小儿肝脏恶性肿瘤的临床与病理分析

Clinical and pathological analysis of children malignant liver tumor

目的分析儿童肝脏恶性肿瘤在临床方面的病理类型和甲胎蛋白的水平,以及预后的特点。方法选择确诊的48例肝脏恶性肿瘤患儿,以病理的不同划分为肝母细胞瘤组和肝细胞癌组,将两组的年龄、临床表现、甲胎蛋白阳性率、乙肝病毒感染率、手术完整切除率等进行比较。结果 48例患者中26例因腹部肿块入院,其中病理分类以肝母细胞瘤为主。而肝母细胞瘤组的平均发病年龄、乙肝病毒感染率低于均肝细胞癌组(P<0.05),但是手术的完整切除率和1年存活率却高于肝细胞癌组(P<0.05)。结论儿童肝脏恶性肿瘤最开始总以腹部肿块为主发病原因。肝细胞癌患者的乙肝病毒感染率高于肝母细胞瘤;且肝母细胞瘤患者的发病年龄比肝细胞癌小,手术完成切除率较高,预后效果好。

Objective To analyze clinical pathological types and characteristics of AFP level and prognosis of children malignant liver tumors. Methods 48 cases of malignant liver tumor were divided into hepatoblastoma group and hepatocellular carcinoma group based on pathology, two groups were compared in age, clinical manifestations, AFP positive, hepatitis B virus infection, complete surgical resection rate and so on. Results In 48 patients, 26 patients were sent to hospital because of abdominal mass and the pathology classification was priority to hepatoblastoma. The average onset age and hepatitis B virus （HBV） infection in hepatoblastoma group were lower than those in hepatocellular hepatoblastoma group （P 〈 0.05） , but the complete resection rate and 1 year survival rate in hepatoblastoma group were high- er than those in hepatocellular carcinoma group （P 〈 0.05）. Conclusion The main cause of children malignant liver tumors is abdominal mass. Hepatitis B virus infection was higher in hepatocellular carcinoma patients than that in hepatoblastoma patients; compared with hepatocellular carcinoma patients, the age of onset is smaller, the surgery removal rate is higher, the prognostic effect is better in hepatoblastoma group.