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目的探讨肝门部肝管分叉部腺癌(K latsk in瘤)的临床病理学特征及其治疗。方法复习我院近十年来16例K latsk in瘤患者的临床资料,对其存档标本进行光镜观察和免疫组织化学分析。结果患者平均年龄59岁,男∶女为2∶1。13例(81%)见明显细胞异型性,15例(94%)见神经周围浸润。行节段性胆管切除加术后放疗者平均生存期15.7个月,比仅行胆汁引流术者(平均生存9.5个月)生存期延长约6个月(P<0.01),但广泛存在术后并发症。结论K latsk in瘤是侵袭性较强的恶性肿瘤,但临床上和病理上与良性硬化性病变较难鉴别,足够的取材有助于诊断,明显的细胞异型性和神经周围浸润是两项重要的病理学指标。积极的手术治疗可延长患者的生存期。
Objective To investigate the clinicopathological features and treatment of K latsk in the hilar hepatic duct. Methods The clinical data of 16 K latsk in tumor patients in our hospital during the past 10 years were reviewed. The specimens were stained with light microscopy and immunohistochemistry. Results The average age of patients was 59 years. The male and female were 2:1.13 cases (81%) showed obvious cell atypia and 15 cases (94%) showed perineural infiltration. The mean survival time of patients undergoing segmental cholecystectomy plus postoperative radiotherapy was 15.7 months, prolonging the survival time by about 6 months (P <0.01) compared with those undergoing biliary drainage only (mean survival 9.5 months) complication. Conclusion K latsk in the tumor is a more aggressive malignant tumor, but clinical and pathological and benign sclerosis lesions more difficult to identify, enough material is helpful in the diagnosis of obvious cell atypia and perineural infiltration are two important Pathological indicators. Positive surgical treatment can extend the patient’s survival.