临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (2): 121-.doi: 10.3969/j.issn.1000-3606.2017.02.011

• 综合报道 • 上一篇    下一篇

儿童肝母细胞瘤36 例预后分析

姚东亚, 罗源, 盛光耀   

  1. 郑州大学第一附属医院儿科(河南郑州 450052)
  • 收稿日期:2017-02-15 出版日期:2017-02-15 发布日期:2017-02-15
  • 通讯作者: 盛光耀 E-mail:shenggy 2959@126 .com

Prognostic analysis of hepatoblastoma in children

YAO Dongya, LUO Yuan, SHENG Guangyao   

  1. Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
  • Received:2017-02-15 Online:2017-02-15 Published:2017-02-15

摘要: 目的 探讨肝母细胞瘤(HB)患儿的预后。方法 回顾性收集2010年9月至2015年2月初治HB患儿的病历 及随访资料,总结临床疗效和预后。结果 共纳入HB患儿36例,男23例、女13例,中位年龄20个月。36例患儿的中位随 访时间37个月(7~71个月)。36例患儿死亡8例,参照美国儿童肿瘤研究组(POG/CCG)亚组分析,Ⅰ、Ⅱ期患儿预后明显 好于Ⅲ、Ⅳ期,胎儿型患儿预后明显优于其他亚型(P<0.05)。35例患儿疾病初期甲胎蛋白(AFP)水平增高,存活者治疗 后AFP水平均降至正常; 8例死亡患儿中3例复发后AFP水平增高, 5例经辅助化疗AFP水平持续不降。初诊时乳酸脱氢 酶(LDH)升高组(>245 U/L)及C反应蛋白(CRP)升高组(>5 mg/L)存活率明显低于正常组,天冬氨酸氨基转移酶(AST) ≥80 U/L的患儿存活率明显低于AST<80 U/L的患儿,差异均有统计学意义(P<0.05)。 结论 血清AFP可作为HB复发 和预后的监测指标。POG/CCG分期、病理分型是评估HB预后的重要因子,血清LDH、CRP、AST水平升高可能与HB患儿 预后不良有关。

Abstract:   Objective To study the prognosis of  hepatoblastoma (HB) in children. Methods Retrospective analysis on the clinical data and follow-up of children with HB admitted from September 2010 to February 2015 and sum up the clinical outcome and prognosis. Results   Thirty-six children with HB (23 males and 13 females) were enrolled. The median age on diagnosis was 20 months. All the 36 patients received follow-up, the median follow-up time was 37 months (7~71 months).(1) Of the 36 patients, 8 died. The prognosis of patients with stage Ⅰ or Ⅱ was significantly better than those with stage Ⅲor Ⅳ (P<0.05). The prognosis of patients with fetal type was significantly better than those with other subtypes (P<0.05). (2) Serum AFP level of 35 newly diagnosed cases increased, AFP level of survivors returned to normal after treatment. Of the 8 died patients, 3 patients had AFP elevated when relapsed, 5 cases had a persistently high AFP level after adjuvant chemotherapy. The levels of LDH, CRP, and AST at diagnosis had significant influence on the prognosis (P<0.05). Conclusions Serum AFP can be a monitoring indicator for recurrence and prognosis of hepatoblastoma.  POG / CCG staging, pathology classification are key points when assessing the prognosis of hepatoblastoma. The prognosis of patients with high levels of LDH, CRP, and AST might be worse.