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目的总结儿童原发性肝癌(primary liver cancer,PLC)临床特点,探讨其防治策略。方法回顾总结我院收治的27例儿童PLC相关资料。结果在我院确诊的27例PLC的患儿中,有18例(66.7%)为HBV感染者。有18例存在肝硬化基础,其中失代偿期12例。22例有不同的肝病背景,但另外5例无任何肝病基础。Child-Pugh分级A级15例,B级11例,C级1例;临床肝癌巴塞罗那(Barcelona clinic liver cancer,BCLC)分期A期8例,B期3例,C期14例,D期2例。27例中行肝切除术的仅有2例,行肝动脉化疗栓塞术者3例,行射频消融术者3例,患者经治疗后预后较好。结论 27例PLC儿童基础疾病大多数为慢性乙型肝炎(67%),有肝硬化基础者更易发生。儿童PLC恶性度高、进展快,致其手术切除率低。防止感染HBV,积极治疗慢性乙型肝炎患者尤其是肝硬化患者,加强高危人群肝癌的筛查和监管,对于儿童PLC的防治至关重要。
Objective To summarize the clinical features of children with primary liver cancer (PLC) and to explore the strategies of prevention and treatment. Methods To review and summarize the PLC-related data of 27 children admitted in our hospital. Results Of the 27 children diagnosed with PLC in our hospital, 18 (66.7%) were HBV infected. There are 18 cases of liver cirrhosis, of which 12 cases of decompensation. Twenty-two had different liver disease backgrounds, but the other five had no liver disease basis. There were 15 cases of grade A, 11 cases of grade B and 1 case of grade C in Child-Pugh class A, 8 cases of stage A, 3 cases of stage B, 14 cases of stage C, and 2 cases of stage D in Barcelona clinic liver cancer . There were only 2 cases of hepatectomy in 27 cases, 3 cases of transcatheter arterial chemoembolization in hepatic artery and 3 cases of radiofrequency catheter ablation. The prognosis was good after treatment. Conclusions Most of the 27 cases of PLC-based childhood diseases are chronic hepatitis B (67%), and those with basic cirrhosis are more likely to develop. Childhood PLC high degree of malignancy, rapid progress, resulting in low surgical resection rate. Prevent infection with HBV, active treatment of patients with chronic hepatitis B, especially cirrhosis patients, to strengthen screening and supervision of high-risk groups of liver cancer, prevention and treatment of children’s PLC is essential.