Pediatric hepatocellular carcinoma  

作　　者：Rajeev Khanna Sanjeev Kumar Verma 

机构地区：[1]Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences,New Delhi 110070, India [2]Department of Pediatrics, King George Medical University

出　　处：《World Journal of Gastroenterology》2018年第35期3980-3999,共20页世界胃肠病学杂志（英文版）

摘　　要：Pediatric hepatocellular carcinoma (HCC) is the second common malignant liver tumor in children after hepato-blastoma. It differs from the adult HCC in the etiological predisposition, biological behavior and lower frequency of cirrhosis. Perinatally acquired hepatitis-B virus, hepa-torenal tyrosinemia, progressive familial intrahepatic cho-lestasis, glycogen storage disease, Alagille's syndrome and congenital portosystemic shunts are important predis-posing factors. Majority of children (87%) are older than 5 years of age. Following mass immunization against hepatitis-B, there has been a drastic fall in the incidence of new cases of pediatric HCC in the Asia-Pacific region. Management is targeted on complete surgical removal either by resection or liver transplantation. There is a trend towards improving survival of children transplanted for HCC beyond Milan criteria. Chemotherapeutic regi-mens do not offer good results but may be helpful for down-staging of advanced HCC. Surveillance of children with chronic liver diseases with ultrasound and alpha-fetoprotein may be helpful in timely detection, intervention and overall improvement in outcome of HCC.Pediatric hepatocellular carcinoma (HCC) is the second common malignant liver tumor in children after hepato-blastoma. It differs from the adult HCC in the etiological predisposition, biological behavior and lower frequency of cirrhosis. Perinatally acquired hepatitis-B virus, hepa-torenal tyrosinemia, progressive familial intrahepatic cho-lestasis, glycogen storage disease, Alagille's syndrome and congenital portosystemic shunts are important predis-posing factors. Majority of children (87%) are older than 5 years of age. Following mass immunization against hepatitis-B, there has been a drastic fall in the incidence of new cases of pediatric HCC in the Asia-Pacific region. Management is targeted on complete surgical removal either by resection or liver transplantation. There is a trend towards improving survival of children transplanted for HCC beyond Milan criteria. Chemotherapeutic regi-mens do not offer good results but may be helpful for down-staging of advanced HCC. Surveillance of children with chronic liver diseases with ultrasound and alpha-fetoprotein may be helpful in timely detection, intervention and overall improvement in outcome of HCC.

关 键 词：HEPATOCELLULAR CARCINOMA Children RISKFACTORS OUTCOME Liver TRANSPLANTATION 

分 类 号：R57[医药卫生—消化系统]