中国临床医学2016，Vol.23Issue(5)：591-596,6.DOI:10.12025/j.issn.1008-6358.2016.20160882
肝脏局灶性结节性增生的临床诊疗分析
Retrospective analysis on diagnosis and treatment of patients with focal nodular hyperplasia
摘要
Abstract
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:252 cases 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 71 years old,average age 33.3±9.1.42 patients in this group manifested clinical symptoms,accounted for 16.7%,among them 28 cases (11.1%)of patients with abdominal discomfort and 9 cases (3.57%)patients with abdominal neoplasm.80 patients manifested abnormal liver function,mainly showing moderately elevated ALT and AST;99.2%of patients was classified as Child-Pugh A.The rate of 252 FNH patients showing AFP,HBsAg positive combined with hepatic cirrhosis were 0.40%,3.17%,and 1.59%,respectively.Among the 252 patients,172 cases had ultrasound diagnostic report showing a total of 111 patients diagnosed with FNH (coincidence rate:64.53%);98 cases had ultrasound contrast showing 82 patients with a clear diagnosis of FNH (coincidence rate:83.67%);45 cases had routine and enhancement CT showing 31 patients with a clear diagnosis of FNH (coincidence rate:68.9%);142 cases had MRI showing 110 patients with a clear diagnosis of FNH (coincidence rate:77.5%).The positive rate of immunohistochemical markers CK7,CK19,CD34 and GS in 252 patients were 78.97%,71.03%,80.95%,38.89%, respectively,all manifesting characteristic expression.Conclusions:Combined with its clinical manifestation and pathological phenotypes,the characteristic of central scar changes of the FNH patients in imaging can improve the accuracy of differential rate with other hepatic tumor.In the process of diagnosis and treatment of FNH,enhanced MRI combining with contrast-enhanced ultrasound can improve the diagnostic accuracy of FNH.For those with significant clinical symptoms,rapid progression in lesions,focal hemorrhage or difficulties to identified with hepatic adenoma and hepatocellular carcinoma (HCC), surgical resection should be considered.关键词
肝脏局灶性结节性增生/肝脏肿瘤/鉴别诊断Key words
focal nodular hyperplasia (FNH)/hepatic tumors/differential diagnosis引用本文复制引用
孙超,樊嘉,杨欣荣,史颖弘,徐泱,邱双健,孙惠川,王燕,周海英,周俭..肝脏局灶性结节性增生的临床诊疗分析[J].中国临床医学,2016,23(5):591-596,6.基金项目
国家自然科学基金（81472676），上海市科委项目（14DZ1940300，14411970200）．Supported by National Natural Science Foundation of China （81472676）and Foundation of Science and Technology Commission of Shanghai Municipality （14DZ1940300，14411970200）． （）
