摘要
目的总结原发性肝脏腺鳞癌(primary hepatic adenosquamous carcinoma,ASC)的临床病理特点和外科诊疗方法。方法回顾性分析2006至2019年间安徽医科大学第一附属医院收治的5例行手术切除并经病理证实的ASC患者资料,总结探讨ASC患者的临床、病理、影像、治疗及预后。结果5例ASC患者中,男4例,女1例;年龄48~73岁;初始症状中,上腹痛5例,合并发热2例,合并体重下降和黄疸者各1例;CA19-9高于正常值4例,AFP均未见异常,术前均未获明确诊断。5例患者均行手术切除,病理诊断皆为肝脏腺鳞癌。4例伴淋巴结转移,2例伴神经侵犯。TNM分期4例处于ⅣA期,另1例处于ⅠB期。术后随访中位无瘤生存期(disease-free survival,DFS)为5个月,中位总生存期(overall survival,OS)为9个月。结论ASC是一种预后极差的罕见肝脏恶性肿瘤,手术切除改善其预后作用有限。
Objective To explore the clinicopathological characteristics of the primary hepatic adenosquamous carcinoma(ASC).Methods A retrospective analysis was performed on the clinical data of 5 ASC patients admitted to the First Affiliated Hospital of Anhui Medical University from 2006 to 2019 who underwent surgical resection and were pathologically confirmed.Results Among the 5 ASC cases,there were 4 males and 1 female.The age ranged from 48 to 73 years.As for the initial symptoms,there were 5 cases complaining upper abdominal pain,2 cases presenting fever,1 case presenting weight loss and 1 case presenting jaundice.CA19-9 was significantly higher than normal in 4 cases,while AFP was normal in all.None had definite preoperative diagnosis.All the 5 patients underwent surgical resection with pathology proved primary hepatic ASC.Lymph node metastasis was found in 4 cases and nerve invasion in 2 cases.There were 4 cases at TNM stageⅣA,one at stageⅠB.The median disease-free survival(DFS)was 5 months and the overall survival(OS)was 9 months.Conclusions Primary hepatic adenosquamous carcinoma is a rare type of liver malignant tumor with an extremely poor prognosis.Surgical resection helps little in improving the prognosis.
作者
陈子祥
陈江明
郭旗
谢青松
方强
濮天
蔡茗
谢坤
赵义军
耿小平
刘付宝
Chen Zixiang;Chen Jiangming;Guo Qi;Xie Qingsong;Fang Qiang;Pu Tian;Cai Ming;Xie Kun;Zhao Yijun;Geng Xiaoping;Liu Fubao(Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230001,China;The Anhui Provincial Hospital,Hefei 230001,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2020年第11期874-878,共5页
Chinese Journal of General Surgery
基金
安徽省科技攻关项目(1804h08020239)。
关键词
肝肿瘤
癌
腺鳞状
诊断
治疗
Liver neoplasms
Carcinoma,adenosquamous
Diagnosis
Treatment
