小儿肝脏恶性肿瘤的诊断和治疗

DIAGNOSIS AND TREATMENT FOR LIVER MALIGNENT TUMOR IN CHILDREN

目的 报告小儿肝脏恶性肿瘤的诊断和治疗。方法 近 10年间 2 6例小儿原发性肝脏恶性肿瘤病例。其中 ,14例经手术、介入等治疗列为治疗组。另 12例因病情严重放弃治疗 ,列为非治疗组。结果 2 6例肝脏恶性肿瘤中肝细胞癌 (HCC) 19例 (73.0 8% ) ,肝母细胞瘤 (HB) 5例 (19.2 3% ) ,恶性间叶瘤和横纹肌肉瘤各一例。 2 1例以 B超为首次肝脏肿瘤确诊方法。 HCC病例中 73.6 8%HBs Ag为阳性 ;非治疗组病儿均在一年内死亡 ;治疗组中 ,HCC切除治疗和介入治疗平均存活时间分别是 2 3.2和 2 .5个月。非HCC组肿瘤切除后多数长期存活。结论 1本组 HCC已显著多于 HB,乙肝病毒感染是重要原因。 2 HCC切除率低 ,预后差 ,但手术切除仍是延长病儿存活期的最好方法。 3非 HCC肿瘤的手术切除效果远好于 HCC。

Objective To report the diagnosis and treatment for liver malignent tumor in children.Methods Over the past 10 years ,26 children with primery liver malignent tumor were reported.Among those patients,14 cases who underwent operation or intervene treating were divided into treatment group, and the remainders without any treatment were divided into untreatment group.Result 19(73.18%) were Hepatocellular Carcinoma(HCC) and 5(19.23%) Hepatoblastoma (HB),1 sarcoma and rhabdomyosarcoma in 1 patient respectively.Ultrasonic exemination as first diagnositic way was perfomed in 21 patients.The HBsAg positive rate was 73.68% in patients with HCC.The all patients in untreatment group died within 1 year after diagnosed.The mean survival time of HCC patients with resection or intervene treating were only 23.2 and 2.5 months respectively,the no-HCC tumor paitnets who underwent operation obtained a longer survival time.Conclusion The number of HCC cases were larger then that of HB in our unit,and HBV infection may be the leading cause.Although there are a rather low resction rate and poor prognosis in chilren with HCC,sugery is still the best treatment method to prolong the patient's survival time.The results of resecction for no-HCC tumors were better than that of HCC.