儿童肝脏肿瘤158例临床分析

Clinical analysis of 158 children with liver tumor

目的总结儿童肝脏肿瘤临床特点,为临床早期诊断提供依据。方法收集2002年2月至2017年2月深圳市儿童医院收治的儿童肝脏肿瘤患儿158例进行病例分析。结果 158例肝脏肿瘤患儿以1岁内儿童多见(113例,71.5%)。肝脏良性肿瘤89例(56.3%),第1位是血管瘤54例,其次是婴儿肝血管内皮瘤18例;恶性肿瘤69例(43.7%),第1位是肝母细胞瘤55例;其次是肝细胞癌7例;随着年代增长,恶性肿瘤患者随之增多,差异有统计学意义(P<0.05);但随着年龄增长,恶性肿瘤呈下降趋势,差异有统计学意义(P<0.05)。结论儿童肝脏肿瘤以1岁内儿童多见。肝脏良性肿瘤以血管瘤最常见,一般无临床表现,血常规、肝功能、AFP正常;儿童肝脏恶性肿瘤以肝母细胞瘤多见,其次是肝细胞癌,临床表现为腹胀、腹块、纳差、腹痛、体质量减轻、贫血、肝酶升高、甲胎蛋白异常升高;随着年代增长,恶性肿瘤呈上升趋势,但随着年龄增长,恶性肿瘤呈下降趋势。

Objective To summarize the clinical characteristics of children with liver tumor,and to provide evidence for early clinical diagnosis.Methods One hundred and fifty-eight cases of children with liver tumor in Shenzhen Children’s Hospital from Feb.2002 to Feb.2017 were collected and analyzed.Results One hundred and fifty-eight cases of children with liver tumor were more common in children within one year old(n=113,71.5%).Benign liver tumors were 89 cases(56.3%),the first was hemangioma in 54 cases,followed by infantile hepatic hemangioendothelioma in 18 cases;69 cases(43.7%)were malignant tumors,the first was hepatoblastoma in 55 cases,followed by liver cancer in 7 cases;with the increase of the years,the malignant tumor was increased(P<0.05),but with the increase of age,the malignant tumor was decreased(P<0.05).Conclusion Children with liver tumors are often seen in children within one year old.Benign tumor of liver hemangioma is the most common in general,there are no clinical manifestations,blood routine,liver function and AFP are normal;hepatoblastoma is common in children with malignant liver tumor,the second is liver cancer,clinical manifestations are abdominal distension,abdominal mass,abdominal pain,anorexia,weight loss,anemia,liver enzymes elevated,the abnormal fetal protein increased.With the increase of the years,the incidence of malignant tumor is on the rise,but with the increase of age,the incidence of malignant tumor is decreased.