目的 探討肝臟局灶性結(jié)節(jié)性增生(FNH)的臨床診斷與治療,以提高對(duì)FNH的認(rèn)識(shí)。
方法 回顧性分析我院普通外科2004年7月至2011年7月期間收治的21例經(jīng)術(shù)后病理證實(shí)為FNH的臨床資料。
結(jié)果 本組21例FNH患者中男6例,女15例,平均年齡31.1歲。單發(fā)19例,多發(fā)2例。9例為體檢發(fā)現(xiàn),無(wú)不適癥狀;12例有右上腹隱痛不適癥狀,均無(wú)肝炎、肝硬變病史;1例女性患者有長(zhǎng)期口服雌激素病史。化驗(yàn)檢查:谷丙轉(zhuǎn)氨酶輕度升高1例,其余肝功能檢查、腫瘤標(biāo)志物及HBsAg均為陰性。術(shù)前影像學(xué)檢查診斷符合率:彩超檢查為42.9% (6/14),CT檢查為50.0% (6/12),MRI檢查為38.5% (5/13)。術(shù)后均恢復(fù)良好,隨訪至今無(wú)復(fù)發(fā)。
結(jié)論 FNH術(shù)前確診率仍較低,主要依賴術(shù)后病理學(xué)檢查。對(duì)于術(shù)前診斷不明確、病灶巨大或有臨床癥狀者仍應(yīng)采取手術(shù)切除治療。
引用本文: 賈昌俊,戴朝六,卜獻(xiàn)民,彭松林,徐鋒,許永慶,趙陽(yáng). 肝臟局灶性結(jié)節(jié)性增生21例的診斷與治療. 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(5): 553-554. doi: 復(fù)制
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- 1. Bosman FT, Carneiro F, Hruban RH, et al. World Health Organi-zation classification of tumours of the digestive system[M]. 4th ed.lyon:Iarc Press, 2010:198-204.
- 2. 陳伶俐, 紀(jì)元, 許建芳, 等. 肝臟局灶結(jié)節(jié)性增生238例臨床病理分析[J]. 中華病理學(xué)雜志, 2011, 40(1):17-22.
- 3. 王征旭, 胡桂芳, 吳孟超. 肝臟局灶性結(jié)節(jié)增生的診斷和治療(附21例報(bào)告)[J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2003, 10(2):147-150.
- 4. Cong WM, Dong H, Tan L, et al. Surgicopathological classification of hepatic space-occupying lesions:a single-center experience with literature review[J]. World J Gastroenterol, 2011, 17(19):2372-2378.
- 5. Kapp N, Curtis KM. Hormonal contraceptive use among women with liver tumors:a systematic review[J]. Contraception, 2009, 80(4):387-390.
- 6. Hussain SM, Terkivatan T, Zondervan PE, et al. Focal nodular hyperplasia:findings at state-of-the-art MR imaging, US, CT, and pathologic analysis[J]. Radiographics, 2004, 24(1):3-17.
- 7. 李迎春, 宋彬, 蔣莉莉, 等. 新型MR造影劑釓貝葡胺診斷肝臟局灶性結(jié)節(jié)樣增生的價(jià)值(附5例報(bào)告)[J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(5):598-604.
- 8. Rahili A, Cai J, Trastour C, et al. Spontaneous rupture andhemorrhage of hepatic focal nodular hyperplasia in lobus caudatus[J]. J Hepatobiliary Pancreat Surg, 2005, 12(2):138-142.
- 9. Langrehr JM, Pfitzmann R, Hermann M, et al. Hepatocellular carcinoma in association with hepatic focal nodular hyperplasia[J]. Acta Radiol, 2006, 47(4):340-344.