原发性肝血管肉瘤10例临床特点及治疗

Q4 Medicine

中华肝胆外科杂志 Pub Date : 2019-12-28 DOI:10.3760/CMA.J.ISSN.1007-8118.2019.12.001

Saisai Meng, H. Hao, Xiu-xian Ma

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引用次数: 0

摘要

目的探讨原发性肝血管肉瘤的临床特点、治疗方法及疗效。方法对2012年4月至2018年7月在郑州大学第一附属医院肝胆外科就诊的10例原发性肝血管肉瘤患者进行回顾性研究。男6例，女4例，平均年龄55.1岁（39.0～71.0岁）。分析患者的临床特点、影像学表现、治疗方法及生存时间。结果10例原发性肝血管肉瘤的临床表现为非特异性，均经病理证实。3例肝脏超声表现为弥漫性回声改变，7例为边界模糊的低回声病变。CT检查发现10例占位性病变，共5例接受肝部分切除术，1例接受化疗，1例经导管动脉化疗栓塞（TACE），2例接受分子靶向治疗，1例未经治疗。从诊断到最后一次随访，接受手术切除的5名患者的生存时间分别为9个月、15个月、19个月、21个月和26个月。接受化疗的患者生存时间为7个月。接受TACE的患者的生存时间为3个月。两名患者被靶向治疗，一名存活了32个月，另一名被靶向15个月，治疗仍在继续。一名患者在未经治疗的情况下存活了1个月。结论原发性肝血管肉瘤恶性程度高，预后差。无具体临床表现和影像学表现，经病理检查证实。肝部分切除术的患者有更好的生存率。靶向治疗可能是未来治疗原发性肝血管肉瘤最有效的方法。关键词：血管肉瘤；肝脏；诊断；治疗结果

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Clinical features and treatment of ten patients with primary hepatic angiosarcoma

Objective To investigate the clinical characteristics, treatment and curative effect of primary hepatic angiosarcoma. Methods A retrospective study was conducted on 10 patients with primary hepatic angiosarcoma who were treated in the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University from April 2012 to July 2018. There were 6 males and 4 females, with an average age of 55.1 (range 39.0 to 71.0) years. The clinical features, imaging findings, treatment methods and survival time of the patients were analyzed. Results The clinical manifestations of 10 patients with primary hepatic angiosarcoma were non-specific and all were confirmed by pathology. Three cases had diffuse liver echo changes on ultrasound, and 7 cases had hypoechoic lesions with blurred borders. Space occupying lesions were found in 10 cases by CT. A total of five patients underwent partial hepatectomy, 1 case received chemotherapy, 1 case received transcatheter arterial chemoembolization (TACE), 2 case received molecular targeted therapy, and 1 case was untreated. From diagnosis to the last follow-up, the survival time of the 5 patients receiving surgical resection were 9 months, 15 months, 19 months, 21 months and 26 months. The survival time of the patient receiving chemotherapy was 7 months. The survival time of the patient receiving TACE was 3 months. Two patients were targeted for treatment, one survived for 32 months, another had been targeted for 15 months, and treatment was continuing. One patient survived for 1 month without treatment. Conclusions Primary hepatic angiosarcoma has a high degree of malignancy and a poor prognosis. No specific clinical manifestations and imaging findings, confirmed by pathological examination. Patients with partial hepatectomy have a better survival. Targeted therapy may be the most effective treatment for primary hepatic angiosarcoma in the future. Key words: Hemangiosarcoma; Liver; Diagnosis; Treatment outcome

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来源期刊

中华肝胆外科杂志 Medicine-Gastroenterology

CiteScore

0.20

自引率

0.00%

发文量

7101

期刊介绍： Chinese Journal of Hepatobiliary Surgery is an academic journal organized by the Chinese Medical Association and supervised by the China Association for Science and Technology, founded in 1995. The journal has the following columns: review, hot spotlight, academic thinking, thesis, experimental research, short thesis, case report, synthesis, etc. The journal has been recognized by Beida Journal (Chinese Journal of Humanities and Social Sciences). Chinese Journal of Hepatobiliary Surgery has been included in famous databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Source Journals of China Science Citation Database (with Extended Version) and so on, and it is one of the national key academic journals under the supervision of China Association for Science and Technology.