肝脏穿刺活检病理学检查联合CT检查对肝恶性肿瘤的诊断意义  

Diagnostic Significance of Liver Biopsy Pathology Combined with CT Examination for Liver Malignant Tumors

作　　者：余江华 黎子峰 汪军兵 YU Jianghua;LI Zifeng;WANG Junbing(Shunde New Rongqi Hospital,Foshan,Guangdong 528303)

机构地区：[1]广东顺德新容奇医院,广东佛山528303

出　　处：《智慧健康》2024年第31期4-6,10,共4页Smart Healthcare

摘　　要：目的探讨肝脏穿刺活检病理学检查联合CT检查对肝恶性肿瘤的诊断意义。方法回顾性分析本院2020年1月—2023年7月共31例肝脏穿刺活检病理学检查,根据显微镜下形态特点,联合运用免疫组化,确诊肝恶性肿瘤的类型,结合CT表现,掌握肿瘤的大体形态和具体的肝内位置,分析和对比两种检查的结果及两种检查结合应用对临床所起的作用。结果31例肝脏穿刺病例中,活检病理学检查,结合显微镜下组织形态特点及免疫组化结果,得出病理诊断,其中肝细胞癌14例,胆管癌3例,癌肉瘤1例,转移瘤7例(其中包括转移性胰腺神经内分泌肿瘤或胰腺腺癌共4例,转移性乳腺浸润性导管癌1例,转移性肺鳞状细胞癌或腺癌共2例);诊断为良性病变的有6例(包括结核1例、肝细胞结节性增生1例、炎性病变2例、其他病变2例)。所有的病例均有做CT检查,其诊断结论为肝细胞癌9例,胆管癌3例,转移瘤8例,多发性肝硬化结节伴恶性变1例,混合型肝癌1例,多发性血管瘤1例,需在不典型血管瘤与胆管细胞癌相鉴别1例,良性结节、囊肿或炎性病变的共有7例。结论肝脏穿刺活检病理学检查联合影像学CT检查,对临床医生明确和掌握患者肝脏恶性肿瘤的类型和肝内分布情况有重要的意义。Objective To explore great significance of pathological examination of liver biopsy combined with CT imaging findings for clinical doctors to make up treatment and surgical plans of liver malignant tumors.Methods The paper reviw and analyzed 31 patients with liver biopsy pathological examination in our hospital from January 2020 to July 2023.Based on morphological characteristics under microscope,and combined with immunohistochemistry,the paper diagnosed type of liver malignant tumor,grasped general morphology and specific intrahepatic position of tumor combined with CT findings,analyzed and compared correlation of them and clinical.Results Among 31 cases of liver biopsy,pathological examination combined with microscopic tissue morphology and immunohistochemical results showed pathological diagnosis,including 14 cases of hepatocellular carcinoma,3 cases of cholangiocarcinoma,1 case of carcinosarcoma,and 7 cases of metastatic tumors(including 4 cases of metastatic pancreatic neuroendocrine tumors or pancreatic adenocarcinoma,1 case of metastatic invasive ductal carcinoma of breast,and 2 cases of metastatic squamous cell carcinoma or adenocarcinoma of the lung).There were 6 cases of benign lesions(including 1 case of tuberculosis,1 case of hepatocellular nodular hyperplasia,2 cases of inflammatory lesions,and 2 cases of other lesions).All cases were treated with CT examination,diagnostic conclusions showed,there were 9 cases of hepatocellular carcinoma,3 cases of cholangiocarcinoma,8 cases of metastatic tumors,1 case of multiple liver cirrhosis nodules with malignant transformation,1 case of mixed liver cancer,and 1 case of multiple hemangioma,1 case of possible atypical hemangioma or cholangiocarcinoma,and 7 cases of benign nodules,cysts or inflammatory lesions.Conclusion Combination of liver biopsy pathology examination and imaging CT examination is of great significance for clinical doctors to clarify and grasp type and distribution of malignant liver tumors of patients.

关 键 词：肝脏穿刺活检 病理学检查 免疫组织化学染色 CT检查 

分 类 号：R73[医药卫生—肿瘤]