肝脏占位性病变的临床病理诊断教学思考  

Thoughts on the Teaching of Clinicopathological Diagnosis of Liver Space-Occupying Lesions

作　　者：王瀚 朱恒美 钱尤雯 WANG Han;ZHU Hengmei;QIAN Youwen(Department of Pathology,the Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China;Department of Special Diagnosis and Treatment,the Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China)

机构地区：[1]中国人民解放军海军军医大学第三附属医院病理科,上海200438 [2]中国人民解放军海军军医大学第三附属医院特需科,上海200438

出　　处：《中国继续医学教育》2025年第1期171-176,共6页China Continuing Medical Education

基　　金：上海市科学技术委员会科技计划项目(22Y11908700);海军军医大学第三附属医院人才培养“腾飞工程”蓄势项目(院政[2024]29号)。

摘　　要：肝脏占位性病变是一系列肝脏原发性或继发性肿瘤的统称。具有不同的组织起源、临床症状不一、发病机制迥异、有特征性影像学表现等特点,是消化道病理教学的重要组成之一,也是肝胆专科病理教学的重点授课内容,大部分可通过术前血清学或影像学等检查手段初诊,但显微镜下的病理诊断仍然是肝脏占位性病变定性的金标准,术中快速冰冻诊断将决定病灶的良恶性以及后续正确的手术方式和切除范围。文章在肝脏疾病临床外检的实际操作中探索出一条结合临床表现-影像检查-大体标本-镜下形态-免疫组化和分子病理检测的教学方法,以强化学员对消化系统病理诊断的理解和教学效果,提高对肝脏外科疾病的认识,夯实肝胆专科病理诊断人才队伍的建设和发展,培养学员临床病理思维水平和实操技能。Hepatic space occupying lesions are a general term for a series of primary or secondary liver tumors.There are different organizational origins,clinical symptoms,different pathogenesis and characteristics of special imaging manifestations.It is one of the important components of gastrointestinal pathological teaching,and is also the key content of the clinical hepatobiliary pathological teaching.Most of them can be initially diagnosed by means of preoperative serology or imaging,However,microscopic pathologic diagnosis is still the gold standard for the qualitative characterization of hepatic space-occupying lesions,and intraoperative rapid freezing diagnosis will determine the benign and malignant lesions as well as the subsequent correct surgical method and scope of resection.In this paper,a teaching method combining clinical manifestations,imaging examination,gross specimen,microscopic morphology,immunohistochemistry and molecular pathology detection is explored in the actual operation of clinical surgical examination of liver diseases,so as to strengthen students’understanding of pathological diagnosis of digestive system and teaching effect,improve their understanding of liver surgical diseases,and consolidate the construction and development of the hepatobiliary pathological diagnosis talent team.Cultivate students’clinical pathological thinking level and practical operation skills.

关 键 词：肝脏占位性病变 病理学 临床病理 鉴别诊断 医学教育 教学方法 

分 类 号：G642[文化科学—高等教育学]