外生性肝癌23例临床分析

Clinical analysis of 23 pedunculated hepatocellular carcinoma

目的总结外生性肝癌(P-HCC)的临床特点、诊断、治疗和预后。方法回顾性分析23例P-HCC患者的临床资料。结果 P-HCC的临床症状无特异性,术前确诊率47.83%。根治性手术切除率为91.3%,患者的l、2和3年生存率分别为60%、37%和14%,中位生存时间为17.2个月。Cox分析显示:P-HCC的预后与Child-Pugh肝功能分级、肝硬化和肿块分布有关。结论 P-HCC少见,易误诊,手术切除是其主要的治疗方法,且有较高的切除率。术前有效改善肝功能、早期诊断和根治性切除是提高生存率、延长生存时间的关键。

Objective This study was to review the clinical feature, diagnosis, treatment, and prognosis of pedunculated hepatocellular carcinoma （P-HCC）. Methods The clinical data of 23 patients with P-HCC were retrospectively analyzed. Results There were no specific clinical manifestations in P-HCC patients. The pre-operative diagnosis rate was 47.83%. The radical resection rate was 91.3 % .The cumulated 1-,2- and 3-years survival of those with complete resection were 60, 37 and 14 %, respectively, with a median survival time of 17.2 months. Cox analysis indicated that Child-Pugh score, liver cirrhosis and different part of the liver were significant predictors of survival（P〈0.05）. Conclusion P-HCC is a rare disease. Operation is the main therapeutic method. It has a high operability rate. The key point of rising survival rate and extending life time of the patients is improving liver function effectively, early diagnosis and radical resection.