肝内胆管囊腺癌临床及影像分析  

Clinical and imaging analysis of intrahepatic biliary cystadenocarcinoma

作　　者：刘渊 安维民 任洪伟 李勇武 刘长春 董景辉 LIU Yuan;AN Wei-min;REN Hong-wei;LI Yong-wu;LIU Chang-chun;DONG Jing-hui(Department of Radiology,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第五医学中心放射科,北京100039

出　　处：《肝脏》2020年第7期682-685,共4页Chinese Hepatology

基　　金：“首都临床特色应用研究”专项(Z181100001718006);院长创新基金(QNPY2015022)。

摘　　要：目的分析肝内胆管囊腺癌的临床特点及影像学表现。方法回顾性分析2010年10月至2019年12月在解放军总医院第五医学中心住院治疗的10例经病理证实的肝内胆管囊腺癌患者的临床资料,对主诉、临床表现、实验室检查、影像学表现进行总结归纳。结果10例肝内胆管囊腺癌患者以腹痛、腹胀为主要症状,其中5例各项肿瘤标志物均为阴性,3例CA125升高,4例CA199升高,2例CEA升高,1例CA724升高。8例CT或MR检查显示为囊实性病灶,病灶长径为1.50~11.10 cm,7例表现为病灶周边轻度到明显肝内胆管扩张,有壁结节者7例,有不规则分隔及分隔样强化者6例,8例增强扫描表现为渐进性强化。4例患者可见淋巴结转移,1例患者术后1年复查MR及CT表现为多发转移。结论肝内胆管囊腺癌好发于中老年女性,主要临床表现为腹痛、腹胀,部分患者可有CA199及CA125升高,影像学多表现为界限清晰的囊实性肿物,可有壁结节、胆管扩张、不规则分隔及渐进性强化,部分可出现转移,治疗手段应选择手术完整切除。Objective To analyze the clinical and imaging features of intrahepatic biliary cystadenocarcinoma(IBC).Methods The clinical data of 10 patients with IBC hospitalized in our hospital from October 2010 to December 2019 were analyzed retrospectively.The main complaints,clinical manifestations,laboratory examination and imaging features were summarized.Results In 10 patients with IBC,abdominal pain and abdominal distension were the main symptoms.There were 5 cases with no increased tumor markers,3 cases with increased cancer antigen(CA)125,4 cases with increased CA199,2 cases with increased carcinoembryonic antigen(CEA),and 1 case with increased CA724.Computed tomography(CT)or magnetic resonance(MR)showed cystic solid lesions with a long diameter of 1.50 cm-11.10 cm in 8 cases,mild to obvious intrahepatic bile duct dilatation around the lesions in 7 cases,wall nodules in 7 cases,irregular separation and septal enhancement in 6 cases,and progressive enhancement in 8 cases.Lymph node metastasis was found in 4 patients.And multiple metastases were found on MR and CT in 1 patient 1 year after operation.Conclusion IBC is more common in middle-aged and elderly women.The main clinical manifestations are abdominal pain and abdominal distention.Some patients may have elevated CA199 and CA125.The imaging findings are characterized with cystic solid masses with clear boundaries,sometimes with wall nodules,bile duct dilatation,irregular separation and progressive enhancement.Metastasis can occur in some patients,and the treatment should be complete surgical resection.

关 键 词：肝内胆管囊腺癌 磁共振成像 体层摄影术 

分 类 号：R73[医药卫生—肿瘤]