背景:肝脏炎性肌纤维母细胞瘤(HIMT)在文献中很少描述。大多数出版物是单患者病例报告,缺乏关于特征的详细报告,管理,和结果。这篇系统的综述旨在评估人口统计学,临床表现,典型的成像特征,组织病理学,治疗,以及HIMT患者的预后。
方法:在MEDLINE(PubMed)进行了系统的文献检索,EMBASE(Scopus),JSTOR,CochraneCENTRAL(Cochrane图书馆),和WebofScience中包含的数据库,用于1940年至2023年之间在HIMTS上发表的研究,包括其报告的同义词。病例系列或队列研究报告了至少4例经组织学证实的HIMT患者的治疗和结果,纳入分析。
结果:筛选4553种出版物后,22篇文章,包括440例确诊的HIMT患者,符合纳入条件。平均年龄为53.4岁(范围42.0-65.0),男女比例为1.7:1。腹痛,不适,发烧,和体重减轻是最常见的症状。手术切除是HIMT的标准护理,并与3.4%的低死亡率和低疾病复发率相关。
结论:HIMT是一种更常影响中年男性的疾病。病变通常是孤立的,治疗后复发率低。手术与药物治疗的相对作用尚不清楚。临床表现的差异,组织病理学,与肝外部位的炎性肌纤维母细胞瘤(IMT)相比,HIMT的治疗可能会挑战IMT作为单一病理实体的当前观点。
BACKGROUND: Hepatic inflammatory myofibroblastic tumours (HIMTs) are rare and poorly described in the literature. Most publications are single patient case reports and lack detailed reporting on characteristics, management, and outcomes. This systematic
review aimed to assess the demography, clinical presentation, typical imaging features, histopathology, treatment, and outcomes of patients presenting with HIMTs.
METHODS: A systematic literature search was performed in MEDLINE (PubMed), EMBASE (Scopus), JSTOR, Cochrane CENTRAL (Cochrane Library), and the databases included in the Web of Science for studies published between 1940 and 2023 on HIMTs, including its reported synonyms. Case series or cohort studies that reported on the management and outcomes of at least four patients with histologically confirmed HIMTs were included in the analysis.
RESULTS: After screening 4553 publications, 22 articles including a total of 440 patients with confirmed HIMTs were eligible for inclusion. The average age was 53.4 years (range 42.0-65.0) with a male to female ratio of 1.7:1. Abdominal pain, discomfort, fever, and loss of weight were the most common presenting symptoms. Surgical resection is the standard of care for HIMTs and is associated with low mortality of 3.4% and low disease recurrence.
CONCLUSIONS: HIMT is a disease more often affecting middle-aged males. The lesions are typically solitary with low recurrence after treatment. The relative roles of surgical versus medical treatment remain unclear. Differences in clinical presentation, histopathology, and treatment of HIMTs compared to inflammatory myofibroblastic tumour (IMT) at extrahepatic sites could challenge the current view of IMT as a single pathological entity.