非酒精性脂肪肝病相关肝癌4例

摘要

目的 分析非酒精性脂肪肝病(NAFLD)相关肝癌患者的临床特点.方法 回顾性分析2010年6月至2015年6月收治的4例NAFLD相关肝癌患者资料,分析其病史、实验室检查、影像学特点、治疗方式及预后.结果 4例患者均有脂肪肝病史,1例患者有甲胎蛋白(AFP)升高,2例患者术前影像学诊断为血管瘤,但术后病理证实为肝癌.4例患者均接受手术治疗,2例为高分化肝癌,中分化和低分化肝癌各1例.术后均无并发症,平均住院时间为9.5d.术后随访6个月至5年,患者均无复发.结论 对于合并肝脏占位的脂肪肝患者,应考虑肝癌的可能性.即使影像学表现不典型,仍应进一步明确诊断或密切随访,以避免误诊而耽误治疗.%Objective To study the clinical features of non-alcoholic fatty liver disease (NAFLD)-associated hepatocellular carcinoma (HCC).Methods We retrospectively analyzed four patients with NAFLD-associated HCC and summarized their clinical history,laboratory tests,imaging features,treatment and prognosis.Results All the 4 patients had NAFLD and one had elevated AFP.Two patients were initially diagnosed to have an hemangioma according to their imaging findings,but HCC was confirmed by postoperative histopathology.All the 4 patients underwent surgery and were discharged home with no complication.The mean hospitalization stay after surgery was 9.5 days.They were followed up from 6 months to 5 years and no tumor recurrence was detected.Conclusions HCC might be present in NAFLD patients with hepatic lesions.Further examinations should be conducted to avoid a misdiagnosis in these patients.