摘要
目的探讨儿童与成人肝细胞癌在临床特征、手术治疗以及预后等方面的异同，以期提高儿童肝细胞癌的诊治水平。方法对1996～20c14年间手术切除并获得随访的56例肝细胞癌患儿与随机选取的同期112例成人肝细胞癌患者的临床表现、实验室和病理检查结果及随访情况进行回顾性对比分析。结果儿童和成人肝细胞癌的临床表现类似，但儿童组腹部肿块较成人组多见（P〈0．05）；血清AFP≥400μg/L和肝功能Child-Pugh A级所占的比例高于成人组（P〈0．05）；肝硬化合并率显著低于成人组（P〈0．01）；Edmondson分级Ⅲ-Ⅳ级所占的比例显著高于成人组（P〈0．01）；5年生存率低于成人组（P〈0．05）。结论肝细胞癌惠儿肝硬化合并率低，肝硬化程度轻，肝功能储备好，可以耐受大块肝切除；但其症状隐匿，发现较晚，恶性程度高，整体预后差，敌对肝细胞癌的高危患儿应进行定期检查以期早期发现、早期治疗，这是改善预后的重要途径。
Objective To explore the clinicopathological differences between childhood and adult hepatocellular carcinoma（HCC） .Methods A total of 56 childhood HCCs and 112 adult HCCs,which were resected between 1996 and 2004, were retrospectively evaluated. Results The clinical manifestations of HCC were similar between children and adults, while abdominal masses, serum AFP≥400μg/L, Child-Pugh grade A and Edmondson grade Ⅲ-Ⅳ were more frequently seen in children with HCC. In contrast, the accompanying cirrhosis rate and the 5-year cumulative survival rate after operation were significantly higher in adults. Conclusion Compared with adults, the children with HCC have less severe cirrhosis and better hepatic reserve, and as a result, can tolerate major hepatectomy. However, the children＇s prognosis was still poorer than the adults＇ due to delay in diagnosis and high malignant potential of the tumors. Close follow-up in high risk children is advisable.
出处
《肝胆胰外科杂志》
CAS
2006年第4期211-214,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
癌
肝细胞
外科学
临床特征
儿童
carcinoma, hepatocellular
surgery
clinical characteristics
child
