中国实用外科杂志

中国实用外科杂志

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肝内胆管囊腺癌6例诊治分析

李    聪，毕新宇，赵    宏，赵建军，黄    振，阎    涛，李    原，蔡建强   

  1. 北京协和医学院中国医学科学院肿瘤医院腹部外科，北京100021
  • 发布日期:2012-02-24

  • Published:2012-02-24

摘要：

目的    总结肝内胆管囊腺癌的临床特点及诊治经验。方法    回顾性分析中国医学科学院肿瘤医院1999年1月至2011年10月手术切除并病理证实的肝内胆管囊腺癌6例病人的临床资料。结果    病人主要临床表现为非特异性症状，如右上腹不适等或缺乏明显症状。4例出现血CA19-9升高。1例术后病理证实区域淋巴结转移，术后8个月发现肝内多发转移并于术后10个月死亡；另1例外科切缘不足5mm，术后6个月肝内多发转移及骨转移，在外院行全身化疗后疾病进展，术后21个月死亡；其余4例无瘤生存至今。结论    CA19-9升高、B超和增强CT扫描有助于鉴别肝内胆管囊腺癌和其他肝内囊性病变并提高诊断率。手术切除是其根治的首选治疗，保证充分的外科切缘可减少肝内复发并明显延长生存期，伴有区域淋巴结转移可能是影响预后的重要因素之一。

关键词: 肝内胆管囊腺癌, CA19-9, 肝切除

Abstract:

Diagnosis and treatment of  hepatobiliary cystadenocarcinoma: an analysis of 6 cases        LI Cong, BI Xin-yu, ZHAO Hong, et al. Department of Abdominal Surgery, Cancer Institute Hospital, Chinese Academy of Medical Sciences, Beijing100021, China
Corresponding author: CAI Jian-qiang, E-mail: caijianqiang188@sina.com
Abstract    Objective    To summarize the diagnosis and treatment of hepatobiliary cystadenocarcinoma. Methods    The clinical data of 6 cases of hepatobiliary cystadenocarcinoma received complete excision and confirmed by histopathologic examination between January 1999 and October 2011 in Cancer Institute Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. Results    Most cases presented with non-specific symptoms. Four cases were with an elevated serum CA19-9 level. One cases of regional lymph nodes metastasis occurred hapatic metastasis 8 months after operation and died 10 months after operation. Another cases sufferred inadequate surgical margin (<5mm) recurred six months after operation and survived for 21 months with chemotherapy. The other 4 cases survived for 9, 10, 38, 108 months respectively. Conclusion    An elevated serum CA19-9 level and imaging examinations may be useful to differentiate hepatobiliary cystadenocarcinoma from other hepatic cystic diseases. Complete excision with negative margin is essential to reduce local recurrence. Regional lymph nodes metastasis may be an important prognostic factor for the disease.

Key words: hepatobiliary cystadenocarcinoma, CA19-9, hepatectomy