27例儿童原发性肝癌的临床特点分析

目的总结儿童原发性肝癌(primary liver cancer,PLC)临床特点,探讨其防治策略。方法回顾总结我院收治的27例儿童PLC相关资料。结果在我院确诊的27例PLC的患儿中,有18例(66.7%)为HBV感染者。有18例存在肝硬化基础,其中失代偿期12例。22例有不同的肝病背景,但另外5例无任何肝病基础。Child-Pugh分级A级15例,B级11例,C级1例;临床肝癌巴塞罗那(Barcelona clinic liver cancer,BCLC)分期A期8例,B期3例,C期14例,D期2例。27例中行肝切除术的仅有2例,行肝动脉化疗栓塞术者3例,行射频消融术者3例,患者经治疗后预后较好。结论 27例PLC儿童基础疾病大多数为慢性乙型肝炎(67%),有肝硬化基础者更易发生。儿童PLC恶性度高、进展快,致其手术切除率低。防止感染HBV,积极治疗慢性乙型肝炎患者尤其是肝硬化患者,加强高危人群肝癌的筛查和监管,对于儿童PLC的防治至关重要。

Clinical characteristics of primary liver cancer in 27 children

ObjectiveEvaluate the clinical characteristics of primary liver cancer (PLC) in children and explore the strategies for prevention and treatment of PLC.MethodsThe data of 27 children with primary liver cancer treated in our hospital were reviewed and summarized since 2004.ResultsIn 27 cases of PLC diagnosed children, Child-Pugh stage were grade A in 15 , grade B 11 and grade C 1. Barcelona clinic liver cancer stage were grade A in 8, grade B 3, grade C 14 and grade D 2. There were 18 (66.7%) patients infected with HBV . There were 18 cases of liver cirrhosis, including 12 decompensated cirrhosis cases. There were 22 patients with different liver backgrounds, but the other 5 had underlying liver disease. In 27 cases, 2 patients received liver resection, 3 transcatheter arterial chemoembolization and 3 radio frequency ablation. The prognosis of the patients who had been treated was better. ConclusionsTwenty-seven cases of PLC children with basic diseases are chronic hepatitis B (67%), which is more likely to occur in patients with liver cirrhosis. Because of high degree of malignancy and rapid progress of PLC in children, rate of surgical resection is very low. Prevention of HBV infection, active treatment of chronic hepatitis B patients, especially in patients with cirrhosis, and strengthening of the screening and supervision of high-risk groups of liver cancer are really important for the prevention and treatment of PLC children.