肝脏局灶性结节性增生的临床诊疗分析

目的：探讨肝脏局灶性结节性增生（focal nodular hyperplasia,FNH）患者的临床特点、影像和病理学特征及临床诊治。方法：回顾性分析复旦大学附属中山医院2006年6月至2014年7月期间进行手术切除252例FNH患者临床资料,并选取典型病例,从影像学、病理学等方面与其他肝脏良、恶性肿瘤进行对比和分析。结果：252例患者中,172例患者经彩超检查,拟诊断为FNH者111例,诊断符合率为64.53%;98例患者行超声造影检查,明确诊断为FNH者82例,诊断符合率为83.67%;45例患者行CT平扫加增强检查,明确诊断为FNH者31例,诊断符合率为68.9%;142例患者行MRI...

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Published in中国临床医学 Vol. 23; no. 5; pp. 591 - 596
Main Author 孙超 杨欣荣 史颖弘 徐泱 邱双健 孙惠川 王燕 周海英 周俭 樊嘉
Format Journal Article
LanguageChinese
Published 复旦大学附属中山医院肝外科，复旦大学肝癌研究所，上海 200032 2016
Subjects
肝脏局灶性结节性增生
肝脏肿瘤
鉴别诊断
鉴别诊断
hepatic tumors
differential diagnosis
肝脏局灶性结节性增生
肝脏肿瘤
focal nodular hyperplasia (FNH)
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ISSN1008-6358
DOI10.12025/j.issn.1008-6358.2016.20160882

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Summary:目的：探讨肝脏局灶性结节性增生（focal nodular hyperplasia,FNH）患者的临床特点、影像和病理学特征及临床诊治。方法：回顾性分析复旦大学附属中山医院2006年6月至2014年7月期间进行手术切除252例FNH患者临床资料,并选取典型病例,从影像学、病理学等方面与其他肝脏良、恶性肿瘤进行对比和分析。结果：252例患者中,172例患者经彩超检查,拟诊断为FNH者111例,诊断符合率为64.53%;98例患者行超声造影检查,明确诊断为FNH者82例,诊断符合率为83.67%;45例患者行CT平扫加增强检查,明确诊断为FNH者31例,诊断符合率为68.9%;142例患者行MRI检查,明确诊断为FNH者110例,诊断符合率为77.5%。免疫组化标志物检查显示,CK7、CK19、CD34、GS在252例患者中阳性率分别为78.97%、71.03%、80.95%、38.89%,并呈特征性表达。结论：FNH在影像学上表现出特征性的中央瘢痕改变,可以结合患者的临床表现及病理表型,提高与其他肝脏肿瘤鉴别的准确性。在FNH的诊治过程中,增强MRI结合超声造影可以提高FNH的诊断准确率。对于临床症状明显、短期内病灶显著增大或出现病灶内出血、与肝腺瘤及肝细胞癌鉴别困难者,则需考虑手术切除。
Bibliography:focal nodular hyperplasia（FNH）; hepatic tumors; differential diagnosis
31-1794/R
Objective：To study the clinical features,imaging and pathological characteristics,as well as the clinical diagnosis and treatment of patients with hepatic focal nodular hyperplasia（FNH）.Methods：Retrospective analysis was used in observing the clinical data of the 252 cases of FNH patients experiencing the surgical removal in Zhongshan hospital affiliated to Fudan University during June 2006 to July 2006,among which the typical cases were selected for the comparison of imaging and pathologic features with benign and malignant tumor.Results：252cases of FNH patients were recruited,150 cases of male and 102 cases of female,the sex ratio of 1.47∶1,age from 15 to 71years old,average age 33.3±9.1.42 patients in this group manifested clinical symptoms,accounted for 16.7%,among them 28cases（11.1%）of patients with abdominal discomfort and 9cases（3.57%）patients with abdominal neoplasm.80 patients manifested abnormal liver function,mainly show
ISSN:1008-6358
DOI:10.12025/j.issn.1008-6358.2016.20160882