透明细胞型肝细胞癌1例及文献复习

肝癌电子杂志 ›› 2025, Vol. 12 ›› Issue (1): 19-23.

透明细胞型肝细胞癌1例及文献复习

王晶, 徐恩伟^*

山西省肿瘤医院病理科,太原 030013

收稿日期:2024-12-22 出版日期:2025-03-31 发布日期:2025-05-08
通讯作者: ^*徐恩伟,E-mail: xewcn@qq.com

A case of clear cell type hepatocellular carcinoma and review of literature

Wang Jing, Xu Enwei

Received:2024-12-22 Online:2025-03-31 Published:2025-05-08

摘要/Abstract

摘要： 回顾性分析2022年山西省肿瘤医院确诊的透明细胞型肝细胞癌1例,女性,年龄54岁。结合显微镜下细胞形态和免疫组织化学结果符合肝细胞癌,约70%透明细胞型,约20%普通细梁型,10%富脂型。免疫组织化学结果显示,4号切片为普通型+富脂型,Hepatocyte（+）、Ki-67增殖指数（热点区约2%+）、Arg-1（部分+）、CD10（+）、其余（-）;6号切片为透明细胞型,Hepatocyte （部分+）、CD68（组织细胞及巨细胞）（+）、其余（-）。仅单纯手术切除并定期复查,2023年2月发现肝右叶占位术后改变,腹膜后多发肿大淋巴结,未见复发转移灶。2023年9月复查发现肝左右叶多发直径71 mm以下类圆形不均低密度影,增强扫描不均匀强化,考虑均为新发转移灶,肝门、腹膜后多发肿大淋巴结。现中药治疗效果可。通过对患者进行定期观察、营养支持和健康宣讲,有助于提高患者的自我管理能力,增强其主动参与随访和复查的意识,最终提高患者的生存质量和延长生存期。

关键词: 透明细胞型肝细胞癌, 病理学, 诊断与治疗, 鉴别诊断

王晶, 徐恩伟. 透明细胞型肝细胞癌1例及文献复习[J]. 肝癌电子杂志, 2025, 12(1): 19-23.

Wang Jing, Xu Enwei. A case of clear cell type hepatocellular carcinoma and review of literature[J]. Electronic Journal of Liver Tumor, 2025, 12(1): 19-23.

参考文献

[1] NEPOMNYASHCHAYA E M, SHAPOSHNIKOV A V, YURIEVA E A.Hepatocellular carcinoma: new provisions of the WHO classification, 5th edition, 2019[J]. Arkh Patol, 2020, 82(6): 36-40.
[2] KOKUBO R, SAITO K, SHIROTA N, et al.A case of primary clear cell hepatocellular carcinoma comprised mostly of clear cells[J]. Radiol Case Rep, 2019, 14(11): 1377-1381.
[3] BANNASCH P, RIBBACK S, SU Q, et al.Clear cell hepatocellular carcinoma: origin, metabolic traits and fate of glycogenotic clear and ground glass cells[J]. Hepatobiliary Pancreat Dis Int, 2017, 16(6): 570-594.
[4] JEON J, PARK J, LEE E, et al. Huge primary clear cell hepatocellular carcinoma: a case report and review of radiologic findings[J]. Curr Med Imaging, 2023. Online ahead of print.
[5] 朱达东,林凯,陈海波. 8例原发性肝透明细胞癌的病理特征与影像学误诊分析[J]. 中西医结合肝病杂志,2019,29(4):357-360,388.
[6] 刘欣灵,林展. 透明细胞型肝细胞癌的临床及MRI特征分析[J]. 中国医疗器械信息,2022,28(22):8-10,153.
[7] HUGHES K, RADAKOVIC M, GORMAN F, et al.Immunohistochemical characterization of clear cell variant of hepatocellular carcinoma in a sheep[J]. J Comp Pathol, 2023, 204: 47-50.
[8] LEE J H, SHIN D H, PARK W Y, et al.IDH1 R132C mutation is detected in clear cell hepatocellular carcinoma by pyrosequencing[J]. World J Surg Oncol, 2017, 15(1): 82.
[9] 吕亮,宋玉燕,李同心,等. 原发性透明细胞型肝细胞癌1例[J]. 诊断病理学杂志,2021,28(11):990-992.
[10] 盛云峰,徐静,李平,等.原发性透明细胞型肝癌1例[J].肝脏,2016,21(4):331-332.
[11] KIDA K, OIDA T, MIMATSU K, et al.Hand-assisted laparoscopic hepatectomy for primary clear cell hepatocellular carcinoma of the liver[J]. Case Rep Gastroenterol, 2012, 6(2): 328-332.
[12] LIU J H, TSAI H L, HSU S M,et al.Clear cell and non-clear cell hepatocellular carcinoma: a case report and literature review[J]. Kaohsiung J Med Sci, 2004, 20(2): 78-82.
[13] EMILE J F, LEMOINE A, AZOULAY D, et al.Histological, genomic and clinical heterogeneity of clear cell hepatocellular carcinoma[J]. Histopathology, 2001, 38(3): 225-231.
[14] COWZER D, CHOU J F, WALCH H, et al.Clinicogenomic predictors of outcomes in patients with hepatocellular carcinoma treated with immunotherapy[J]. Oncologist, 2024, 29(10): 894-903.
[15] ORIKASA H, OHYAMA R, TSUKA N, et al.Lipid-rich clear-cell hepatocellular carcinoma arising in non-alcoholic steatohepatitis in a patient with diabetes mellitus[J]. J Submicrosc Cytol Pathol, 2001, 33(1-2): 195-200.