中华分支睾吸虫病与原发性肝(胆管)癌关系的研究(附病例报告)

Studies on the Relationship between Clonorchiasis and primary Hepatic Cholangiocarcinoma

本文报道一较典型华支睾吸虫痛所致原发性肝胆管癌病例。患者经B超、肝扫描、CT均显示“肝内占位性病变”,行选择性肝动脉造影证实“肝右叶肿瘤”。外科作肝肿瘤切除并送病理检查,确诊肝华支睾吸虫感染伴发肝胆管上皮腺瘤样增生,肝胆管上皮癌变及胆管腺癌。对华支睾吸虫病所致原发性肝胆管癌的病理变化过程,作了较详细的描述,同时对其发病机理进行了讨论。鉴于原发性肝胆管癌目前治疗尚有一定困难,病死率极高,作者认为积极防治华支睾吸虫病,将对流行区内原发性肝胆管癌发病率的下降及对原发性肝胆管癌的防治会具有极为重要的意义。

A case of primary hepatic cholangiocarcinoma induced by clonorchiasis is reported. B-mode ultrasonography, radionuclide scan and computed tomography (C. T.) suggested the presence of space-occupying lesion in the liver of this patient. Tumor mass of liver, right lobe was demonstrated by screening hepatoangiography. Adenomatous hyperplasia, carcinomatous change and cholangiocarcinoma of bile duct epithelium associated with clonorchiasis were identified from the surgical resection specimen of tumor mass by pathological examination. The process of pathological change is described in detail and its pathogenesis is discussed. It is emphasized that energetic prevention and treatment of clonorchiasis to lower the prevalence of clonorchiasis in endemic area is of significance.