CAJ | 학술논문

目的探讨肝细胞腺瘤(hepatocellular adenoma,HCA)及肝腺瘤病(liver adenomatosis,LA)的临床表现、治疗方法和预后.方法回顾性分析经手术治疗的10例HCA及1例LA患者的临床资料.结果本组女性发病居多,共7例(63.6％),1例女性肝腺瘤病患者有口服避孕药病史.全组中位发病年龄33(范围25～70)岁.多数无临床症状(72.7％).肿瘤标记物CA19-9和甲胎蛋白(AFP)正常.超声造影、CT及磁共振(MRI)增强扫描多提示病灶动脉期强化,门脉期、延迟期去强化.组织病理提示10例为单发病灶,诊断HCA,其中1例肿瘤细胞轻度异型及不典型增生,1例存在细胞不典型增生,1例细胞生长活跃；另外1例为多发病灶,细胞存在异型,诊断肝腺瘤病.11例患者均经手术切除,经随访21～125个月,无复发.结论 HCA患者多无明显临床表现,肝脂肪变性可能为HCA和LA的共同病因,口服避孕药物可能为LA的病因.动态影像学检查有助于诊断,HCA有病灶破裂出血及癌变危险,首选手术治疗,预后良好.
목적 탐토간세포선류(hepatocellular adenoma,HCA)급간선류병(liver adenomatosis,LA)적림상표현、치료방법화예후.방법 회고성분석경수술치료적10례HCA급1례LA환자적림상자료.결과 본조녀성발병거다,공7례(63.6％),1례녀성간선류병환자유구복피잉약병사.전조중위발병년령33(범위25～70)세.다수무림상증상(72.7％).종류표기물CA19-9화갑태단백(AFP)정상.초성조영、CT급자공진(MRI)증강소묘다제시병조동맥기강화,문맥기、연지기거강화.조직병리제시10례위단발병조,진단HCA,기중1례종류세포경도이형급불전형증생,1례존재세포불전형증생,1례세포생장활약；령외1례위다발병조,세포존재이형,진단간선류병.11례환자균경수술절제,경수방21～125개월,무복발.결론 HCA환자다무명현림상표현,간지방변성가능위HCA화LA적공동병인,구복피잉약물가능위LA적병인.동태영상학검사유조우진단,HCA유병조파렬출혈급암변위험,수선수술치료,예후량호.
Objective To review the clinical features,therapeutic approach and prognosis of hepatocellular adenoma(HCA)and liver adenomatosis(LA).Methods The clinical data from patients with histopathological diagnosis confirmed on operative specimens were analyzed retrospectively.Results There were 10 patients with HCA and 1 with LA.The disease was found mainly in females (n=7,63.6％),and only one female patient with LA had a history of use of oral contraceptive.The median age at presentation was 33 years(range,25-70 years).Most patients(n=8,72.7％)had no significant symptom.Tumor markers including CA19-9 and alpha fetoprotein(AFP)were normal.On dynamic ultrasonography,CT and MRI,most lesions showed contrast enhancement in the arterial phase and washout in the portal venous phase and delayed phase.For the 10 patients with HCA,the lesion was solitary.On histopathology,atypia and dysplasia were present in 1 patient,dysplasia in 1 patient,and active tumor cell growth in 1 patient.The patients with liver adenomatosis had multiple lesions and atypia.All patients underwent liver resection.There was no recurrence on follow-up which ranged from 21 to 125 months.Conclusions Most patients had no clinical symptoms.Hepatic steato sis may be a potential cause for HCA and LA.Oral contraceptive plays an important role in the patho genesis of LA.Dynamic imaging examinations were helpful for diagnosis.In view of the associated risks of hemorrhage and malignant transformation,surgical resection is the optimal treatment.The prognosis is good.