- 期刊
Clear Cell and Non-Clear Cell Hepatocellular Carcinoma: A Case Report and Literature Review
清細胞及非清細胞肝癌：病例報告
摘要
清細胞肝癌是少見的一種肝癌變異體，內含大量脂肪及肝醣，其曾被認為預後較好，但近年來則仍有爭議性。基因研究認為，diploid及non-diploid基因引導細胞分化，與肝癌預後較有關係。清細胞肝癌可分為局部與瀰漫型，而本病例含有二顆結節，分別為清細胞與非清細胞肝癌，則甚少見。本案例為61歲男性，肝臟右葉含二個相鄰的高迴音與低迴音結節。甲-胎兒蛋白6,370ng/mL，曾接受肝臟右葉第八節切除術。經病理證實分別為清細胞肝癌（高迴音）與非清細胞肝癌（低迴音）。在肝臟完全切除後，仍發生左肩骨轉移，並接受放射治療。由本例得知，合併清細胞與非清細胞肝癌，雖已完全切除腫瘤，仍須密切觀察。
並列摘要
Clear cell hepatocellular carcinoma (HCC) is an uncommon variant of HCC. It is considered to have a better prognosis than non-clear cell HCC, but recent large studies show that there is some controversy. DNA image cytometry reveals diploid and non-diploid DNA content tumors that have different pleomorphisms and mitosis corresponding to different prognoses. Clear cell HCC is classified as focal or diffuse. Herein, we report a rare case of a 61-year-old male with two adjacent hyper-and hypoechoic hepatic nodules and an α-fetoprotein concentration of 6,370ng/mL. Pathologic examination of a specimen obtained during wedge hepatectomy showed both clear cell and non-clear cell HCC. Bone metastasis was later found. We suggest that a patient with clear cell HCC should be followed up closely after complete resection.
延伸閱讀
- Lin, R. C., Jao, Y. T. F. N., Wu, C. J., & Mo, L. R. (2005). 原發性肝類癌：一病例報告. 臺灣消化醫學雜誌, 22(3), 221-229. https://doi.org/10.6557/GJT.200509_22(3).0002
- Chen, C. B., Lai, H. C., Peng, C. Y., Jeng, L. B., Ho, Y. J., & Chiang, I. P. (2005). 原發性肝類癌：－病例報告. 臺灣消化醫學雜誌, 22(2), 129-135. https://doi.org/10.6557/GJT.200506_22(2).0003
- Chan, H. H., Cheng, J. S., Lo, G. H., Lai, K. H., Wong, B. H., Pan, H. B., & Chen, C. J. (1998). 類肉瘤樣肝癌：一病例報告. 中華民國消化系醫學雜誌, 15(2), 156-162. https://doi.org/10.6557/GJTb.199806_15(2).0006
- Li, Y. H., Chang, T. A., Wang, C. K., Wang, C. S., Ting, C. C., Lin, K. Y., & Liao, L. Y. (2005). 肝實質無原發肝細胞癌之膽管內肝癌：－病例報告. 臺灣消化醫學雜誌, 22(2), 121-128. https://doi.org/10.6557/GJT.200506_22(2).0002
- 蔡明發（1988）。無症狀肝細胞癌的診治。當代醫學，(179)，694-696。https://doi.org/10.29941/MT.198809.0003