Abstract

目的: 探讨肝内胆管结石相关的隐匿性胆管细胞癌的临床病理特征及治疗和预后情况。 方法: 收集湖南省人民医院2014—2019年诊断的28例肝内胆管结石相关的隐匿性胆管细胞癌患者的临床信息,分析其组织学形态、免疫表型特征及治疗和预后情况。 结果: 患者男性9例,女性19例,平均年龄59岁。临床、影像、大体检查均未见占位性病变。镜下观察,所有病例均可见高级别胆管上皮内肿瘤,其中13例可见浸润癌,浸润灶直径从0.2~1.2 cm不等。免疫组织化学显示癌胚抗原(CEA)及p53在高级别胆管上皮内肿瘤及浸润癌中均为阳性,Ki-67呈核阳性表达,在浸润癌区域阳性率5%~10%。25例随访1~51个月,6例死亡,余19例无复发和转移。 结论: 肝内胆管结石合并隐匿性胆管细胞癌是临床、影像及病理都易漏诊的病例,需要提高对其的临床及病理特征的认识,但其预后及治疗尚需更多病例进一步研究。.

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