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目的探讨肝移植治疗肝脏上皮样血管内皮瘤的临床经验和疗效。方法回顾性分析2例肝脏上皮样血管内皮瘤患者肝移植诊疗经过和相关临床资料,并进行文献复习。结果 2例均为女性。术前腹部B超、CT均提示肝实质多发占位性病变:肝穿刺组织病理学检查均提示肝上皮样血管内皮瘤;免疫组化染色均显示肿瘤标志物CD31(+)、CD34(+)和FactorⅧ(+)。肝移植术后采用他克莫司(FK506)+吗替麦考酚酯(骁悉)二联免疫抑制方案,早期维持FK506血药浓度为8～12μg/L。分别于术后13 d及8 d肝功能恢复正常。术后早期1例并发急性阑尾炎,行阑尾切除术后治愈,2例均未发生急性排斥反应,康复出院。随访2年余移植物、受体正常存活,无肿瘤复发。结论肝移植是治疗不能手术切除的肝脏上皮样血管内皮瘤的最有效的治疗措施,术后效果满意。
Objective To investigate the clinical experience and efficacy of liver transplantation for the treatment of hepatic epithelioid hemangioendothelioma. Methods Retrospective analysis of 2 cases of liver epithelial hemangioendothelioma in patients with liver transplantation after treatment and related clinical data, and literature review. Results 2 cases were female. Preoperative abdominal B ultrasound, CT showed liver parenchyma lesions: Liver biopsy showed liver epithelioid hemangioendothelioma; immunohistochemical staining showed tumor markers CD31 (+), CD34 (+) And Factor VIII (+). After liver transplantation, tacrolimus (FK506) plus mycophenolate mofetil was used, and the initial serum concentration of FK506 was 8 ~ 12μg / L. Liver function returned to normal 13 days and 8 days after operation respectively. One patient was complicated with acute appendicitis in the early postoperative period and was cured after appendectomy. No acute rejection occurred in both of the two cases and the patients were discharged. After 2 years of follow-up, the recipients survived without tumor recurrence. Conclusion Liver transplantation is the most effective treatment for unresectable hepatic epithelioid hemangioendothelioma. The postoperative results are satisfactory.