• 安徽醫(yī)科大學(xué)第一附屬醫(yī)院普外科(合肥230032);

目的 探討肝癌自發(fā)性破裂的機(jī)理。
方法采用文獻(xiàn)回顧的方法，對(duì)肝癌自發(fā)性破裂患者的資料加以綜述。
結(jié)果肝癌自發(fā)性破裂的患者體內(nèi)抗原抗體復(fù)合物積聚并沉積在小動(dòng)脈壁彈力膜上，在其沉積處的小動(dòng)脈壁存在血管受損現(xiàn)象。
結(jié)論乙肝病毒感染所形成的抗原抗體復(fù)合物沉積在血管壁導(dǎo)致小動(dòng)脈脆性病變，可能與肝癌自發(fā)性破裂出血有關(guān)。

引用本文： 呂成超,朱立新. 肝癌自發(fā)性破裂機(jī)理的研究進(jìn)展. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(2): 181-183. doi: 復(fù)制

1. Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma: a review of 172 Japanese cases [J]. Am J Gastroenterol， 1991; 86(1)∶67.
2. 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.
3. Kew MC, Hodkinson J. Rupture of hepatocellular carcinoma as a result of blunt abdominal trauma [J]. Am J Gastroenterol， 1991; 86(8)∶1083.
4. Hermann RE, David TE. Spontaneous rupture of the liver caused by hepatomas [J]. Surgery， 1973; 74(5)∶715.
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. Nagasue N, Inokuchi K, Kobayashi M, et al. Hepatoportal arteriovenous fistula in primary carcinoma of the liver [J]. Surg Gynecol Obstet， 1977; 145(4)∶504.
7. Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma [J]. Br J Surg， 1996; 83(5)∶602.
8. Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury [J]. Arch Surg, 2001; 136(6)∶682.
9. Zhu LX, Liu Y, Fan ST. Ultrastructural study of the vascular endothelium of patients with spontaneous rupture of hepatocellular carcinoma [J]. Asian J Surg, 2002; 25(2)∶157.
10. Zhu LX, Meng XL, Fan ST. Elasticity of small artery in patient with spontaneous rupture of hepatocellular carcinoma [J]. Hepatol Res, 2004; 29(1)∶13.
11. 朱立新， 耿小平， 范上達(dá). 肝癌自發(fā)性破裂與抗原抗體復(fù)合物的庫管沉積 [J]. 中華肝膽外科雜志， 2001； 7（11）∶674.
12. Cooper NR Eds. Adv immunol [M]. New York： Hirsch, 1985∶151-216.
13. Fan PT, Davis JA, Somer T, et al. A clinical approach to systemic vasculitis [J]. Semin Arthritis Rheum, 1980; 9(4)∶248.
14. 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.
15. 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.
16. Ross R. Plateletdrived growth factor [J]. Lancet, 1989; 1(8648)∶179.
17. 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.
18. Ghadially FN Eds. Ultrastructure pathology of the cell and matrix [M]. London: Butterworths, 1988∶1099-1129.
19. Johannessen JV Eds. Electron microscopy in human medicine [M]. New York: McGAWHALL, 1980∶94-154.
20. Tsuboi R, Sato Y, Rifkin DB. Correlation of cell migration, cell invasion, receptor number, proteinase production, and basic fibroblast growth factor levels in endothelial cells [J]. J Cell Biol, 1990; 110(2)∶511.
21. James TW, Wagner R, White LA, et al. Induction of collagenase and stromelysin gene expression by mechanical injury in a vascular smooth musclederived cell line [J]. J Cell Physiol, 1993; 157(2)∶426.
22. Dobrin PB, Mrkvicka R. Failure of elastin or collagen as possible critical connective tissue alterations underlying aneurysmal dilatation [J]. Cardiovasc Surg， 1994; 2(4)∶484.
23. Liu CL, Fan ST, Lo CM, et al. Management of spontaneous rupture of hepatocellular carcinoma: singlecenter experience [J]. J Clin Oncol， 2001; 19(17)∶3725.
  1. 1. Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma: a review of 172 Japanese cases [J]. Am J Gastroenterol， 1991; 86(1)∶67.
  2. 2. 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.
  3. 3. Kew MC, Hodkinson J. Rupture of hepatocellular carcinoma as a result of blunt abdominal trauma [J]. Am J Gastroenterol， 1991; 86(8)∶1083.
  4. 4. Hermann RE, David TE. Spontaneous rupture of the liver caused by hepatomas [J]. Surgery， 1973; 74(5)∶715.
  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. Nagasue N, Inokuchi K, Kobayashi M, et al. Hepatoportal arteriovenous fistula in primary carcinoma of the liver [J]. Surg Gynecol Obstet， 1977; 145(4)∶504.
  7. 7. Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma [J]. Br J Surg， 1996; 83(5)∶602.
  8. 8. Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury [J]. Arch Surg, 2001; 136(6)∶682.
  9. 9. Zhu LX, Liu Y, Fan ST. Ultrastructural study of the vascular endothelium of patients with spontaneous rupture of hepatocellular carcinoma [J]. Asian J Surg, 2002; 25(2)∶157.
  10. 10. Zhu LX, Meng XL, Fan ST. Elasticity of small artery in patient with spontaneous rupture of hepatocellular carcinoma [J]. Hepatol Res, 2004; 29(1)∶13.
  11. 11. 朱立新， 耿小平， 范上達(dá). 肝癌自發(fā)性破裂與抗原抗體復(fù)合物的庫管沉積 [J]. 中華肝膽外科雜志， 2001； 7（11）∶674.
  12. 12. Cooper NR Eds. Adv immunol [M]. New York： Hirsch, 1985∶151-216.
  13. 13. Fan PT, Davis JA, Somer T, et al. A clinical approach to systemic vasculitis [J]. Semin Arthritis Rheum, 1980; 9(4)∶248.
  14. 14. 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.
  15. 15. 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.
  16. 16. Ross R. Plateletdrived growth factor [J]. Lancet, 1989; 1(8648)∶179.
  17. 17. 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.
  18. 18. Ghadially FN Eds. Ultrastructure pathology of the cell and matrix [M]. London: Butterworths, 1988∶1099-1129.
  19. 19. Johannessen JV Eds. Electron microscopy in human medicine [M]. New York: McGAWHALL, 1980∶94-154.
  20. 20. Tsuboi R, Sato Y, Rifkin DB. Correlation of cell migration, cell invasion, receptor number, proteinase production, and basic fibroblast growth factor levels in endothelial cells [J]. J Cell Biol, 1990; 110(2)∶511.
  21. 21. James TW, Wagner R, White LA, et al. Induction of collagenase and stromelysin gene expression by mechanical injury in a vascular smooth musclederived cell line [J]. J Cell Physiol, 1993; 157(2)∶426.
  22. 22. Dobrin PB, Mrkvicka R. Failure of elastin or collagen as possible critical connective tissue alterations underlying aneurysmal dilatation [J]. Cardiovasc Surg， 1994; 2(4)∶484.
  23. 23. Liu CL, Fan ST, Lo CM, et al. Management of spontaneous rupture of hepatocellular carcinoma: singlecenter experience [J]. J Clin Oncol， 2001; 19(17)∶3725.