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目的总结小儿肝母细胞瘤诊治经验,探讨影响预后因素。方法回顾性分析1992年1月至2005年1月经手术、病理证实的29例肝母细胞瘤的临床资料。结果29例中TNMⅠ期8例、Ⅱ期14例、Ⅲ期6例、Ⅳ期1例;病理学类型有胎儿型18例,胚胎型5例,未分化型3例,混合型3例;行根治性切除25例(86%),姑息性切除4例(14%),并发症发生率13.7%(4/29),术后肝功能10d恢复正常。22例获随访,1、3、4年累积存活率分别为86.4%(n=19)、68.2%(n=15)、36.4%(n=8)。结论手术切除是小儿肝母细胞瘤首选的治疗方法,影响其预后的主要因素是临床分期和肿瘤组织分化程度、病理学类型。
Objective To summarize the experience of diagnosis and treatment of hepatoblastoma in children and explore the factors that affect prognosis. Methods The clinical data of 29 hepatoblastomas confirmed by surgery and pathology from January 1992 to January 2005 were retrospectively analyzed. Results Among the 29 cases, there were 8 cases in stage Ⅰ, 14 cases in stage Ⅱ, 6 cases in stage Ⅲ and 1 case in stage Ⅳ. There were 18 cases of fetal type, 5 cases of embryo type, 3 cases of undifferentiated type and 3 cases of mixed type. Radical resection in 25 cases (86%), palliative resection in 4 cases (14%), complication rate of 13.7% (4/29), postoperative liver function 10d returned to normal. Twenty-two patients were followed up. The cumulative survival rates at 1, 3 and 4 years were 86.4% (n = 19), 68.2% (n = 15) and 36.4% (n = 8), respectively. Conclusions Surgical resection is the preferred treatment for hepatoblastoma in children. The main factors that influence the prognosis of the patients are clinical staging, tumor differentiation and pathological types.