摘要
目的总结儿童期及青春期肝细胞肝癌的临床病理特点，探讨其与预后的关系。方法回顾性分析1996年1月～2004年12月间手术切除并获得随访的56例儿童期及青春期肝细胞肝癌的临床资料和预后状况。选择13项可能对儿童期及青春期肝细胞肝癌切除术后预后产生影响的特征性临床病理因数，利用Cox比例风险模型，与术后生存率的关系进行单因素及多因素分析。结果手术后1、2、3、5年的生存率分别为75．0％、53．7％、44．1％、23．8％。单因素分析提示发现方式、HBsAg阳性、肿瘤多灶性、肿瘤分化程度、门静脉癌栓、肿瘤切缘、输血量、术后是否复发及复发后的治疗措施对预后有影响；多因素分析显示发现方式、门静脉癌栓、输血量、术后是否复发及复发后的治疗措施是影响术后生存率的预后因素。结论儿童期及青春期肝细胞肝癌术后生存率与发现方式、门静脉癌栓、输血量、术后是否复发及复发后的治疗措施密切相关。手术后定期随访，复发后及时采取个体化的综合治疗，有助于提高患儿生存率。
Objective To summarize the clinicopathological characteristics and analyze the prognostic factors that may influence postoperative survival in children and adolescents with hepatocellular carcinoma. Methods This study retrospectively analyzed the surgical outcomes of hepatocellular carcinoma in 56 children and adolescents who underwent hepatic resection between 1996 and 2004. Post-resection prognostic factors were analyzed using a univariate log-rank test and a multivariate Cox proportional hazards model. Results Postoperatively,the cumulative survival rate of 1, 2, 3 and 5-year was 75. 0%, 53. 7%, 44. 1 % and 23.8%0. Univariate analysis showed that ways of cancer discovery, HBsAg-positive, multiclonality in tumor, Edmondson tumor grade, portal vein tumor thrombi（PVTT）, margin of resection, transfusion quantity, postoperative recurrence and treatment measures were all related to the postoperative recurrence. Multivariate analysis indicated that ways of cancer discovery, PVTT, transfusion quantity, postoperative recurrence and treatment measures for postoperative recurrence were prognostic factors influencing the survival rate. Conclusions Early detection, routinely ultrasound examination and measurement of AFP after operation, and individual treatment plan for post-operative recurrence are the effective methods to prolong the survival time of children and adolescents with hepatocellular carcinoma.
出处
《中华小儿外科杂志》
CSCD
北大核心
2006年第1期1-5,共5页
Chinese Journal of Pediatric Surgery
关键词
癌
肝细胞
肝切除术
青春期
预后
Carcinoma, hepatocelluar
Hepatectomy
Puberty
Prognosis
