儿童肝脏恶性肿瘤52例分析  

Malignant liver tumor in children and 52 cases reported

作　　者：王中林[1] 王晓红[1] 王岱明[1] 

机构地区：[1]复旦大学附属儿科医院感染科肝病中心,上海200032

出　　处：《复旦学报（医学版）》2008年第1期133-135,共3页Fudan University Journal of Medical Sciences

摘　　要：目的研究儿童肝脏恶性肿瘤的临床特点。方法回顾性分析1990-2005年期间收住我院诊断为肝脏恶性肿瘤的52例患临床和病理。结果52例中男：女2．7：1。分类以肝母细胞瘤为主（29／52），其次为肝细胞肝癌（12／52）。肝母细胞瘤较多发生在小年龄儿童，29例肝母细胞瘤中24例（82．8％）〈6岁，而12例肝细胞癌中5例（41．7％）〈6岁。HBsAg阳性在肝细胞癌多见，12例肝细胞癌中5例HBsAg标记阳性，29例肝母细胞瘤中仅2例阳性，两者差别有统计学意义（P=0．03）。本组肝肿瘤患儿临床表现大多为腹块、腹胀或腹痛。常见体征有肝肿大、脾肿大等。B超和CT等影像学检查示右肝叶病变为多。甲胎蛋白阳性71．4％。结论儿童肝脏恶性肿瘤多见于男孩，以肝母细胞瘤为多；肝细胞癌患儿乙肝病毒携带率高于肝母细胞瘤，显示乙肝病毒与肝细胞癌关系密切。Objective To investigate clinical characteristics of malignant liver tumor in children. Methods A retrospective study was conducted in 52 cases of chidren with malignant liver tumor between 1990 and 2005. Clinical features and pathological results of all patients were analyzed. Results Ratio of male to female was 2.7：1 （38： 14）. Of the 52 cases,29 were diagnosed as hepato- blastoma, 12 were hepatocelluar carcinoma. Hepatoblastoma was more often than hepatocelluar carcinoma in younger chidren. 82.8 percent of hepatoblastoma （24/29） and 41.7 percent of hepatocelluar carcinoma （5/12） were younger than 6 years old （P = 0.01）. The prevalence of HBsAg was higher for hepatocelluar carcinoma （41. 7%） than that of hepatoblastoma （6. 9%） with statistical significant difference （P = 0.03）. Asymptomatic abdominal mass, abdominal pain and hepatosplenomegaly were usually found in patients. Tumors were more often located in the right lobe of liver than in left. 71.4 percent of alpha-fetoprotein （AFP） were beyond normal limit. Conclusions The patients were pre- dominantly male. In all types of tumor hepatoblastoma was at the first place, with hepatocelluar carcinoma second,higher prevalence of HBsAg for hepatocelluar carcinoma than hepatoblastoma indictates that hepatocelluar carcinoma has close relationship with hepatitis B virus.

关 键 词：肝母细胞瘤 肝细胞癌 儿童 

分 类 号：R735.7[医药卫生—肿瘤]