22例小儿肝母细胞瘤临床分析.docVIP

22例小儿肝母细胞瘤的临床分析 　　【摘要】目的分析小儿肝母细胞瘤的临床资料，总结其临床诊治方案及经验，探讨可能影响其预后的因素。方法收集2009年1月至2014年12月间分期明确，经病理确诊且能随访的小儿肝母细胞瘤22例，均有完整的辅助检查资料。针对不同分期采用化疗联合手术的个体化规范化治疗并完成随访。结果按国际肿瘤协会（SLOP）Pretext临床分期，随访4～68个月，其中Ⅰ期、Ⅱ期共15例，复发2例，均存活，Ⅲ期4例，复发3例，1例死亡，Ⅳ期3例均复发，1例存活，1例多处转移，因多器官功能衰竭治疗无效死亡，1例复发肝功能衰竭死亡。结论肿瘤完整切除是小儿肝母细胞瘤治疗的关键点，化疗对实施根治性手术及预防肿瘤复发有重要意义，AFP水平、病理学分型、Pretext分期、多学科合作等是影响预后和复发的重要因素。 　　【关键词】小儿肝母细胞瘤；AFP；手术；化疗；预后 　　中图分类号：R735.7 文献标识码：ADOI：10.3969/j.issn2015.03.013 　　Analysis of clinical data of 22 children with hepatoblastoma 　　HUANG Meijing1，WANG Hong2▲，YANG Tiquan2，LIU Qiang2，WANG Tianlong2 　　（1.Teaching and Research Section of Surgery，Ethnic Minority Health School of Baise， 　　Baise 533000；2. Department of Pediatric Surgery，The First Affiliated Hospital of 　　Guangxi Medical University，Nanning 530021，Guangxi，China） 　　【Abstract】ObjectiveTo analyze the clinical data of children with hepatoblastoma，summarize clinical diagnosis and treatment plan and experience，and explore the factors that might affect prognosis of the patients.Methods22 cases of hepatoblastoma，those who had clear stages，confirmed by pathology，and could be followed up from January，2009 to December，2014，were collected to the study.All of the patients had complete secondary examination data.Individualized and standardized treatment for different stages of chemotherapy combined with operation were provided to the patients.And followup visits were given to them.Results According to the International Cancer Association （SLOP） Pretext clinical stage，the followup visits were given to patients for 4 to 68 months，which showed that 15 cases of stageⅠand stage Ⅱwere all alive，with 2 cases relapsing.Of all the 4 cases of stage Ⅲ，3 cases relapsed，and 1 case died.3 cases of stage Ⅳ all relapsed，with 1 case relapsing，1case with multiple metastasis died of multiple organ failure，and 1 case died of recurrence of liver failure.ConclusionComplete tumor resection is the key point in children with hepatoblastoma therapy，chemothera