The purpose of this study was to conduct a systematic review and meta-analysis of case reports presenting HCC spread to the diaphragm muscle and to determine possible risk factors for this condition. An extensive literature search was performed using the following electronic databases: MEDLINE, CINAHL, ScienceDirect, Google Scholar, and DOAJ. A total of 18 articles describing 27 hepatocellular carcinoma patients were included in this review. The presence of HCC cells in the superior liver segment is strongly associated with metastases to the diaphragm. Among the two types of diaphragm involvement by HCC cells, diaphragm infiltration occurs much more frequently than diaphragm adhesion. However, an HCC nodule in the 8th liver segment and a higher number of liver segments involved by HCC cells predispose patients to diaphragm adhesion. Hepatitis B is a risk factor for diaphragm metastases in recurrent HCC. The tumor diameter is not associated with HCC spread to the diaphragm muscle. We did not find specific symptoms reported by patients that could indicate HCC metastasis to the diaphragm muscle. The presence of hepatitis B and the localization of HCC cells in superior liver segments, especially in the 8th liver segment, should be take into consideration in the diagnostic process.
本研究旨在对肝癌转移至膈肌的病例报告进行系统性回顾与荟萃分析，以确定该病症的潜在风险因素。通过检索MEDLINE、CINAHL、ScienceDirect、Google Scholar及DOAJ电子数据库完成文献系统检索。共纳入18篇文献，涉及27例肝细胞癌患者。肝癌细胞位于肝脏上段与膈肌转移密切相关。在肝癌细胞侵犯膈肌的两种类型中，膈肌浸润的发生率显著高于膈肌粘连。然而，位于第8肝段的肝癌结节及多肝段受累更易导致膈肌粘连。乙型肝炎是复发性肝癌发生膈肌转移的风险因素。肿瘤直径与肝癌向膈肌扩散无显著关联。本研究未发现能提示肝癌膈肌转移的特异性临床症状。在诊断过程中应重点关注乙型肝炎感染状态及肝癌细胞在肝脏上段（特别是第8肝段）的定位情况。
肿瘤(癌症)患者之家