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目的探讨肝脏原发性类癌(PHCT)的诊断及治疗方法。方法报告2004年2月收治的1例巨大 PHCT 病例,并检索1994年1月至2006年12月国内文献报告的19例 PHCT 患者的临床资料,对该病的临床表现、病变特点、诊断及治疗进行临床分析。结果 PHCT 的症状以腹胀、腹疼等上腹不适(8例)和腹部肿块(7例)为主,少数表现为类癌综合征(3例)。病灶免疫组织化学染色显示神经元特异性烯醇化酶、嗜铬颗粒蛋白 A 和突触素的阳性率较高。16例接受手术治疗,其中13例完全切除病灶;4例接受介入栓塞化疗。结论 PHCT 的确诊依赖于术后病理学及免疫组织化学检查,手术切除足最佳治疗手段,预后较好。介入栓塞化疗足有效的非手术治疗方法。
Objective To investigate the diagnosis and treatment of hepatic primary carcinoid (PHCT). Methods A case of huge PHCT was reported in February 2004 and the clinical data of 19 PHCT patients reported from January 1994 to December 2006 in China were retrieved. The clinical manifestations, pathological features, diagnosis and treatment of PHCT Perform clinical analysis. Results The symptoms of PHCT were abdominal distension, abdominal pain and other abdominal discomfort (8 cases) and abdominal mass (7 cases), with the minority being carcinoid syndrome (3 cases). Immunohistochemical staining of the lesions showed a higher positive rate of neuron-specific enolase, Chromogranin A and synaptophysin. Sixteen patients underwent surgical treatment, of which 13 had complete removal of the lesion and 4 received interventional chemoembolization. Conclusions The diagnosis of PHCT depends on postoperative pathology and immunohistochemical examination, and the best prognosis for surgical excision is good. Interventional embolization chemotherapy is an effective non-surgical treatment.