混合细胞型肝癌的临床病理分析

发布时间：2018-06-16 05:39

本文选题：肝肿瘤 + 混合型肝癌　；参考：《临床与实验病理学杂志》2017年05期

【摘要】：目的探讨混合型肝细胞-胆管细胞癌(combined hepatocellular carcinoma-cholangio carcinoma,c HCC-CC)的临床病理学特征、诊断、鉴别诊断、治疗及预后。方法回顾性分析24例c HCC-CC的临床病理学、影像学、免疫表型特征及治疗,并复习相关文献。结果 24例c HCC-CC中,男性18例,女性6例,年龄36~68岁,平均54.38岁。肿瘤位于肝右叶15例,肝左叶6例,肝左叶及右叶1例,肝尾叶及左外叶1例,弥漫性肝结节肿瘤1例。眼观:肿瘤质地和切面色泽与肿瘤所含成分有关。镜检:c HCC-CC经典型可见2个区域即肝细胞癌(hepatocellular carcinoma,HCC)和胆管细胞癌(cholangio carcinoma,CC)区域相互混杂分布或移行分布,另见3例伴干细胞特征——细胆管癌(cholangiolocellular carcinoma,CLC)型。免疫表型:HCC区域主要表达CD10、CK8、Hepatocyte及CD10,CC区域表达CK7及EMA,CLC表现为中间型肝细胞免疫表型。结论 c HCC-CC的临床表现无特异性,术前诊断较困难,需结合病理学特点、影像学特征及免疫表型诊断;首选的治疗方法是手术完整切除肿瘤。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis, differential diagnosis, treatment and prognosis of mixed hepatocellular cholangiocarcinoma (HCC). Methods the clinicopathological, imaging, immunophenotypic features and treatment of 24 cases of c HCC-CC were retrospectively analyzed. Results among 24 cases of c HCC-CC, 18 cases were males and 6 cases were females. The average age was 54.38 years. The tumors were located in the right lobe of the liver in 15 cases, Zuo Ye in 6 cases, Zuo Ye and right lobe in 1 case, caudate lobe and left lateral lobe in 1 case, diffuse hepatic nodule tumor in 1 case. Eye view: the texture and color of the tumor are related to the components of the tumor. Microscopic examination showed that two regions, i.e. hepatocellular carcinoma (HCC) and cholangio carcinomata (CCC), were mixed or transfered, and 3 cases of cholangio carcinoma (CCC) with stem cell were found in the classical type of HCC-CC, which was characterized by cholangiolocellular carcinoma of cholangiolocelluar (CLCc). The expression of CK7 and EMA-CLC in CD10 CK8 Hepatocyte and CD10C CC region of HCC was expressed as intermediate hepatocyte immunophenotype. Conclusion the clinical manifestation of c HCC-CC is not specific and it is difficult to diagnose the tumor before operation. It is necessary to combine the pathological features, imaging features and immunophenotypic diagnosis. The first choice of treatment is to remove the tumor completely.
【作者单位】：安徽医科大学第二附属医院普外科;安徽医科大学第二附属医院病理科;
【分类号】：R735.7

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