2例肝细胞癌伴胆管癌栓的MDT讨论

MDT discussion of 2 cases of hepatocellular carcinoma with bile duct tumor thrombus

目的讨论肝细胞癌伴胆管癌栓(hepatocellular carcinoma with bile duct tumor thrombus,HCCBDT)的临床及影像学特点、诊断及治疗方法,以提高对该病的诊疗水平。方法回顾性分析西南医科大学附属医院分别于2016年3月和7月收治的2例HCCBDTT患者的临床资料,并结合相关文献进行总结。结果 2例HCCBDTT患者术前均误诊为肝门部胆管癌,行手术治疗,术后病理学检查证实为HCCBDTT。术后2例患者分别获访20个月和13个月,随访期间均存活。结论临床诊断HCCBDTT时,应综合分析患者的临床资料,避免误诊。积极的外科治疗能有效地提高HCCBDTT患者的生活质量,延长生存期。

Objective To discuss the clinical characteristics, radiological characteristics, diagnosis, and treatment of hepatocellular carcinoma with bile duct tumor thrombus （HCCBDTT）, and to improve the level of diagnosis and treatment for it. Methods Clinical data of 2 cases of HCCBDTT admitted in March 2016 and July 2016 in our hospital were analyzed retrospectively, and the related literatures were reviewed. Results Two cases of HCCBDTT were misdiag- nosed as hilar cholangiocarcinoma before operation, and then proved to be HCCBDTT after operation. The 2 cases were both alive during the follow-up period （20 months and 13 months respectively）. Conclusions HCCBDTT patients should be comprehensively analyzed basing on the clinical data for diagnosis, and avoiding misdiagnosis. Active surgical treatment can effectively improve the quality of life in HCCBDTT patients, and prolong the survival time.