Abstract:

Hepatic dysplastic nodules：A management and prognostic analysis of 20 cases        ZHENG Yong-chang，QU Wang，WANG Wen-ze，et al. Department of Liver Surgery，Peking Union Medical College Hospital，Peking Union Medical College，Beijing 100730，China
Corresponding author：DU Shun-da，E-mail：shundadu@hotmail.com
Abstract    Objective    To summarize the clinical and pathological characteristics as well as management experience of hepatic dysplastic nodule (HDN). Methods    The clinical data and follow-up results of 20 cases of HDN treated from October 2002 to December 2014 in Peking Union Medical College Hospital were analyzed retrospectively. Results All cases underwent operation，and the postoperative recovery was good. In postoperative pathological examination，only 1 case of tumor boundary was ambiguous；12 cases combined with liver cirrhosis. Pathological diagnosis：10 cases of simple HDN，1 case of HDN complicated with focal nodular hyperplasia，7 cases of HDN complicated with HCC，1 case of HDN complicated with focal lesions，1 case of HDN complicated with liver cell adenoma. In the postoperative follow-up，1 case was lost. 5 cases of HDN complicated with canceration recurrented hepatocellular carcinoma after 6-24 months. The rest of the cases were followed up to January 2015 without recurrence. Conclusion    HDN might be a precancerous lesion with relatively good prognosis while carcinogenesis would change prognosis. So the intensive following-up is necessary. Medical history，tumor markers and imaging are helpful for the diagnosis. Surgical resection should be considered when nodules are difficult to differentiate or hepatocarcinogenesis have occurred.

Key words: liver tumor；dysplastic nodule, hepatocellular carcinoma, hepatectomy

摘要：

目的    总结肝脏不典型增生结节（HDN）病例的临床、病理特点及治疗经验。方法    回顾性分析2002年10月至2014年12月北京协和医院收治的20例HDN病人临床资料，总结临床特征并进行随访。结果    所有病人均行手术 ，且术后恢复良好。术后大体病理检查中仅1例病人肿物边界不完整。12例HDN病人合并肝硬化。病理诊断：10例为单纯HDN，1例为HDN合并局灶性结节性增生，7例为HDN合并HCC，1例为HDN合并灶性癌变，1例为HDN合并肝细胞腺瘤。术后1例失访。5例HDN合并癌变病人术后6～24个月肝癌复发，其余病人术后随访至2015年1月无复发。结论    HDN可能是具有相对良好预后的癌前病变，如发生癌变则将改变预后，应密切随访，病史、肿瘤标记物及影像学检查有助于诊断，对于难以鉴别或怀疑性质改变时可考虑积极手术处理。

关键词: 肝脏肿瘤, 不典型增生结节, 肝细胞癌, 肝切除术