儿童肝母细胞瘤25例临床分析

临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (5): 417-420.

儿童肝母细胞瘤25例临床分析

侯维纳¹, 邹湘¹, 郭佳¹, 王璐¹, 盛光耀¹, 孙素珂²

1. 郑州大学第一附属医院儿科；2. 河南省高等学校临床医学重点开放实验室（河南郑州　450052）

收稿日期:2013-11-09 出版日期:2014-05-15 发布日期:2014-05-15

Clinical analysis of childhood hepatoblastoma

HOU Weina¹, ZOU Xiang¹, GUO Jia¹, WANG Lu¹, SHENG Guangyao¹, SUN Suke²

(1.Department of Pediatrics, the FirstAffiliated Hospital of Zhengzhou University , Zhengzhou 450052, China; 2. Key Disciplines Laboratory of Henan Clinical Medicine, Zhengzhou 450052, China)

Received:2013-11-09 Published:2014-05-15 Online:2014-05-15

摘要/Abstract

摘要：

　目的　总结儿童肝母细胞瘤（HB）的治疗效果，探讨合理治疗策略。方法　回顾性分析2009年2月至2013年3月初治的HB患儿的临床及随访资料。结果　入选25例初治HB患儿，男14例、女11例，中位发病年龄为25个月（3~92个月）。其中原发肿瘤完整切除18例，存活17例；未完全切除7例，仅1例存活；原发肿瘤完整切除者的生存率明显高于未完整切除者，Ⅰ、Ⅱ期患儿生存率明显高于Ⅲ、Ⅳ期患儿，差异均有统计学意义（P均<0.05）。结论　手术完整切除是所有临床分期的HB患儿获得长期无瘤生存的关键，对于复发和转移的HB患儿的治疗策略有待进一步完善。

Abstract: 　Objective　To investigate the rational treatment strategy of hepatoblastoma (HB) in children. Methods Clinical data and follow-up of 25 children with HB admitted from February 2009 to March 2013 were retrospectively analyzed. Results Twenty-five children with newly diagnosed HB (14 males and 11 females) were enrolled. The median age on diagnosis was 25 months (3-92 months); In 18 of 25 cases with complete resection of the primary tumor, 17 cases survived. Only 1 of 7 cases with incomplete resection survived. The survival rate in children with complete resection of primary tumor is significantly higher than those without complete resection (P<0.05). The survival rate in children of stage I or II is significantly higher than the children of stage III or IV (P<0.05). Conclusions Complete tumor resection is the cornerstone of therapy for long-term disease-free survival in HB patients. Treatment strategy remains to be further improved for children with recurrent and metastatic HB.

侯维纳, 邹湘, 郭佳, 王璐, 盛光耀, 孙素珂. 儿童肝母细胞瘤25例临床分析[J]. 临床儿科杂志, 2014, 32(5): 417-420.

HOU Weina,ZOU Xiang,GUO Jia,WANG Lu,SHENG Guangyao,SUN Suke. Clinical analysis of childhood hepatoblastoma[J]. , 2014, 32(5): 417-420.

参考文献

[1] Ismail H，Broniszczak D，Kaliciński P，et al. Changing treatment and outcome of children with hepatoblastoma：analysis of a single center experience over the last 20 years [J]. J Pediatr Surg，2012，47(7)：1331-1339.
[2] Trobaugh-Lotrario AD，Katzenstein HM. Chemotherapeutic approaches for newly diagnosed hepatoblastoma：past，pre-sent，and future strategies [J]. Pediatr Blood Cancer，2012，59(5)：809-812.
[3] Roebuck DJ，Perilongo G. Hepatoblastoma：an oncological review [J]. Pediatr Radiol，2006，36(3)：183-186.
[4] Pham TH，Iqbal CW，Grams JM，et al. Outcomes of primary liver cancer in children：an appraisal of experience [J]. J Pediatr Surg，2007，42(5)：834-839.
[5] 潘慈，汤静燕，陈静，等. 14例肝母细胞瘤患儿的临床疗效观察 [J]. 中国当代儿科杂志，2009，11(8)：659-662.
[6] 汤静燕，李志光，陈静，等. 儿童肿瘤诊断治疗学 [M]. 北京：人民军医出版社，2011：336-337.
[7] Schnater JM，Aronson DC，Plaschkes J，et al. Surgical view of the treatment of patients with hepatoblastoma：results from the first prospective trial of the International Society of Pediatric Oncology Liver Tumor Study Group [J]. Cancer，2002，94(4)：1111-1120.
[8] Ortega JA，Douglass EC，Feusner JH，et al. Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma：a report from the Children's Cancer Group and the Pediatric Oncology Group [J]. J Clin Oncol，2000，18(14)：2665-2675.
[9] Lovvorn HN 3rd， Ayers D， Zhao Z，et al. Defining hepatoblastoma responsiveness to induction therapy as measured by tumor volume and serum α-fetoprotein kinetics [J]. J Pediatr Surg，2010，45(1)：121-128.
[10] Sasaki F，Matsunaga T，Iwafuchi M，et al. Outcome of hepatoblastoma treated with the JPLT-1 (Japanese Study Group for Pediatric Liver Tumor) Protocol-1：a report from the Japanese Study Group for Pediatric Liver Tumor [J]. J Pediatr Surg，2002，37(6)：851-856.
[11] Matsunaga T，Sasaki F，Ohira M，et al. Analysis of treatment outcome for children with recurrent or metastatic hepatoblastoma [J]. Pediatr Surg Int，2003，19(3)：142-146.　　　
[12] Chan KL，Fan ST，Tam PK，et al. Paediatric hepatoblastoma and hepatocellular carcinoma：retrospective study [J]. Hong Kong Med J，2002，8(1)：13-17.
[13] Madanur MA，Battula N，Davenport M，et al. Staged resection for a ruptured hepatoblastoma：a 6-year follow-up [J]. Pediatr Surg Int，2007，23(6)：609-611.