【作者】 王健； 李强； 崔云龙； 孙燕； 肖建宇；

【Author】 Wang Jian Li Qiang Cui Yun-Long et al Department of Hepatobiliary Surgery, Cancer Hospital of Tianjin Medical University, Tianjin 300060, China

【机构】 天津医科大学附属肿瘤医院肝胆外科； 天津医科大学附属肿瘤医院病理科； 天津医科大学附属肿瘤医院放射科；

【摘要】 目的:探讨肝血管肉瘤的特点,为临床诊断、治疗和预防提供理论依据。方法:回顾性分析16例肝血管肉瘤的流行病学、临床表现、实验室检查、影像学和病理学特点及治疗效果。结果:①肝血管肉瘤分别占同期原发性肝脏肿瘤和肝脏恶性肿瘤的0．53％(16／3027)和0．61％(16／2603),10例 (62．50％)患者有氯乙烯接触史。②患者血清AFP值正常或轻度升高,2例(12．50％)患者HBsAg阳性,CT阳性诊断率仅为 6．67％,病理学图像典型。③单纯手术治疗和手术+化疗患者的平均生存期分别为8．20和18．39个月,后者的生存曲线优于前者(P=0．02)。结论:肝血管肉瘤进展迅速,预后较差,发病与长期致癌物暴露有关,影像学诊断率低,病理学检查结果是诊断盱血管肉瘤的重要依据,手术联合化疗有助于延长生存期。更多还原

【Abstract】 Objective: To explore the features of hepatic angiosarcoma and provide the basis for diagnosis, treatment and prevention. Methods: The data of epidemiology, clinical feature, laboratory, image and pathology and the effect of modalities in 16 patients with hepatic angiosarcoma were analyzed retrospectively. Results: ① The percentages of hepatic angiosarcoma in primary hepatic tumor and hepatic malignant neoplasm were 0.53%(16/3027) and 0.61%(16/2603) respectively. Ten patients (62.50%) had a history of exposure to vinyl chloride. ② AFP in serum was normal or mildly increased. HBsAg of two patients (12.50%) was positive. The diagnosis rate of CT was only 6.67%. The pathological pictures are typical.③ The mean survival time of only operation patients and operation plus chemotherapy ones were 8.20 and 18.39 months, the survival curve of the latter was better than that of the former (P=0.02). Conclusion: Hepatic angiosarcoma, progressing rapidly, has a poor prognosis. The relationship between its development and long period of exposure to carcinogens is intimate. The diagnosis rate of imageology was low. Pathology can provide the important diagnostic evidence. The operation adjuvant chemotherapy is beneficial to prolong the survival time of patients with hepatic angiosarcoma.更多还原