混合型肝细胞-胆管细胞癌临床诊断及预后分析  

Clinical Diagnosis and Prognosis Analysis of Combined Hepatocellular Carcinoma-chonlangio Carcinoma

作　　者：斯琴塔娜 王黎明 吴健雄 Siqin Tana;WANG Liming;WU Jianxiong(National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《大医生》2020年第18期108-112,共5页Doctor

摘　　要：混合型肝细胞-胆管细胞癌(combined hepatocellular carcinoma-cholangio carcinoma,cHCC-CC)是一种罕见的肝脏原发恶性肿瘤,cHCC-CC好发于男性,平均年龄51岁,病毒感染及肝硬化比例高,组织分化程度低,易于淋巴结转移,易于血管侵犯及肝被膜侵犯。目前临床诊断主要依赖于肝脏增强MRI,在增强MRI中,大多数患者表现出典型的“快进快出”“假包膜”特征,部分患者表现出典型的延迟强化特征,部分患者则表现为动脉期的环型强化特征。cHCC-CC的1、3、5年总生存率(OS)分别是77%、59.5%、48%。1、3、5年无病生存期(DFS)分别为70%、40%、25%,多项研究比较了肝细胞肝癌(HCC)、肝内胆管细胞癌(ICC)、cHCC-CC的OS发现HCC预后最好,cHCC-CC次之,ICC预后最差。然而,三者的DFS尚无显著差异。对于cHCC-CC的OS和DFS,多因素分析中独立影响因素为AFP≥400 ng/mL、淋巴结转移、组织低分化。Combined hepatocellular carcinoma-cholangio carcinoma(cHCC-CC)is a rare primary malignant tumor of the liver,Male patients with cHCC-CC were predisposed,at an average age of 51,having a high proportion of viral infection and cirrhosis,and low degree of tissue differentiation,and were prone to lymph node metastasis,vascular invasion and liver capsule invasion.During enhanced MRI,most patients showed typical“fast in and fast out”characteristics.Some patients showed typical delayed enhancement characteristics,and few patients showed only rim enhancement in arterial phase.The 1,3 and 5 year OS of cHCC-CC were 77%,59.5%and 48%respectively.And the 1,3 and 5 year DFS were 70%,40%and 25%,respectively.For OS and DFS,independent influencing factors include:AFP≥400 ng/mL,lymph node metastasis,low tissue differentiation.

关 键 词：混合型肝细胞-胆管细胞混合癌 预后相关因素 诊断 研究进展 

分 类 号：R73[医药卫生—肿瘤]