原发性肝内胆管细胞癌的诊断和手术治疗分析

目的探讨原发性肝内胆管细胞癌的诊断与手术治疗方法，以提高其诊治水平。方法回顾性分析1990年6月至2008年6月经外科治疗的18例原发性肝内胆管细胞癌患者的临床资料。结果18例患者均无特异性早期症状，其中血清甲胎蛋白（AFP）升高者2例，癌胚抗原（CEA）升高者4例，糖类抗原（CA）199升高者3例，肝硬化4例。超声诊断率11．1％（2／18），CT诊断率42．9％（6／14），MRI诊断率45．5％（5／11）。7例术前诊断为原发性肝内胆管细胞癌，11例误诊；行根治性切除术8例，姑息性切除术10例。结论原发性肝内胆管细胞癌缺乏特异性的临床表现和血清肿瘤标记物，误诊率高，根治性手术切除率低，应进一步熟悉本病的临床病理特征。根治性手术切除是治疗本病最有效的方法。

Operation analysis and diagnosis of primary intrahepatic cholangiocellular carcinoma

Objective To investigate the diagnosis and operation treatment of primary intrahepatic cholangiocellular carcinoma （PICC）, for improving the level of diagnosis and treament of PICC. Methods The clinical data of 18 cases with PICC confirmed by operation were analyzed retrospectively. Results In the early stage, no specific symptoms was found in all the 18 cases, the positive cases of AFP, CEA, CA199 and live cirrhosis were 2, 4, 3 and 4. The diagnostic rates of ultrasound examination, CT and MRI were 11.1% （2/18）, 42.9%（6/14） and 45.5% （5/11 ）. Seven cases were diagnosed as suffering from PICC and the others were misdiagnosed. Of all the 18 patients, 8 cases underwent radical resection and 10 cases received palliative excision. Conclusions PICC patients lack clinical features and serum tumor marker,the rate of misdiagnosis is high, but that of radical resection is low. Knowing its clinicopathological features well. Radical resection is the best way for treatment of PICC.