消化系统隐匿性恶性肿瘤相关化脓性肝脓肿的研究进展  

Advances in the study of occult malignant tumor-related pyogenic liver abscesses in the digestive system

作　　者：黎伟政 黄杰安[1] Li Weizheng;Huang Jiean(Department of Gastroenterology,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第二附属医院消化内科,南宁530021

出　　处：《中华肝脏病杂志》2021年第3期275-278,共4页Chinese Journal of Hepatology

摘　　要：化脓性肝脓肿(PLA)伴随隐匿性恶性肿瘤是一种少见的、危及生命的疾病。研究表明,其可能预示癌症的发生,特别是肝胆、结直肠癌症。PLA患者存在合并隐匿性原发性肝癌、胆管癌、胃肠癌的高风险。恶性肿瘤相关PLA症状、体征缺乏特异性,能谱CT病灶与正常肝组织碘浓度比值对肝癌和肝脓肿的鉴别有一定价值。计算机断层扫描结肠成像具有筛查PLA患者的隐匿性结直肠癌和观察脓肿病变的治疗反应的双重作用。肺炎克雷伯菌是结直肠癌、肝细胞癌相关PLA的主要微生物,大肠杆菌是肝内胆管细胞癌相关PLA的主要微生物。肝胆恶性肿瘤相关PLA治疗的并发症、病死率高,预后不佳。隐匿性结直肠癌绝大部分处于早期阶段,早期发现,预后比合并肝胆恶性肿瘤的PLA患者好。Pyogenic liver abscess(PLA)accompanied by occult malignant tumors is a rare kind of lifethreatening disease.Studies have shown that it can predict the occurrence of cancer,especially hepatobiliary and colorectal cancer.The risk of combined occult primary liver cancer,cholangiocarcinoma,and gastrointestinal cancer is high in PLA patients.Malignant tumor-related PLA lacks specific symptoms and signs.The iodine concentration ratio between the energy spectrum CT lesions and normal liver tissue is of certain value in the differentiation of liver cancer and liver abscess.Computed tomography coIonography has a dual role.It can screen patients with PLA for occult colorectal cancer and determine the treatment response of abscess lesions.Klebsiella pneumoniae and Escherichia coli is the main microorganism of PLA related to colorectal cancer,hepatocellular carcinoma,and intrahepatic cholangiocarcinoma.PLA treatment related to hepatobiliary malignant tumor has high complications and mortality,and poor prognosis.Most occult colorectal cancers are in the early stage,and their early detection and prognosis are better than those of PLA patients combined with hepatobiliaiy malignancies.

关 键 词：化脓性肝脓肿 隐匿性恶性肿瘤 原发性肝癌 胃肠癌 

分 类 号：R735[医药卫生—肿瘤] R575.4[医药卫生—临床医学]