临床肿瘤学杂志

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41例肝脏原发性恶性血管肿瘤的临床病理特点

赵骞,刘海平,冼志红,陆新元,董辉,丛文铭   

  1. 上海东方肝胆外科医院病理科
  • 收稿日期:2013-03-13 修回日期:2013-05-13 出版日期:2013-08-31 发布日期:2013-08-31
  • 通讯作者: 丛文铭

Clinicopathological features of primary hepatic malignant vascular tumors: A analysis on 41 cases

ZHAO Qian, LIU Haiping, XIAN Zhihong, LU Xinyuan, DONG Hui, CONG Wenming.   

  1. Department of Pathology, Eastern Hepatobilliary Surgery Hospital, Second Millitary Medical University
  • Received:2013-03-13 Revised:2013-05-13 Online:2013-08-31 Published:2013-08-31
  • Contact: CONG Wenming

摘要: 目的 探讨肝脏原发性恶性血管肿瘤(PHMVT)的临床病理学及预后的特点。
方法 回顾性分析1982年1月至2012年12月在我院手术切除并经病理组织学证实的41例PHMVT,对其临床表现、病理学特点及预后进行分析。结果 41例患者中,肝上皮样血管内皮瘤(EHE) 19例(46.3%),平均瘤体直径为49cm(1.2~6.3cm);肝血管肉瘤(PHA)14例(34.1%),平均瘤体直径为8.3cm(3.0~14.0cm);肝婴儿型血管内皮瘤(IHE)5例(12.2%),平均瘤体直径为3.8cm(1.2~6.3cm);肝恶性血管外皮瘤(MHP)3例(7.3%),平均瘤体直径为7.8cm(2.1~13.0cm)。免疫组化显示41例肿瘤细胞均表达Vimentin、CD34或因子Ⅷ。EHE患者术后中位生存期为87个月,优于PHA的12个月(P<0.05);2例有完整随访资料的MHP患者分别于术后43个月死亡和术后84个月复发;IHE患者术后均无复发,预后良好。结论 PHMVT的病理类型与预后有关,PHMVT的恶性程度由高到低依次为PHA>MHP>EHE>IHE。

Abstract: Objective To investigate the clinicopathological and prognostic features of primary hepatic malignant vascular tumor(PHMVT). Methods Forty-one patients with PHMVT who underwent surgical resection and confirmed by pathology in our hospital from January 1982 to December 2012 were analyzed for their clinical manifestations, pathological characteristics and prognosis. Results Of the 41 patients, pathological classification contained 19 EHE(46.3%),14 PHA(34.1%),5 IHE(12.2%)and 3 MHP(7.3%). The average diameters of the 4 kinds tumor were followed by 4.9cm(1.2-6.3 cm), 8.3cm(3.0-14.0 cm), 3.8cm(1.2-6.3cm) and 7.8cm(2.1-13.0cm). Immunohistochemistry showed all of 41 cases expressed Vimentin, CD34 or factor Ⅷ. EHE patients showed better postoperative survival than PHA patients(87 months vs. 12 months, P<0.05). Two patients with MHP who had complete followup data, one patient relapsed at the 84th month postoperative, another died of disease in 43 months after operation. Patients with IHE recovered well with no recurrence after operation. Conclusion The prognosis of patients with PHMVT is associated with pathological types; and the malignant degree of PHMVT are in sequence of PHA>MHP>EHE>IHE.

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