PRETEXT术前分期在40例肝母细胞瘤手术切除中的价值分析

Analysis of the PRETEXT Preoperative Staging of Hepatoblastoma for Surgical Resection

目的:分析PRETEXT术前分期系统对肝母细胞瘤手术切除的指导价值。方法:选取天津医科大学附属肿瘤医院1997年1月至2008年1月间年龄<14岁的肝母细胞瘤患者40例,均经外科手术切除,其中术前化疗32例,统计术前影像学分期与术后病理判定是否一致。结果:40例接受原发灶切除的患者,术前PRETEXT分期与术后病理判定一致28例,占70%(28/40);术前PRETEXT分期与术后病理判定不一致12例,其中超期8例,占20%(8/40),低期4例,占10%(4/40)。结论:PRETEXT术前分期提供了一个监测术前治疗效果、帮助判断患者能否手术的依据,从而体现其预后价值。

Objective： To analyze the accuracy of the PRETEXT preoperative staging and its value to guide the surgical resection of hepatoblastoma. Methods： Statistical analysis was conducted on data from 40 hepatoblastoma patients younger than 14 years who underwent tumor resection between 1997 and 2008. Preoperative chemotherapy was administered in 32 of the patients. The PRETEXT preoperative staging, modes of surgery, and the results of postoperative pathology were compared to analyze the value of the PRETEXT preoperative staging to guide surgical resection. Results： Of the 40 patients who underwent resection of the primary lesion, 28 had concordance between the PRETEXT staging and histopathology, accounting for 70% of all cases （ 28/40 ）. The remaining 12 cases had inconsistencies between the preoperative staging and postoperative histopathology, in which 8 were inappropriately assigned to more advanced stages （ 20%, 8/40 ）, and 4 were inappropriately assigned to less advanced stages （ 10%, 4/40 ）. Conclusion： PRETEXT preoperative staging provides a basis for the preoperative prognosis, and helps in evaluating whether surgery should be conducted in patients.