婴儿腹腔实体肿瘤临床病理与预后分析

目的探讨婴儿腹腔实体肿瘤的临床病理与预后的关系。方法回顾上海儿童医学中心1998年4月-2007年2月及上海新华医院2001年1月-2007年2月住院的52例1d～1岁腹部肿瘤患儿临床资料。患儿病史资料通过病史采集方式获得。病理类型通过复查病理切片和病理报告核对。随访采用电话和信访方式及患儿来院复诊记录。随访时间5个月～8a。结果52例中年龄1d～1个月7例,≥1个月～1岁45例。其中畸胎瘤23例(44.23%),神经母细胞瘤9例(17.31%),肾母细胞瘤6例(11.54%),肝母细胞瘤5例(9.62%),肝血管内皮瘤、先天性中胚层肾瘤各3例(5.77%),胰头梭形细胞血管内皮瘤、肝错构瘤、后腹膜小细胞恶性肿瘤各1例(1.92%)。良性肿瘤:恶性肿瘤=1:1,良性肿瘤中男:女=1:1,恶性肿瘤中男:女=2.33:1.0。患儿均手术切除肿瘤,恶性肿瘤辅以化疗。良性肿瘤均无复发;恶性肿瘤中复发或转移2例,其中1例死亡。失访4例。结论婴儿腹腔实体肿瘤以畸胎瘤和神经母细胞瘤居多。良性肿瘤数量与恶性肿瘤相当。良性发病无性别差异,手术切除后预后良好。恶性肿瘤中,男性比例显著高于女性,完整手术切除配合术后化疗,复发少,病死率低。早期诊断和治疗对其预后至关重要。

Analysis of Clinical Characteristic Pathology and Prognosis in Infant with Intra-Abdominal Solid Tumor

ObjectiveTo analyze the relationship between clinical characteristic pathology and prognosis in infant with intra-abdominal solid tumor.MethodsFifty-two infants(less than 1 year old) with abdominal solid tumor from Apr.1998 to Feb.2007 in Shanghai Children's Medical Center and from Jan.2001 to Feb.2007 in Shanghai Xinhua Hospital were reviewed.The history of these children were reviewed.Features and clinical pathology of these children with their prognosis were analyzed and followed up by telephones and children return visit records from 5 months to 8 years.ResultsLess than 1 month,7 cases;1 month to 1 year old,45 cases.Teratoma 23 cases(44.23%),neuroblastoma 9 cases(17.31%),nephroblastoma 6 cases(11.54%),hepatoblastoma 5 cases(9.62%),epithelioid hemangioendothelioma of the liver 3 cases(5.77%),congenital mesoblastic nephroma 3 cases(5.77%),fusiform cell epithelioid hemangioendothelioma of pancreas 1 case(1.92%),hamartoma of the liver 1 case(1.92%),retroperitoneal small cell malignant tumor 1 case(1.92%).Benign:malignant=1:1.Among the benign tumor,male:female=1:1.Among the malignant tumor,male:female=2.33:1.0.All children were treated with tumor resection,and combined with chemotherapy for those whose tumors were malignant.ConclusionsAmong infant abdominal solid tumors,teratoma and neuroblastoma are much more than other tumors.The cases of benign tumors are almost as much as the malignant tumors.The benign tumors did not have sex differences,and had good prognosis after surgical resection.However,in malignant tumors,the incidence rate of male is obviously higher than female.Completely resection of those malignant tumors with chemotherapy would get little incidence of recrudescence and low case fatality rate.Early diagnosis and early treatment play an important role in prognosis.