肝血管肉瘤:16例回顾

Hepatic angiosarcoma:an analysis of 16 cases

目的探讨肝血管肉瘤的特点,为临床诊断、治疗和预防提供理沦依据。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%)病人有氯乙烯接触史。②病人血清 AFP 值正常或轻度升高,2例(12.50%)病人HBsAg 阳性:CT 阳性诊断率仪为6.67%;病理学图像典型。③单纯手术治疗和手术+化疗病人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肝血管肉瘤的重要依据;手术联合化疗有助于延长生存期。

Objective To explore the features of hepatic angiosarcoma to provide basis for its diagnosis, treatment and prevention. Methods The data of epidemiology, clinical features, laboratory tests, image and pathology and the effect of rnodalities in 16 patients with hepatic angiosarcoma treated in our hospital were retrospectively analyzed. Results 1） The percentage of hepatic angiosarcorna in primary hepatic tumor and hepatic malignant neoplasm was O. 535 （16/3027） and O. 61% （16/2603）, respectively. Ten patients （62.50%） had a history of exposure to vinyl chloride. 2） The AFP in the serum was normal or slightly increased. Two patients （12.50%） were positive for HBsAg. The diagnostic rate of CT was only 6.67%. The pathological pictures were typical. 3） The mean survival time of the patients receiving only operation and those receiving operation plus chemotherapy was 8. 20 months and 18. 39 months, respectively （P=0. 02）. Conclusions The rapidly progressing hepatic an giosarcoma has a poor prognosis. The disease is related to long period of exposure to carcinogens. The diagnostic rate of the disease by imaging methods is low. Pathological examination can provide important diagnostic evidence. Operation plus chemotherapy is beneficial to prolong the survival time of the patients with hepatic angiosarcoma.