肝细胞腺瘤的临床特点及诊治  

Diagnosis and treatment of hepatocellular adenoma

作　　者：徐林[1] 刘红[2] 吴泽华 安玉芬 曲林林[1] 胡维昱[1] 王祖森[1] 逄锦忠 曹景玉[1] Xu Lin;Liu Hong;Wu Zehua;An Yufen;Qu Linlin;Hu Weiyu;Wang Zusen;Pang Jinzhong;Cao Jingyu(Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Oncology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Pathology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院肝胆胰外科,山东省266000 [2]青岛大学附属医院肿瘤科,山东省266000 [3]青岛大学附属医院病理科,山东省266000

出　　处：《中华普通外科杂志》2021年第10期746-749,共4页Chinese Journal of General Surgery

基　　金：国家自然科学基金(81602083);山东省优秀中青年科学家科研奖励基金项目(BS2011YY004)。

摘　　要：目的探讨肝细胞腺瘤的诊断和治疗经验。方法回顾性分析青岛大学附属医院2013年5月至2020年5月收治的23例肝细胞腺瘤患者的临床资料。结果23例肝细胞腺瘤患者中,女15例,发病年龄21~60岁。肿瘤直径2.5~15 cm。15例患者无临床症状。20例(87%)为单发病灶,3例(13%)为多发病灶。增强CT及增强MRI扫描多提示病灶动脉期强化,门静脉期、延迟期去强化。23例肝细胞腺瘤患者均经手术治疗,均获得病理证实。1例部分区域发生癌变。术前16例未获得正确诊断,误诊率高达69.6%。术后20例获得随访,中位随访时间36个月,均无复发。结论肝细胞腺瘤临床少见,易误诊。MRI扫描较具价值;肝细胞腺瘤虽为良性疾病,但有恶变的倾向,手术切除仍是主要治疗方法。Objective To explore the diagnosis and treatment of hepatocellular adenoma.Methods The clinical data of 23 hepatocellular adenoma patients admitted to the Affiliated Hospital of Qingdao University from May 2013 to May 2020 were retrospectively analyzed.Results Fifteen patients were female,the age ranged from 21 to 60.The maximum tumor diameter was from 2.5 cm to 15 cm.Most patients(15/23)were asymptomatic.There were 20 cases(87%)with single lesion and 3 cases(13%)with multiple lesions.Contrast-enhanced CT and MRI showed enhancement in the arterial phase,and de-enhancement in the portal phase as well as in the delayed phase.All cases underwent tumor resection.Hepatocellular adenoma was confirmed by pathology with partial canceration in one case and intratumoral hemorrhage in two cases.Sixteen cases were misdiagnosed preoperatively,20 were followed up with the median follow-up time of 36 months.Recurrence was not found.Conclusion Hepatocellular adenoma is uncommon and often misdiagnosed.Preoperative diagnosis is dependent on MRI.Given the fact of high rate misdiagnosis and a tendency of canceration,resection is recommended.

关 键 词：腺瘤 肝细胞 诊断 治疗 

分 类 号：R735.7[医药卫生—肿瘤]