GAO Hui jiang,DONG Qian,JIANG Bu xian,et al.Clinicopathological correlative analysis in infants with liver tumor.[J].Journal of Clinical Pediatric Surgery,,9():422.
Clinicopathological correlative analysis in infants with liver tumor.
- Keywords:
- Liver Neoplasma; Pathology; Infant
- Document code:
- A
- Abstract:
- ObjectiveTo discuss the clinical and pathological characteristics of liver tumor in infants and the relationship between tumor markers’ level and histopathology.MethodsWe retrospectively evaluated 26 liver tumor infants who admitted in our hospital between April 2000 to April 2010.ResultsAmong 26 infants, 23 underwent an integrity resection of liver tumor and diagnosed by the results of histopathology . Malignant liver tumor was more often than benign tumor and the ratio of them was 2.29:1 .The majority of malignant liver tumor was hepatoblastoma (15/16) and most benign tumors were hemangioma(3/7) and hamartoma (3/7). The rate of AFP (+) was higher for malignant liver tumor than that of benign tumor with statistical significant difference (P=0.007).Whereas the prevalence of age and clinical symptoms had no statistical difference (P>0.05).The three other infants gave up therapy eventually.ConclusionsThe majority clinical symptom of liver tumor is abdominal mass , and most of them have no specific characteristics . We believe that many pediatric liver tumor may have well defined margins and tend to compress, rather than infiltrate or become embedded on the hepatic hilum, although this type of tumor may be enormous. The resected giant liver tumors involving the main hepatic veins and/or the retrohepatic vena cava, although challenging, is feasible and safe. The AFP levels correlate with tumor classification even in patients less than 1 year of age . Despite the baseline AFP levels are elevated within these populations , we conclude that AFP levels can be valuable in differentiating malignant from benign liver tumors and in predicting prognosis.
References:
1Stiller CA,Pritchard J,Steliarova Foucherc E. Liver cancer in European children:incidence and survival, 1978-1997. Report from the au tomated childhood cancer information system project \[J\].Eur J Cancer,2006,42: 2115—2123.2Samuel M,Spitz L.Infantile hepatic hemangioendothelioma:the role of surgery\[J\].J Pediatr Surg 1995,30: 1425—9.3DeMaioribus CA,Lally KP,Sim K,et al.Mesenchymal hamartoma of the liver A 35year review\[J\].Arch Surg,1990,125: 598—600.4董蒨.小儿肝脏肿瘤//董蒨.小儿肿瘤外科学\[M\].第1版,北京:人民卫生出版社,2009,508—552.5Giorgio Perilongo,Elizbeth Shafford,Jack Plaschkes.SIOPEL trails using preop- erative chemotherapy in hepatoblastoma\[J\].Lancet,2000,10(1): 94—100.6Badera D,Riskina A,Vaf sia O,et al.Alphafetoprotein in the early neonatal period—a large st udy and review of t he literature\[J\].Clin Chim Acta,2004,349 :15—23.7Wu JT,Book L.Serum alphafetoprotein (AFP) levels innormal infants\[J\].Pediatr Res,1981,15: 50—52.8张法标,王义,丛文铭,等.儿童期及青春期肝细胞癌临床病理特点及影响术后生存率的多因素分析\[J\].中华小儿外科杂志,2006,27 (1) : 1—5.9Oue T,Kubota A,Okuyama H,et al.Hepatoblastoma in children of extremely low birth weight: a report from a single perinatal center\[J\].J Pediatr Surg 2003,38: 134—137.10Kapfer SA,Petruzzi MJ,Caty MG.Hepatoblastoma in low birth weight Infants: an institutional review\[J\].Pediatr Surg Int,2004,20: 753—756.11Kenney LB,Miller BA, Ries LA,et al.Incidence of cancer in infants in the U.S 1980–1990\[J\].Cancer,1998,82: 1396—1400.12董蒨.小儿肝脏肿瘤\[M\]//董蒨.小儿肝胆外科学.北京:人民卫生出版社,2005,225—274.13Perilongo G,Shafford E,Maibach R,et al.Riskadapted treatment for childhood hepatoblastoma. Final report of the second study of the International Society of Paediatric OncologySIOPEL 2\[J\].Eur J Cancer,2004,40: 411—421.14Weinberg AG,Finegold MJ.Primary hepatic tumors in childhood\[M\].In: Finegold M, editor. Pathology of neoplasia in children and adolescents.Philadelphia (Pa): WB Saunders,1986,333—365.15Hart Isaacs Jr.Fetal and neonatal hepatic tumors\[J\].J Pediatr Surg,2007,42: 1797—1803.16Stocker JT,Ishak KG.Mesenchymal hamartoma of the liver: report of 30 cases and review of the literature\[J\].Pediatr Pathol,1983,1: 245—267.17McLaughlin C,Bap tisteM,Schymural M,et al.Maternal and infant birth Characteristics and hepatoblastoma\[J\]. Am J Epidemiol,2006,163 (9): 818—828.18Tsuchida Y,Endo Y,Saito S,et al.Evaluation of alphafetoprotein In early infancy\[J\].J Pediatr Surg,1978,13: 155—162.19董蒨,江布先,张虹,等.螺旋CT三维成像在小儿巨大及复杂部位肝脏肿瘤诊治中的临床意义\[J\].中华小儿外科杂志,2005,27(1): 6.20Qian Dong,Wenjian Xu,Buxian Jiang,et al.Clinical applications of compute- rized tomography 3-D reconstruction imaging for diagnosis and surgery in children with large liver tumors or tumors at the hepatic hilum\[J\].Pediatr Surg Int,2007,23(11): 1045—1050.21赵静,董蒨,江布先,等.CT三维重建及肝脏体积测定在小儿肝脏肿瘤手术中的应用\[J\].临床小儿外科杂志,2009,8(4): 13—16.
Memo
通讯作者:董蒨Email:dong.qian@qdumh.qd.sd.cn本课题获山东省医药卫生系统杰出学科带头人经费资助