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肝脏不典型增生结节(HDN)在历史上曾有过多种名称,通常被认为是肝细胞癌的癌前病变,常见于肝硬化的背景上,根据细胞的异型程度可分为低度不典型增生结节和高度不典型增生结节,HDN可能会以一定的比例和速度以“结节内”和“结节外”的方式进展为HCC,HDN对于小肝癌的早期诊治意义重大。在病理诊断中,高度不典型增生结节(HGDN)和肝细胞肝癌(HCC)最有效的鉴别是间质浸润的有无。异型增生结节无特异性临床表现,与小肝细胞癌鉴别困难,术前诊断困难,主要依赖于影像学检查。B超、CT、MRI对HDN的检出率都不高,HDN在CT和MRI上的表现多样,MRI被认为是显示HDN相对最为敏感的影像学方法,一些新型造影剂对HDN的鉴别诊断可能有一定意义。某些免疫组化对HDN的病理诊断也可能有一定的意义。HDN不能按照肝癌随诊治疗,对于较大的HDN结节应该积极处理,在随访过程中结节性质发生改变时要积极处理。
Liver dysplasia nodules (HDN) in history there have been many names, is generally considered to be a precancerous lesion of hepatocellular carcinoma, common in cirrhosis of the liver background, according to the degree of cell dysmorphism can be divided into low-level Typical hyperplastic nodules and highly atypical hyperplastic nodules, HDN may progress to HCC and HDN in the early diagnosis and treatment of small hepatocellular carcinoma with a certain proportion and speed in the manner of “nodules” and “nodules outside” Significant. In the pathological diagnosis, the most effective identification of highly dysplastic nodules (HGDN) and hepatocellular carcinoma (HCC) is the presence of interstitial infiltration. No specific clinical manifestations of dysplastic nodules, identification of small hepatocellular carcinoma difficult, preoperative diagnosis is difficult, mainly depends on imaging studies. B ultrasound, CT, MRI HDN detection rate is not high, HDN performance in CT and MRI, MRI is considered to be the most sensitive HDN imaging method, some of the new contrast agent for the differential diagnosis of HDN may Have a certain meaning. Some immunohistochemistry on the pathological diagnosis of HDN may also have some significance. HDN can not follow the treatment of liver cancer, should be actively treated for larger HDN nodules, nodules in the follow-up process to change the nature of positive treatment.