noda T, Nagano H, Tomimaru Y, et al. Prognosis of hepatocellular carcinoma with biliary tumor thrombi after liver surgery. Surgery, 2011, 149(3): 371-377.