CAJ | 학술논문

目的分析原发性肝透明细胞癌(PCCCL)的临床特点、诊断、治疗与预后.方法回顾性分析1996年5月至2003年12月间收治的24例PCCCL患者的临床资料、治疗和随访情况.男性21例,女性3例,平均年龄46岁.肿瘤位于肝左叶4例,尾状叶1例,肝右叶16例,肝左、右叶3例.HBsAg阳性20例(83.3%),甲胎蛋白(AFP)阳性18例(75.0%).2例行左肝肝段切除,2例行左半肝切除,1例行肝尾状叶切除,10例行右肝肝段切除,3例行右肝局部切除,2例行右半肝切除,3例行左、右肝部分切除,1例行肝移植.采用SPSS 13.0统计软件包,以Kaplan-Meier法进行生存分析.结果 24例患者共有28个肿瘤,平均肿瘤直径为(6.64±5.54)cm.术中显示,17例(70.8%)有肝硬化,5例(20.8%)有肉眼癌栓,7例(29.2%)有镜下癌栓,1例(4.2%)伴淋巴结转移.全组患者术后1、3、5年累积生存率分别为75.0%、41.7%和27.8%,中位生存时间为29个月.结论 PCCCL临床表现无特异性,术前诊断困难,明确诊断需病理学检查,手术切除可取得较好疗效.
목적 분석원발성간투명세포암(PCCCL)적림상특점、진단、치료여예후.방법 회고성분석1996년5월지2003년12월간수치적24례PCCCL환자적림상자료、치료화수방정황.남성21례,녀성3례,평균년령46세.종류위우간좌협4례,미상협1례,간우협16례,간좌、우협3례.HBsAg양성20례(83.3%),갑태단백(AFP)양성18례(75.0%).2례행좌간간단절제,2례행좌반간절제,1례행간미상협절제,10례행우간간단절제,3례행우간국부절제,2례행우반간절제,3례행좌、우간부분절제,1례행간이식.채용SPSS 13.0통계연건포,이Kaplan-Meier법진행생존분석.결과 24례환자공유28개종류,평균종류직경위(6.64±5.54)cm.술중현시,17례(70.8%)유간경화,5례(20.8%)유육안암전,7례(29.2%)유경하암전,1례(4.2%)반림파결전이.전조환자술후1、3、5년루적생존솔분별위75.0%、41.7%화27.8%,중위생존시간위29개월.결론 PCCCL림상표현무특이성,술전진단곤난,명학진단수병이학검사,수술절제가취득교호료효.
Objective To investigate the clinicopathological features, diagnosis, treatment and prognosis of primary clear cell carcinoma of the liver (PCCCL). Methods The clinicopathological data of 24 cases with pathologically proven PCCCL in the First Affiliated Hospital of Cuangxi Medical University from May 1996 to December 2003 were collected and analyzed. Results There were 21 males and 3 females in this group, with an average age of 46 years (range; 30 - 78 years). HBV infection was detected in 83.3% , and AFP expression was found in 75.0% of them. Of the 24 cases, 28 tumors were found with an average size of (6. 64 ± 5. 54) cm. Liver cirrhosis was found in 75. 0% of the patients. Macroscopic and microscopic tumor thrombi were found in 20.8% and 29.2% , respectively. Lymph node metastasis was found in 4.2% of the patents. The 1-, 3-, and 5-year overall survival rates of the 24 cases were 75. 0% , 41. 7% and 27.8% , respectively, with a median survival time of 29 months. Conclusion The clinical characteristics of primary clear cell carcinoma of the liver are similar to that of common hepatocellular carcinoma. It is difficult to be diagnosed preoperatively and final diagnosis depends on pathological examination. Surgical resection is an effective way to achieve favorable treatment outcome and even long-term survival.