• 1.安徽醫(yī)科大學(xué)第一附屬醫(yī)院普外科（合肥230022）2.香港大學(xué)瑪麗醫(yī)院外科（香港）;

目的  探討血管壁彈性變化與肝癌自發(fā)性破裂的相關(guān)關(guān)系。
方法  選用肝癌破裂及未破裂患者的肝癌組織標(biāo)本各30例，采用免疫組化ABC法及電子顯微鏡檢測其與血管病變有關(guān)的因素： 第八因子相關(guān)抗原因子（vWF因子）、彈性硬蛋白、彈性蛋白酶（中性粒細(xì)胞性）。
結(jié)果  與未破裂組相比，肝癌破裂患者中血管內(nèi)皮vWF因子表達(dá)量明顯下降，小動脈壁中彈性蛋白酶分布異常、彈性硬蛋白增生過度、彈力膜斷裂。vWF因子為血管受損指標(biāo)之一，并參與凝血過程。上述病變的結(jié)果，導(dǎo)致患者小動脈壁脆性增加及凝血功能下降，稍遇外力的作用即易發(fā)生血管破裂，進而可導(dǎo)致腫瘤組織的破裂。
結(jié)論  肝癌患者體內(nèi)的血管壁硬變可能與肝癌腫瘤破裂有關(guān)。

引用本文： 鄒兵兵,耿小平,朱立新,熊奇如,范上達(dá). 血管硬化性病變與肝癌自發(fā)性破裂的關(guān)系. 中國普外基礎(chǔ)與臨床雜志, 2004, 11(2): 154-156. doi: 復(fù)制

1. Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma: a review of 172 Japanese cases [J]. Am J Gastroenterol， 1991; 86(1)∶67.
2. Ong GB, Chu EP, Yu FY, et al. Spontaneous rupture of hepatocellular carcinoma [Ｊ]. Br J Surg， 1965; 52∶123.
3. Chearanai O, Plengvanit U, Asavanich C, et al. Spontaneous rupture of primary hepatoma: report of 63 cases with particular reference to the pathogenesis and rationale treatment by hepatic artery ligation [Ｊ]. Cancer, 1983; 51(8)∶1532.
4. Lai EC, Wu KM, Choi TK, et al. Spontaneous ruptured hepatocellular carcinoma. An appraisal of surgical treatment [Ｊ]. Ann Surg, 1989; 210(1)∶24.
5. Kanematsu M, Imaeda T, Yamawaki Y, et al. Rupture of hepatocellular carcinoma: predictive value of CT findings [Ｊ]. AJR Am J Roentgenol, 1992; 158(6)∶1247.
6. Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma [Ｊ]. Br J Surg, 1996; 83(5)∶602.
7. Leib ES, Hibrawi H, Chia D, et al. Correlation of disease activity in systemic necrotizing vasculitis with immune complexes [Ｊ]. J Rheumatol, 1981; 8(2)∶258.
8. Assoian RK, Sporn MB. Type beta transforming growth factor in human platelets: release during platelet degranulation and action on vascular smooth muscle cells [Ｊ]. J Cell Biol, 1986; 102(4)∶1217.
9. Ross R. Plateletderived growth factor [Ｊ]. Lancet, 1989; 1(8648)∶1179.
10. Cozzolino F, Torcia M, Lucibello M, et al. Interferonalpha and interleukin 2 synergistically enhance basic fibroblast growth factor synthesis and induce release, promoting endothelial cell growth [Ｊ]. J Clin Invest, 1993; 91(6)∶2504.
11. Baugh RJ, Travis J. Human leukocyte granule elastase: rapid isolation and characterization [Ｊ]. Biochemistry, 1976; 15(4)∶836.
12. Liu JM, Davidson JM. The elastogenic effect of recombinant transforming growth factorbeta on porcine aortic smooth muscle cells [Ｊ]. Biochem Biophys Res Commun, 1988; 154(3)∶895.
  1. 1. Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma: a review of 172 Japanese cases [J]. Am J Gastroenterol， 1991; 86(1)∶67.
  2. 2. Ong GB, Chu EP, Yu FY, et al. Spontaneous rupture of hepatocellular carcinoma [Ｊ]. Br J Surg， 1965; 52∶123.
  3. 3. Chearanai O, Plengvanit U, Asavanich C, et al. Spontaneous rupture of primary hepatoma: report of 63 cases with particular reference to the pathogenesis and rationale treatment by hepatic artery ligation [Ｊ]. Cancer, 1983; 51(8)∶1532.
  4. 4. Lai EC, Wu KM, Choi TK, et al. Spontaneous ruptured hepatocellular carcinoma. An appraisal of surgical treatment [Ｊ]. Ann Surg, 1989; 210(1)∶24.
  5. 5. Kanematsu M, Imaeda T, Yamawaki Y, et al. Rupture of hepatocellular carcinoma: predictive value of CT findings [Ｊ]. AJR Am J Roentgenol, 1992; 158(6)∶1247.
  6. 6. Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma [Ｊ]. Br J Surg, 1996; 83(5)∶602.
  7. 7. Leib ES, Hibrawi H, Chia D, et al. Correlation of disease activity in systemic necrotizing vasculitis with immune complexes [Ｊ]. J Rheumatol, 1981; 8(2)∶258.
  8. 8. Assoian RK, Sporn MB. Type beta transforming growth factor in human platelets: release during platelet degranulation and action on vascular smooth muscle cells [Ｊ]. J Cell Biol, 1986; 102(4)∶1217.
  9. 9. Ross R. Plateletderived growth factor [Ｊ]. Lancet, 1989; 1(8648)∶1179.
  10. 10. Cozzolino F, Torcia M, Lucibello M, et al. Interferonalpha and interleukin 2 synergistically enhance basic fibroblast growth factor synthesis and induce release, promoting endothelial cell growth [Ｊ]. J Clin Invest, 1993; 91(6)∶2504.
  11. 11. Baugh RJ, Travis J. Human leukocyte granule elastase: rapid isolation and characterization [Ｊ]. Biochemistry, 1976; 15(4)∶836.
  12. 12. Liu JM, Davidson JM. The elastogenic effect of recombinant transforming growth factorbeta on porcine aortic smooth muscle cells [Ｊ]. Biochem Biophys Res Commun, 1988; 154(3)∶895.