肝肉瘤样癌9例临床特征及诊疗分析OACSTPCD

Objective To summarize the clinical features,diagnosis and treatment plan and prognosis of patients with hepatic sarcomatoid carcinoma(HSC).Methods A retrospective study was conducted in 9 HSC patients,who admitted in Zhejiang Provincial People's Hospital between Jan.2012 and Mar.2024 and then were pathologically diagnosed as HSC postoperatively.Results Among the 9 HSC patients,there were 3 males and 6 females,aged from 33 to 90 years.Preoperative examination revealed elevated levels of tumor markers(AFP,CEA,CA199)in 4 cases.Preoperative imaging diagnosis of liver tumor in 8 patients and misdiagnosis of liver abscess in 1 patient.MRI examination of the tumor boundary was not clear,showing"progressive enhancement"or"peripheral enhancement".All the 9 HSC patients underwent laparoscopic liver tumor resection.The mean maximum tumor diameter was(6.24±3.98)cm.The AJCC stages were as follows:1 case of stage Ⅰ,4 cases of stage Ⅱ and 4 cases of stage Ⅳ.Three patients received postoperative chemotherapy,of which 1 patient received combined targeted therapy(Anlotinib+AG regime).The postoperative pathological manifestations were fusiform cell malignant tumor,immunohistochemical results showed CK(+)epithelioid phenotype and mesenchymal phenotype Vim(+)to varying degrees.Follow-up was conducted till to Mar.14,2024,the postoperative survival time in 9 HSC patients was 1.6-29.9 months,and the median survival time was 4.3 months.Conclusion HSC is highly malignant,and surgical resection is the preferred treatment.The strategy of HSC postoperative chemotherapy combined with target therapy and immune therapy needs to be further explored.