Right hepatic lobectomy for hepatocellular carcinoma which developed in primary biliary cirrhosis: Report of a case
Right hepatic lobectomy for hepatocellular carcinoma which developed in primary biliary cirrhosis: Report of a case
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肝右叶切除术治疗原发性胆汁性肝硬化肝细胞癌一例
DOI：
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
Y. Yamaoka
中科院分区：
文献类型：
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作者：
T. Morimoto;G. Honda;Y. Kawai;T. Hirose;T. Nishio;N. Shinkura;Y. Iimuro;N. Yamamoto;Yuzo Yamamoto;I. Ikai;Y. Shimahara;Y. Yamaoka
本文报告一例74岁女性因原发性胆汁性肝硬变发展为肝细胞癌而行右肝叶切除术的病例。在帕金森氏病的后续检查中，发现肝胆管相关酶和α-FetoProtein升高。诊断性影像显示主要位于后段，直径约7厘米的多血管孤立性包裹性肿瘤。抗线粒体和抗核抗体阳性和术前肝活检强烈提示PBC发生分化良好的肝细胞癌(Scheuer‘s分级II期)。根据Mayo危险评分评估PBC的自然预后良好，肝功能显示对大范围肝切除有足够的耐受性，术前CT显示右肝叶萎缩，行右肝叶切除术。病理检查显示包膜良好的中等分化的肝细胞癌，部分肿瘤内有高分化的肝细胞癌，非癌区域有II期的PBC。术后第14天CT体积测量显示残肝增大146%。通过严格的筛查及早发现肝癌和PBC将防止由于肝功能恶化而限制手术治疗。
The case of a 74-year-old female patient who underwent a right hepatic lobectomy for hepatocellular carcinoma (HCC) which developed in primary biliary cirrhosis (PBC) is reported herein. During a follow-up examination for Parkinson’s disease, an elevation of hepatobiliary tractrelated enzymes and α-fetoprotein was uncovered. Diagnostic imagings showed a hypervascular, solitary, and encapsulated tumor measuring about 7 cm in diameter located mainly in the posterior segment. Positive antimitochondrial and antinuclear antibodies and a preoperative liver biopsy strongly suggested well differentiated HCC developed in PBC (Scheuer’s classification stage II). Since the natural prognosis of PBC estimated by the Mayo risk score was fairly good and the liver function indicated sufficient tolerance for major hepatic resection, and preoperative computed tomography (CT) volumetry showed the atrophy of the right hepatic lobe, a right hepatic lobectomy was performed. A pathological examination revealed well encapsulated, moderately differentiated HCC with, in part, well-differentiated HCC in the tumor and stage II PBC in the noncancerous region. CT volumetry performed at postoperative day 14 showed a 146% enlargement of the remnant liver. An early detection of HCC and PBC by strict screening would prevent a limitation of surgical therapy due to a deteriorated liver function.
影响因子：
25.7
作者：
FARINATI, F;FLOREANI, A;CHIARAMONTE, M
通讯作者：
CHIARAMONTE, M