本文選題：肝腫瘤 + 混合型肝癌�。� 參考：《臨床與實驗病理學(xué)雜志》2017年05期

【摘要】：目的探討混合型肝細胞-膽管細胞癌(combined hepatocellular carcinoma-cholangio carcinoma,c HCC-CC)的臨床病理學(xué)特征、診斷、鑒別診斷、治療及預(yù)后。方法回顧性分析24例c HCC-CC的臨床病理學(xué)、影像學(xué)、免疫表型特征及治療,并復(fù)習(xí)相關(guān)文獻。結(jié)果 24例c HCC-CC中,男性18例,女性6例,年齡36~68歲,平均54.38歲。腫瘤位于肝右葉15例,肝左葉6例,肝左葉及右葉1例,肝尾葉及左外葉1例,彌漫性肝結(jié)節(jié)腫瘤1例。眼觀:腫瘤質(zhì)地和切面色澤與腫瘤所含成分有關(guān)。鏡檢:c HCC-CC經(jīng)典型可見2個區(qū)域即肝細胞癌(hepatocellular carcinoma,HCC)和膽管細胞癌(cholangio carcinoma,CC)區(qū)域相互混雜分布或移行分布,另見3例伴干細胞特征——細膽管癌(cholangiolocellular carcinoma,CLC)型。免疫表型:HCC區(qū)域主要表達CD10、CK8、Hepatocyte及CD10,CC區(qū)域表達CK7及EMA,CLC表現(xiàn)為中間型肝細胞免疫表型。結(jié)論 c HCC-CC的臨床表現(xiàn)無特異性,術(shù)前診斷較困難,需結(jié)合病理學(xué)特點、影像學(xué)特征及免疫表型診斷;首選的治療方法是手術(shù)完整切除腫瘤。
[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.
【作者單位】： 安徽醫(yī)科大學(xué)第二附屬醫(yī)院普外科;安徽醫(yī)科大學(xué)第二附屬醫(yī)院病理科;
【分類號】：R735.7

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