实用器官移植电子杂志

实用器官移植电子杂志 ›› 2019, Vol. 7 ›› Issue (1): 44-47.DOI: 10.3969/j.issn.2095-5332.2019.01.012

• 论著 • 上一篇    下一篇

肝移植治疗非肝细胞肝癌的肝脏恶性肿瘤：单中心病例分析

李俊杰，汪笑冬，马明，郑虹   

  1. 天津医科大学一中心临床学院，天津市第一中心医院器 官移植中心，天津 300192
  • 出版日期:2019-01-20 发布日期:2021-06-23
  • 基金资助:
    天津市科委慢性病防治科技重大专项（17ZXMFSY00040）

Li Junjie，Wang Xiaodong，Ma Ming，Zheng Hong. 

Li Junjie，Wang Xiaodong，Ma Ming，Zheng Hong.    

  1. Tianjin First Center Hospital of Medical University of Tianjin; Tianjin First Center Hospital，Organ Transplantation Center， Tianjin 300192， China.
  • Online:2019-01-20 Published:2021-06-23

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摘要：

目的 研究肝移植治疗非肝细胞肝癌的肝脏恶性肿瘤的价值。方法 回顾性分析了天津市第一中心医院器官移植中心进行的 40 例成人非肝细胞肝癌接受肝移植的患者资料。其中肝内胆管细胞癌患者 23 例，肝母细胞瘤患者 2 例，纤维板层肝细胞癌 1 例，恶性血管内皮细胞瘤 1 例，肝上皮样血管内皮瘤 2 例，肝脏血管肉瘤 1 例，肝脏多发低分化软组织血管肉瘤 1 例，转移性腺癌 4 例，结直肠癌转移 3 例，膀胱癌转移 1 例，神经内分泌肿瘤转移 2 例，胃肠道间质瘤肝转移 2 例，小细胞淋巴瘤肝脏受累 1 例。结果23 例胆管细胞癌患者中，1 例患者因围术期肝内严重感染死亡。12 例患者出现复发。肝母细胞瘤患者2 例，1 例因复发死亡 ；另 1 例无瘤存活。纤维板层肝细胞癌 1 例，因肿瘤复发死亡。恶性血管内皮细胞瘤 1 例，术后复发死亡。上皮样血管内皮瘤 2 例，1 例围术期死亡，1 例无瘤存活。肝肉瘤 2 例，复发死亡。结直肠癌肝转移 3 例，1 例无瘤存活。膀胱癌肝转移 1 例，复发死亡。神经内分泌肿瘤肝转移 2 例，均存活。胃肠道间质瘤肝脏转移 2 例，1 例围术期死亡，1 例存活。结论 部分胆管细胞癌、肝母细胞瘤、上皮样血管内皮瘤以及神经内分泌肿瘤肝转移、胃肠道间质瘤肝转移患者，肝移植术后能取得良好效果。但部分胆管细胞癌、部分肝母细胞瘤、肝肉瘤则预后较差。 

关键词: 肝移植 , 非肝细胞癌肝恶性肿瘤

Abstract:

Objective To study the value of liver transplantation in the treatment of non-hepatocellularcarcinoma （HCC） malignant liver tumors. Methods The data of 40 adult patients with non-HCC malignancy who underwent liver transplantation were retrospectively analyzed. Among them, 23 cases were intrahepatic cholangiocarcinoma and 2 cases were hepatblastoma. There was 1 case of fibrous lamellar hepatocellularcarcinoma. One case of malignant hemangioma. Two cases of hepatic epithelioid hemangioendothelioma. One case of hepatic angiosarcoma. Multiple low differentiated soft tissue angiosarcoma of the liver was seen in 1 case. Metastatic adenocarcinoma was seen in 4 cases, colorectal cancer metastasis was seen in 3 cases, bladdercancer metastasis was seen in 1 case. Neuroendocrine tumors metastases was seen in 2 cases. There were 2 cases of liver metastases from gastrointestinal stromal tumors. Small cell lymphoma liver involvement was seen in 1 case. Results Of the 23 patients with cholangiocarcinoma, one died of severe intrahepatic infection.Recurrence occurred in 12 patients. One case of hepatblastoma died of recurrence. The other one survived without tumor. 1 case of fibrous lamellar hepatocellular carcinoma died of tumor recurrence. One case of malignant hemangioperangioma died after operation. There were 2 cases of epithelioid hemangioendothelioma, 1 case died during perioperative period, and 1 case survived without tumor. Two cases of hepatic sarcoma recurred and died. Three cases were liver metastases from colorectal cancer and 1 case survived without tumor. One case of liver metastases from bladder cancer recurred and died. Two cases of liver metastases from neuroendocrine tumors survived. There were 2 cases of liver metastases from gastrointestinal stromal tumors, 1 case died during perioperative period, and 1 case survived. Conclusion Some patients with cholangiocarcinoma, hepatoblastoma, epithelioid hemangioendothelioma, neuroendocrine tumor, liver metastasis and gastrointestinal stromal tumors have good results after liver transplantation. However, some cholangiocarcinoma, partial hepatoma and sarcoma of liver have poor prognosis.

Key words: Liver transplantation, Malignant liver tumors of non HCC

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