儿童肝细胞肝癌的临床特点及预后分析

Clinical characteristic and prognosis of pediatric hepatocellular carcinoma

目的:探讨及评价儿童肝细胞肝癌(HCC)临床病理特点及不同治疗方式后的预后情况。方法:回顾总结我院肝胆外科2004年至2010年收治的儿童(<18岁)肝细胞肝癌45例及同时期成人382例的相关资料。结果:患儿中有32例(71.1%)存在乙肝病毒(HBV)感染。45例患者全部获得随访,1年、3年和5年生存率分别为34%、4%和4%。45例患儿中有12例进行了肝切除,10例患儿接受了TAEC治疗,接受手术治疗的12名患者长期生存率明显优于其他治疗组或未接受治疗的患儿(P<0.001)。手术治疗的12例患儿与382例成人HCC手术后总体生存率相似。HBV感染与未感染的患儿长期生存无明显差异性。结论:儿童HCC的发生与HBV感染密切相关。手术可以明显延长存活时间。儿童HCC恶性度高,进展快,致其手术切除率低。其他治疗方式包括化疗需要进一步发展使患者受益。

Objective：To explore clinicopathological characteristics and prognosis of pediatric hepatocellular carcinoma（HCC） in different treatment groups.Methods：All 45 cases of pediatric HCC and 382 cases of adult HCC data were collected in our hospital.Results： Among 45 cases of pediatric HCC,32（71.1%） were hepatitis B virus（HBV） infection.All the cases were followed up.The 1-,3-and 5-year survival rates were 34%,4% and 4%,respectively.12 out of 45 underwent complete surgical resection,the overall survival rates of which was significantly better than 10 cases undergoing transarterial chemotherapy and embolization（TACE） and 19 without any treatment（P0.001）.However,overall survival rates of 12 pediatric HCC undergoing surgical resection was not significantly different from 382 cases of adult HCC undergoing surgery at the same time period（P=0.725）.Conclusion： Pediatric HCC was highly HBV related.Surgical resection was the optimal treatment in prolonging survival.However,the resection rate was low because of the highly malignant behavior of pediatric HCC.Some other adjuvant therapies should be introduced in clinics.