Abstract：
BACKGROUND: To decide treatment of hepatic cysts diagnosis between simple hepatic cyst (SHC) and cystic mucinous neoplasm (CMN). Radiological features are not patognomonic. Some studies have suggested the utility of intracystic tumor markers.
METHODS: Retrospective analysis of our prospective database including patients treated due to symptomatic SHC from 2003 to 2021. The aim of the study was to evaluate the results of treatment of symptomatic SHC and the usefulness of the determination of intracystic \"carcinoembryonic antigen\" (CEA) and \"carbohydrate antigen\" CA 19.9.
RESULTS: 50 patients diagnosed and treated for symptomatic SHC were included. In 15 patients the first treatment was percutaneous drainage. In 35 patients the first treatment was laparoscopic fenestration. Four patients were diagnosed of premalignant or malignant liver cystic lesions (MCN, IPMN, lymphoma B); three of them required surgery after initial fenestration and pathological diagnosis. Median CEA and CA 19-9 were 196 μg/L and 227.321 U/mL respectively. Patients with malignant or premalignant pathology did not have higher levels of intracystic tumor markers. Positive predictive value was 0% for both markers, and negative predictive value was 89% and 91% respectively.
CONCLUSIONS: Values of intracystic tumor markers CEA and CA 19-9 do not allow distinguishing simple cysts from cystic liver neoplasms. The most effective treatment for symptomatic simple liver cysts is surgical fenestration. The pathological analysis of the wall of the cysts enables the correct diagnosis, allowing to indicate a surgical reintervention in cases of hepatic cyst neoplasia.
METHODS: Retrospective analysis of our prospective database including patients treated due to symptomatic SHC from 2003 to 2021. The aim of the study was to evaluate the results of treatment of symptomatic SHC and the usefulness of the determination of intracystic \"carcinoembryonic antigen\" (CEA) and \"carbohydrate antigen\" CA 19.9.
RESULTS: 50 patients diagnosed and treated for symptomatic SHC were included. In 15 patients the first treatment was percutaneous drainage. In 35 patients the first treatment was laparoscopic fenestration. Four patients were diagnosed of premalignant or malignant liver cystic lesions (MCN, IPMN, lymphoma B); three of them required surgery after initial fenestration and pathological diagnosis. Median CEA and CA 19-9 were 196 μg/L and 227.321 U/mL respectively. Patients with malignant or premalignant pathology did not have higher levels of intracystic tumor markers. Positive predictive value was 0% for both markers, and negative predictive value was 89% and 91% respectively.
CONCLUSIONS: Values of intracystic tumor markers CEA and CA 19-9 do not allow distinguishing simple cysts from cystic liver neoplasms. The most effective treatment for symptomatic simple liver cysts is surgical fenestration. The pathological analysis of the wall of the cysts enables the correct diagnosis, allowing to indicate a surgical reintervention in cases of hepatic cyst neoplasia.
摘要：
背景：确定单纯性肝囊肿（SHC）和囊性粘液性肿瘤（CMN）之间肝囊肿诊断的治疗方法。放射学特征不是patognomonic。一些研究表明囊内肿瘤标志物的实用性。
方法：回顾性分析我们的前瞻性数据库，包括2003年至2021年因有症状的SHC治疗的患者。该研究的目的是评估有症状的SHC的治疗结果以及确定囊内“癌胚抗原”（CEA）和“碳水化合物抗原”CA19.9的有用性。
结果：纳入50例诊断和治疗有症状SHC的患者。在15例患者中，首次治疗是经皮引流。在35例患者中，首次治疗是腹腔镜开窗术。4例患者被诊断为癌前或恶性肝囊性病变（MCN，IPMN,淋巴瘤B）；其中三人在初次开窗和病理诊断后需要手术。CEA和CA19-9的中位数分别为196µg/L和227.321U/mL。具有恶性或癌前病理的患者没有更高水平的囊内肿瘤标志物。两种标志物的阳性预测值均为0%，阴性预测值分别为89%和91%。
结论：囊内肿瘤标志物CEA和CA19-9的值不能区分单纯囊肿和囊性肝肿瘤。有症状的单纯性肝囊肿最有效的治疗方法是手术开窗术。对囊肿壁的病理分析可以正确诊断，允许表明在肝囊肿瘤形成的情况下进行手术再干预。
方法：回顾性分析我们的前瞻性数据库，包括2003年至2021年因有症状的SHC治疗的患者。该研究的目的是评估有症状的SHC的治疗结果以及确定囊内“癌胚抗原”（CEA）和“碳水化合物抗原”CA19.9的有用性。
结果：纳入50例诊断和治疗有症状SHC的患者。在15例患者中，首次治疗是经皮引流。在35例患者中，首次治疗是腹腔镜开窗术。4例患者被诊断为癌前或恶性肝囊性病变（MCN，IPMN,淋巴瘤B）；其中三人在初次开窗和病理诊断后需要手术。CEA和CA19-9的中位数分别为196µg/L和227.321U/mL。具有恶性或癌前病理的患者没有更高水平的囊内肿瘤标志物。两种标志物的阳性预测值均为0%，阴性预测值分别为89%和91%。
结论：囊内肿瘤标志物CEA和CA19-9的值不能区分单纯囊肿和囊性肝肿瘤。有症状的单纯性肝囊肿最有效的治疗方法是手术开窗术。对囊肿壁的病理分析可以正确诊断，允许表明在肝囊肿瘤形成的情况下进行手术再干预。
