肝母细胞瘤的诊断与治疗  

The experience in the diagnosis and treatment of hepatoblastoma.

作　　者：王甘露[1] 李晓平[2] 廖彩仙[2] 

机构地区：[1]深圳市宝安区人民医院普外科,广东深圳518101 [2]南方医科大学附属医院肝胆血管外科,广东广州510515

出　　处：《临床和实验医学杂志》2006年第6期707-708,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的 探讨肝母细胞瘤的诊断与治疗方法。方法 回顾性总结南方医科大学附属南方医院1987—2005年6月收治的22例肝母细胞瘤患儿，Ⅰ期2例，Ⅱ期8倒，Ⅲ期9例，Ⅳ期3例。其中根治性手术治疗9例，姑息性手术治疗7例，单纯静脉化疗2例，单纯介入性肝动脉化疗栓塞（TACE）治疗1例，放弃治疗自动出院3例。结果 肝母细胞瘤多以无意中发现上腹部肿堤或体检时发现肝脏占位性病变为首诊：绝大多数病倒术前血清甲胎蛋白（AFP）异常升高，根治性手术治疗后均降低；B超、CT、MRI检查确诊率高，其中B超为首选方法，CT与MRI对肝母细胞瘤有很好的定性定位价值。对常规评估不能切除的6例肝母细胞瘤术前先行TACE，再行Ⅱ期外科手术切除，其中2例达到根治性效果。结论肝母细胞瘤早发现、早诊断、早治疗对提高手术根治性切除率有十分重要的意义；血清AFP的测定对该疾病的诊断及评价手术效果有重要的作用。影像学的检查对“个体化治疗方案”的选择取决定性作用；该疾病的预后取决于能否实施根治性手术，术前TACE作为一种重要的辅助治疗，为达到根治性手术创造条件和机会。Objective To evaluate the methods of diagnosis and choice of treatment for llepatoblastoma. Methods From 1987 to June 2005, 22 patients with hepatoblastoma treated in Nan Fang hospital were reviewed retrospectively. Among them, 2 cases were determined as stage I, 8 cases as stage 11,9 eases as stage Ⅲ,and 3 cases as stage IV. 9 eases were subjected to curative resection, 7 cases to alleviative resection, 2 cases to single chemotherapy, 1 case to single transcatheter arterial chemombolization（TACE）, 3 cases refusing operation and leaving hospital. Results Epigastric lump be found unawares or by physical examination was the major symptom. The concentrations of AFP in most preoperative serum were significantly higher, but lower after curative resection. Ultrasonography, CT and MR1 have a high rate of con＇ection in the diagnosis of the disease. Ultrasonography was the best choice for diagnosis of the disease. CT or MR1 had a high value of determination character and location for the distase, 6 cases of unresectable hcpatohlastoma received TACE ,and then 2 cases got to curative resection, Condusion Early discovering , diag- nosis and treatment of heputoblastoma are very important to improve its curative resection rate. The cheek - up of serum AFP play a important role to diagnose and evaluate effect of operation, Ultrasonography, CT and MR1 are crucial to choice individual, therapy methods. Its prognosis lied on the probability to put in practice curative resection, Preoperative TACE,as a significant assistant therapy method,can creative condition and chance to cutative resection.

关 键 词：肝母细胞 诊断 治疗 

分 类 号：R735.7[医药卫生—肿瘤] R563.1[医药卫生—临床医学]