小儿肝母细胞瘤58例临床病理分析  

Hepatoblastomas in childhood: a clinicopathologic analysis of 58 cases

作　　者：马靖 张忠德[1] 沈萍 陈洁枫 金晓婷 殷敏智[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心病理科,上海200127

出　　处：《临床与实验病理学杂志》2015年第2期169-173,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的分析儿童肝母细胞瘤(hepatoblastoma,HB)的病理形态学特征、免疫表型、诊断及鉴别诊断。方法收集58例儿童HB的临床病理学资料,进行组织学分型,并收集相关预后数据。结果 58例HB中单纯上皮型33例,其中单纯胎儿型18例,包括低核分裂象8例、高核分裂象9例及局灶多形性1例;胚胎型11例,小细胞未分化型3例,过渡肝细胞肿瘤1例。上皮和间叶混合型25例,全部为不伴有畸胎样特征。其中胎儿上皮和间叶混合型6例,胚胎上皮和间叶混合型17例,过渡型肝细胞肿瘤和间叶混合型2例。14例获得随访的患者术后12例化疗有效。结论 HB的病理分型主要依靠组织学形态,依据组织学划分的预后具有一定临床意义。临床分期及组织学类型是影响患儿预后的最重要因素。Purpose To study the morphological features, immunohistochemical phenotype, diagnosis and differential diagnosis of hep-atoblastoma in children. Methods The pathologic data of 58 child patients with hepatoblastoma were enrolled in this study, and histo-logical classification with distinct clinical associations were used. Prognostic data were also collected. Results Pure epithelial type was 33 cases, pure fetal type 18 cases, including 8 cases of low mitotic activity type, 9 cases of high mitotic activity, and 1 case of fo-cal pleomorphic type. 11 cases were embryonal type, 3 small undifferentiated type and 1 transitional liver cell tumor. All the 25 cases of mixed epithelial and mesenchymal type were without teratoid features, including fetal epithelial and mesenchymal type （6 cases）, embryonal epithelial and mesenchymal type （17 cases）, transitional liver cell tumor and mesenchymal type （2 cases）. Follow-up data were available in 14 cases, in which 12 cases were sensitive to chemotherapy. Conclusions Pathologic type of hepatoblastoma rely mainly on the histology, which has a certain clinical prognostic significance. The stage of the tumor and the histopathologic type are two key prognostic factors in determining the survival of children with hepatoblastoma.

关 键 词：肝母细胞瘤 病理学 临床 小儿 诊断 

分 类 号：R735.7[医药卫生—肿瘤]