胆管黏液腺癌的诊断与治疗

Diagnosis and treatment of mucinous cholangiocarcinoma

目的分析胆管黏液腺癌的诊断与治疗。方法回顾分析郑州大学人民医院2015年5月至2017年7月收治的6例胆管黏液腺癌病人的临床病理资料,总结其临床病理学特征、诊断及治疗方式,结合国内外文献分析阐述。结果本组6例病人,男性2例,女性4例,年龄38~67岁,平均52.3岁。主要症状为腹痛、发热、黄疸。CT及MRI均提示肝内外胆管不同程度扩张,磁共振胰胆管成像(MRCP)显示肿瘤在高信号的胆汁衬托下呈结节状、乳头状、斑片状等相对低信号表现。6例病人均行手术治疗,术后顺利出院。随访时间1~27个月,中位随访时间18个月,均存活。结论胆管黏液腺癌术前诊断较为困难,MRCP具有明显的优势,根治性手术切除是最有效的治疗手段。

Objective To analyze the diagnosis and treatment of mucinous cholangiocarcinoma （MCC）. Methods A retrospective study was made on the clinicopathological features of 6 MCC patients in Zhengzhou University People＇s Hospital from May 2015 to July 2017. The clinical and pathological features, diagnosis and treatment of these 6 cases of MCC were summarized, and the relative literatures were reviewed. Results There were 2 males and 4 females with age ranging from 38 to 67 years old （average of 52, 3 years old）. The common symptoms were abdominal pain, fever and jaun- dice. Intra- and extra-hepatic bile duct dilation to varying degrees was seen in CT and MRI scans. Nod- al,manarnillary,plaque relative low signal mass was displayed in MRCP scan. Six patients were discharged after surgery. At a median follow up for 18 months （range 1 to 27 months）, all patients survived. Conclusions The diagnosis of MCC is very difficult preoperatively. MRCP has obvious advantages compared with other methods. Radical surgical resection is the most effective method for MCC patients.