肝多房棘球蚴病脉管侵犯的研究进展

doi:10.12140/j.issn.1000-7423.2022.04.016

中国寄生虫学与寄生虫病杂志 ›› 2022, Vol. 40 ›› Issue (4): 516-523.doi: 10.12140/j.issn.1000-7423.2022.04.016

肝多房棘球蚴病脉管侵犯的研究进展

张婷婷¹^,²^,⁴(), 杜秋沛¹, 郭新建³, 张灵强²^,⁴, 王志鑫²^,⁴, 常正松¹^,³, 赵乾²^,⁴, 王海久²^,⁴, 侯立朝²^,⁴^,^*()

1.青海大学医学院临床医学系,西宁 810001
2.青海大学附属医院肝胆胰外科,西宁 810001
3.青海大学附属医院病理科,西宁 810001
4.青海省包虫病研究重点实验室,西宁 810001

收稿日期:2021-09-23 修回日期:2022-01-04 出版日期:2022-08-30 发布日期:2022-09-07
通讯作者: 侯立朝
作者简介:张婷婷(1995-),女,硕士研究生,从事肝胆胰相关疾病研究,E-mail： 705042690@qq.com
基金资助:
青海省包虫病临床医学研究中心项目(2017-SF-L2);青海省卫生计生委一般指导性课题(2018-wjzdx-118);青海大学附属医院中青年科研基金一般项目(ASRF-2021-YB-09)

Research progress on vascular invasion of hepatic alveolar echinococcosis

ZHANG Ting-ting¹^,²^,⁴(), DU Qiu-pei¹, GUO Xin-jian³, ZHANG Ling-qiang²^,⁴, WANG Zhi-xin²^,⁴, CHANG Zheng-song¹^,³, ZHAO Qian²^,⁴, WANG Hai-jiu²^,⁴, HOU Li-zhao²^,⁴^,^*()

1. Department of Clinical Medicine, School of Medicine,Qinghai University,Xining 810001, China
2. Department of Hepatobiliary and Pancreatic Surgery, Qinghai University Affiliated Hospital, Xining 810001, China
3. Department of Pathology, Affiliated Hospital of Qinghai University, Xining 810001, China
4. Qinghai Research Key Laboratory for Echinococcosis,Xining 810001, China

Received:2021-09-23 Revised:2022-01-04 Online:2022-08-30 Published:2022-09-07
Contact: HOU Li-zhao
Supported by:
Project of Qinghai Echinococcosis Clinical Medical Research Centre(2017-SF-L2);General Guiding Subject of Health and Family Planning Commission of Qinghai Province(2018-wjzdx-118);General Project of Young and Middle-aged Scientific Research Fund of Affiliated Hospital of Qinghai University(ASRF-2021-YB-09)

摘要/Abstract

摘要：

肝多房棘球蚴病病灶对人体重要的脉管系统（血管、胆管、淋巴结）是否侵犯及其侵犯程度,直接影响患者的手术治疗方式。目前,临床对于血管侵犯、胆管侵犯及淋巴结转移的病理状态、检查指征及治疗方式的关系尚不明确。本文综合国内外最新研究进展,对肝多房棘球蚴病的增殖与转移机制,病灶的病理分区,及脉管侵犯的肉眼、影像、显微镜下的特点进行深入阐述,以期推进肝多房棘球蚴病脉管侵犯诊断与治疗等研究的发展。

关键词: 肝多房棘球蚴病, 脉管系统, 侵犯

Abstract:

The surgical treatment for multilocular hepatic echinococcosis is determined by the severity of the lesion invasion to the important vascular system (blood vessels, bile ducts and lymph nodes). Currently, the clinical relationships among the pathological changes, examination indications and treatments of vascular invasion, bile duct invasion and lymph node metastasis are not clear. Here we have summarized recent advances worldwide in multilocular hepatic echinococcosis. The mechanisms of multilocular hepatic echinococcosis progression and metastasis, the pathological distribution of the lesions and the clinical imaging, the morphology and microscopic characteristics of the vascular invasion were reviewed. This review will shed light on the development and research of the diagnosis and treatment of vascular invasion caused by multilocular hepatic echinococcosis.

Key words: Hepatic alveolar echinococcosis, Vascular system, Invasion

中图分类号:

R532.32

张婷婷, 杜秋沛, 郭新建, 张灵强, 王志鑫, 常正松, 赵乾, 王海久, 侯立朝. 肝多房棘球蚴病脉管侵犯的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(4): 516-523.

ZHANG Ting-ting, DU Qiu-pei, GUO Xin-jian, ZHANG Ling-qiang, WANG Zhi-xin, CHANG Zheng-song, ZHAO Qian, WANG Hai-jiu, HOU Li-zhao. Research progress on vascular invasion of hepatic alveolar echinococcosis[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2022, 40(4): 516-523.

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分区	分层	特点
Ⅰ区：病灶	a：角皮层	类同心圆叠层的粉皮,无细胞结构
	第1层：坏死区	角皮层周围广泛的无结构坏死区
Ⅱ区：边缘带/ 浸润带/ 炎症反应带	第2层：内环	不规则,由上皮样细胞和中性粒细胞形成
Ⅱ区：边缘带/ 浸润带/ 炎症反应带	第3a层：内纤维环	长条形纤维化区域,由纤维胶质形成
	第4层：外环	炎症细胞带区,由大量淋巴细胞、嗜酸粒细胞、巨噬细胞、中性粒细胞、浆细胞等炎症细胞及少量反应组织细胞组成（图4-B^[10]）
	第3b层：外纤维环	额外的纤维性边缘,可见淋巴细胞浸润,部分可无该层
Ⅲ区：正常肝组织	第5层：周围肝组织	邻近肝组织,肝细胞气球样变,周围纤维组织增生、淤血、胆汁瘀滞,汇管区炎症细胞浸润

肝多房棘球蚴病脉管侵犯的研究进展

Research progress on vascular invasion of hepatic alveolar echinococcosis

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