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目的总结肝内胆管囊腺瘤(IBCA)的诊疗经验,提高临床诊治水平。方法回顾性总结分析我中心治疗的连续10例经病理学确诊的IBCA,分析其流行病学、影像学、实验室检查、病理学和预后特点。结果 10例患者均为女性,平均年龄48.9(16~73)岁。无症状、轻微症状和明显症状的患者分别为4、4、2例。影像学检查均为多房性囊性肿块,平均直径为(13.3±4.9)cm。内部分隔、乳头或结节样增生、钙化的显示率分别为90%,60%,20%。病理检查大体均为多房性肿块,镜下检查囊内壁均被覆立方或柱状上皮,基质类型为卵巢样(50%)或纤维样(50%)。10例患者中完整切除8例,部分切除2例。平均随访55.3(12~164)月,所有患者均生存。完整切除者均无复发;部分切除者均已复发,且其中1例已恶变。结论IBCA是一种少见的肝内囊性交界性肿瘤,好发于中年女性,影像学检查是术前诊断主要依据。应完整切除肿瘤,以期获得良好生存。
Objective To summarize the diagnosis and treatment experience of intrahepatic cholangiocarcinoma (IBCA) and to improve the clinical diagnosis and treatment. Methods A retrospective analysis of 10 consecutive patients with pathologically confirmed IBCA treated by our center was performed to analyze the epidemiological, radiological, laboratory, pathological and prognostic features of IBCA. Results All 10 patients were female, with an average age of 48.9 (16-73) years. Asymptomatic, mild symptoms and obvious symptoms of patients were 4, 4, 2 cases. Imaging studies were multilocular cystic mass with an average diameter of (13.3 ± 4.9) cm. Internal separation, nipple or nodular hyperplasia, calcification were 90%, 60%, 20%. Pathological examination were generally multilocular masses, microscopic examination of the capsule wall were covered cubic or columnar epithelium, the matrix type of ovarian (50%) or fibrous (50%). Of the 10 patients, 8 had complete resection and 2 had partial resection. All patients survived after an average follow-up of 55.3 (12-164) months. There was no recurrence in the complete resection; some resection had recurred, and 1 of them had malignant transformation. Conclusion IBCA is a rare intracapsular cystic tumor, which occurs in middle-aged women. Imaging examination is the main basis of preoperative diagnosis. The tumor should be completely removed in order to obtain a good survival.