肝样腺癌4例

Four cases of hepatoid adenocarcinoma

本文回顾性分析2008年1月～2013年12月南京大学医学院附属鼓楼医院诊治的4例肝样腺癌患者的临床资料，并综合文献报道探讨肝样腺癌的病理形态和临床特点。结果显示，4例患者中3例临床表现为消化道症状，仅因影像学肝占位收入院；3例血清甲胎蛋白含量异常并持续增高；2例伴有肝转移；3例伴淋巴结多发转移；4例患者存活均〈1年。肝样腺癌的临床症状无特殊性，容易忽视；血清甲胎蛋白多为阳性，是肝样腺癌确诊的一个重要参考指标；同时肝样腺癌易转移，治疗及预后较其他腺癌差，需引起医生的特别重视。

The pathological morphology and clinical characteristics of hepatoid adenocarcinoma were discussed in this text. Four cases clinical data of hepatoid adenocarcinoma from Drum Tower Hospital Affiliated to Medical School of Nanjing University were analyzed. Three in four patients manifest gastrointestinal symptoms including stomachache, in- appetence and malaise. Three of four hepatoid adenocarcinoma cases had a continuously increased level Of alpha fe- topmtein. Liver metastasis was observed in two cases and lymph node metastasis was found in three patients. All cases in this report were dead within one year after diagnosis. Hepatoid adenocarcinoma was difficult to diagnose due to its pathological morphology and clinical characteristics, which performs an increase of alpha fetopmtein, easy metastasis and bad prognosis. It should be paid more attention to diagnosis and treatment of hepatoid adenocarcinoma.