摘要
目的探讨成人和小儿肝母细胞瘤(hepatoblastoma,HB)的临床及病理特点。方法对1例成人和1例小儿HB的临床表现、实验室检查、CT表现及病理大体、镜下、免疫组化等检查结果进行分析观察,并结合文献复习。结果成人与小儿HB实验室检查乙肝病毒检测阴性,血红蛋白均降低,成人AFP、CEA、ALP、GGT增高,小儿AFP、血小板计数、NSE、总胆固醇增高。肿块均位于肝右叶,最大径大于10 cm。成人及小儿HB均为混合性上皮和间叶型,主要由胎儿型及胚胎型上皮细胞及原始间叶成分构成,小儿HB间叶成分还含有骨样成分。免疫组化,β-catenin主要表达在成人胎儿性上皮成分细胞膜和细胞浆上,而小儿胚胎性上皮则为细胞核表达,P53在各成分中的表达均为阴性。结论HB是一种恶性肿瘤,发生在成人和小儿的HB临床病理特点具有一定的特征性,须与肝细胞肝癌、肝肉瘤样癌等鉴别。
Objective To investigate the clinical and pathological features of hepatoblastoma(HB)in adult and children.Methods Analyze and observe the clinical manifestations,laboratory examinations,CT manifestations,gross pathology,microscopy,immunohistochemistry and other examination results of 1 adult and 1 child of HB,and combine the literature review.Results The laboratory detection of hepatitis B virus infection in adults and children were negative,with decreased hemoglobin.The levels of AFP,CEA,ALP,and GGT were increased in adults,and the AFP,platelet count,NSE,and total cholesterol were increased in children.CT examination found that the lumps in 2 cases were both located on the right lobe of the liver,the maximum diameter is larger than 10 cm.Adult and pediatric HB are both mixed epithelial and mesenchymal types,which are mainly composed of fetal and embryonic epithelial cells and primitive mesenchymal components.Pediatric HB mesenchymal components also contain bone-like components.Immunohistochemical staining showedβ-catenin was mainly expressed in the membrane and cytoplasm of fetal type epithelial cells in adult,while the expression was in the nucleus of embryonic epithelial components in children.The both cases P53 were negative in all components.Conclusions Hepatoblastoma is a malignant tumor,The clinical pathology characteristics of Hb occurring in adults and children have certain characteristics,which must be differentiated from hepatocellular carcinoma and the liver sarcomatoid carcinoma.
作者
马晓梅
陈海霞
房新志
MA Xiaomei;CHEN Haixia;FANG Xinzhi(The Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《新疆医学》
2021年第7期749-752,748,共5页
Xinjiang Medical Journal
基金
新疆维吾尔自治区自然科学基金(项目编号:2018D01C254)
关键词
肝母细胞瘤
成人
小儿
临床病理
Hepatoblastoma
adult
children
clinical pathology
