Clinicopathology Analysis Of 50 Cases Of Focal Nodular Hyperplasia Of Liver

Background:Focal nodular hyperplasia(FNH)of the liver is a common benign liver disease second only to hepatic hemangioma.In fact,it is not a real tumor,but a reactive hyperplasia of hepatocytes caused by local blood circulation disorders or vascular injury of the liver,and does not become malignant.With the continuous development of medical technology,the research on the disease has been gradually strengthened.However,the etiology and pathogenesis of FNH are still unclear,and the identification of some benign and malignant tumors of the liver is unclear,and the treatment methods are controversial.These issues deserve further discussion.This study analyzed the clinicopathological and surgical prognosis of FNH,in order to provide reference for the diagnosis and treatment of the disease in clinical work.Objective:By analyzing the clinical manifestations,imaging data,surgical resection effects,and postoperative pathology of focal nodular hyperplasia of the liver,we hope to provide some references for the clinical diagnosis and treatment of FNH.Objects and methods:From June 2018 to December 2021,50 cases of focal nodular hyperplasia of the liver were collected from Nanfang Hospital.The clinical and pathological characteristics and surgical results were retrospectively analyzed.Outcome:1.Among the 50 patients who underwent surgical resection,18(36%)were male and 32(64%)were female,of which 2 women had a history of contraceptive use;six patients were hospitalized due to upper abdominal pain,2 patients were hospitalized due to abdominal distension,and 1 patient was hospitalized due to vomiting.The remaining 41 patients had no clinical symptoms.All patients had no history of hepatitis B cirrhosis,and HbsAg index was negative.All patients were negative for hepatitis C virus antibody.2.A total of 60 lesions were found in 50 patients.In color Doppler ultrasonography,30 cases showed low or slightly low echo,4 cases showed equal echo,6 cases showed slightly high echo,and 6 cases showed uneven echo.Contrast-enhanced ultrasonography was performed in 11 cases,and 6 cases were diagnosed,with a diagnosis rate of 54.5%.In this study,37 cases underwent CT enhanced scan,19 cases were diagnosed,the diagnosis rate was 51.4%;13 cases underwent MRI plain scan and enhanced scan,9 cases were diagnosed,the diagnosis rate was 69.2%.Four patients underwent preoperative liver biopsy,and one of them was diagnosed.3.The operation time was 44min-336min(mean 179.18min),and the intraoperative blood loss was 3ml-700ml(mean 158.36ml).Compared with open surgery,laparoscopic surgery had less blood loss(p<0.05),shorter postoperative hospital stay(p<0.05),and no significant difference in operation time and postoperative exhaust time.4.Ten patients underwent intraoperative frozen pathological examination,and 6 patients were prompted as FNH,with a diagnostic rate of 60%.Gross pathology showed capsule in 4 cases and central scar in 13 cases.Under the microscope,23 cases showed central vein,27 cases showed small bile duct hyperplasia,and 16 cases showed lymphocyte infiltration.The thickness of hepatic plate was less than 2 layers in 3 cases.37 cases were classical,accounting for 74%,and the remaining 26%were non-classical,which was consistent with the incidence of FNH(P<0.05).Postoperative routine immunohistochemical examination showed that GPC3 and AFP were negative.Ki67 was less than 10%.The positive rates of CK19 and GS were 85.71%and 85.71%respectively.Conclusion:1.FNH is a common benign tumor of the liver,with a high incidence in people aged 20-40 years old,and more women than men.It generally has little effect on liver function.FNH is mainly diagnosed by imaging.CT,MRI and CEUS are all helpful for the preoperative diagnosis of FNH,and the diagnostic rate of enhanced MRI is higher than that of other examination methods.The diagnostic value of tumor markers CA199,CEA and AFP for FNH is not high.2.The most common pathological type of FNH is classic.The positive rates of CK7,CK19,CD34 and GS were high,GPC3 and AFP were often negative,and Ki67 expression was often<10%,indicating that the cell proliferation of FNH was not active,but the proliferation of vascular and bile duct endothelial cells was active.3.Compared with traditional open surgery,laparoscopic surgery has the advantages of less intraoperative blood loss and shorter postoperative hospital stay.4.FNH generally does not appear more serious complications after surgery,and the recurrence rate is low.Postoperative follow-up showed no malignant change.