原发性肝脏类癌的诊断和治疗一例并文献复习

Diagnosis and treatment of primary hepaticcarcinoid tumor

目的 探讨原发性肝脏类癌（PHCT）的诊断和治疗经验.方法 回顾山西大医院确诊的1例PHCT的临床资料,并结合国内文献报道的经手术治疗35例PHCT患者的临床资料进行分析.结果 PHCT患者临床表现为上腹疼痛（16例）,腹部肿块（13例）,肝肿大（20例）,少数存在类癌综合征（5例）,术前误诊率86.1％ （31/36）,术后病理确诊为肝脏类癌.有随访记录者术后5年生存率为69.6％（16/23）.结论 PHCT在临床上相对罕见.临床上误诊率极高.其确诊依赖于术后病理学及免疫组织化学检查,手术切除是治疗PHCT的最佳手段,预后较好.

Objective To discuss the diagnosis and treatment of primary hepatic carcinoid tumor （PHCT）.Methods One case of PHCT recently was treated in our hospital,and the other 35 cases PHCT received surgery which were published in Chinese biological and medical literature database were analyzed retrospectively.Results The clinical characteristics of the patients with PHCT were upper abdominal pain （16 cases）,abdominal mass （13 cases）,hepatomegaly （20 cases）,few existing carcinoid syndrome （5 cases）,with preoperative misdiagnosis rate 86.1% （31/36）,and postoperative pathology confirmed the diagnosis of liver cancer.A follow-up record after 5 year survival rate was 69.6% （16/23）.Conclusions PHCT is very rare in clinic.High misdiagnosis rate is high in clinic.Its diagnosis depends on pathological and immunohistochemical examination.Operation resection is the best treatment for PHCT and the prognosis of PHCT is good.