外生型肝癌的外科诊治进展  

Progress on surgical diagnosis and treatment of pedunculated hepatocellular carcinoma

作　　者：赵乃波 黄海浪 李文森 杨远园 李红玉 何远翔 文坤明 ZHAO Nai-bo;HUANG Hai-lang;LI Wen-sen;YANG Yuan-yuan;LI Hong-yu;HE Yuan-xiang;WEN Kun-ming(Department of General Surgery,Kweichow Moutai Hospital,Renhuai Guizhou 564500,China;Department of Gastrointestinal Surgery,Dongguan People's Hospital,Dongguan Guangdong 523000,China)

机构地区：[1]贵州茅台医院普外科,贵州仁怀564500 [2]东莞市人民医院胃肠外科,广东东莞523000

出　　处：《局解手术学杂志》2025年第2期173-177,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：外生型肝癌(PHCC)是一种特殊类型的肝癌,病理上与一般的肝细胞癌相似。综合文献数据,PHCC的发病率低,临床上遇到PHCC患者极少,目前仅仅文献报道数百例,且多为病例报道。临床医师对其诊治缺乏经验,易误诊。当考虑诊断为PHCC时,应对CT检查结果以及患者的肝炎病史、肝功能、甲胎蛋白(AFP)等进行综合全面分析,作出合理诊断,以避免误诊误治;术后的病理结果是支持诊断最重要的检查结果。PHCC的治疗以手术为主,因其包膜完整等特点,手术切除相对容易,且治愈率较普通肝细胞癌高,术后生存率相对较为理想;对于不可切除的PHCC,可采用以经导管动脉化疗栓塞为主的方式进行姑息治疗。笔者就PHCC的诊断和治疗进展作一综述,以期为临床提供参考。Pedunculated hepatocellular carcinoma(PHCC)is a special type of liver cancer,which is pathologically similar to general hepatocellular carcinoma.Based on the literature data,the incidence of PHCC is low,and few patients with PHCC are encountered in clinic.At present,only hundreds of cases have been reported in the literature,and most of them are case reports.Clinicians lack experience in its diagnosis and treatment,and it is easy to be misdiagnosed.When considering the diagnosis of PHCC,a comprehensively analysis of CT examination results and the patient's history of hepatitis,liver function and alpha-fetoprotein(AFP)should be conducted to make a reasonable diagnosis,so as to avoid misdiagnosis and mistreatment.Postoperative pathological findings are the most important findings to support the diagnosis.The treatment of PHCC is mainly based on surgery.Due to the characteristics of intact capsule,surgical resection is relatively easy and the cure rate is higher than that of ordinary hepatocellular carcinoma,and the postoperative survival rate is relatively ideal.For unresectable PHCC,palliative treatment based on transcatheter arterial chemoembolization can be used.This article reviews the progress on diagnosis and treatment of PHCC in order to provide reference for clinical practice.

关 键 词：外生型肝癌 诊断 外科治疗 研究进展 

分 类 号：R657.3[医药卫生—外科学]