小儿肝母细胞瘤临床病理与预后因素的研究

对２３例小儿肝母细胞瘤的临床病理学进行了研究，并分析了病理学改变与预后的关系。本组肿瘤均为手术切除标本，用组织化学ＨＥ染色和免疫组化ＡＦＰ检测。结果表明，该肿瘤病理形态特点为瘤体大，最大直径４５ｃｍ；主要成分为胚胎性肝上皮组织，部分病例有胚胎性或较成熟的间叶组织。肿瘤发生在肝左叶或边缘部者预后较好，瘤体大或多结节型者预后差；胎儿型和混合型预后好，未分化型预后差；肝脏血液循环丰富，肝母细胞瘤生长速度快，易侵袭破坏血管发生血行转移，这是影响其预后的重要因素。

THE CLINICOPATHOLOGY AND PROGNOSTICFACTORS OF STUDY ON HEPATOBLASTOMA ININFANCY AND CHILDHOOD

To analyse the relationship between the pathological changes and the prognosis of hepatoblastoma through the pathological study on 23 cases of hepatoblastoma in infancy and childhood. Twenty-three hepatoblastomas were surgical specimens. The study was performed by using the common and immunohistochemical stainings. The morphologic features were , 1. the tumors are larger in size , the maximum being 45 cm in diameter; 2. the main elements were embryonic epithelial tissues of the liver , and immature mesenchymal tissues in some of the tumors. The clinicopathological observations show that the main factors affecting the prognosis include location , size , type and biological behavior of the tumor. The prognosis of tumors in the left lobe or on the edge of the liver is favorable , and that of large tumors and tumors with multiple nodules is unfavorable. The prognosis of fetal and mixed type one. is good , and that of undifferentiated type tumors is poor. The biological behavior. of hepatoblastomas shows the rapid growth of the tumors as a result of the massive blood circulation in the liver and the consequent vascular invasion presented metastatic growths that is the most important factor effecting the prognosis