肝内胆管细胞癌的诊断与治疗

目的：探讨肝内胆管细胞癌的诊断与治疗方法,以提高肝内胆管细胞癌的诊治水平。方法：回顾性分析我院1990年1月至2006年12月经手术和病理证实的14例肝内胆管细胞癌患者的临床资料。结果：14例患者早期症状均无特异性,血AFP检查均为阴性,血CEA检查显著升高3例,CA199升高明显1例,4例术前诊断为肝内胆管细胞癌,10例误诊;本组行根治性切除手术5例（35.7%）,姑息性手术9例。结论：肝内胆管细胞癌误诊率高,根治性手术切除率低,应进一步熟悉本病的临床特征,B超仍是首选的术前影像学检查方法。术中快速冰冻切片检查是避免误诊漏诊的重要方法,根治性手术切除是治疗本病最有效的方法。

The Diagnosis and Trentment of Intrahepatic Cholangiocarcinoma

Objective:To investigate the diagnosis and treatment of intrahepatic cholangiocarcinoma(ICC),for improving the level of diagnosis and treament of ICC.Methods:The data of 14 cases of pathologically confirmed ICC by pathology and operation in our hospital from January 1990 to December 2006 were retrospectively analyzed.Results:In the early stage,no specific symptoms were found and AFP was negative in all the 14 cases and CEA significantly increased in 3 cases,CA199 significantly increased in only 1 case.Four cases were diagnosed as suffering from ICC and the others were misdiagnosed.Of all the 14 patients,5(35.7%)underwent radical resection and 9 received palliative excision.Conclusion:The rate of misdiagnosis was high but that of radical resection was low for ICC.Knowing its clinical features well,B-US is still the first choice in preoperative radiological examinations,and intraoperative biopsy is important to avoid misdiagnosis.Radical resection is the best way for treatment of ICC.