20例儿童肝母细胞瘤的治疗效果分析及预后因素的探讨

发布时间：2018-11-27 07:57

【摘要】：目的：分析总结我科对儿童肝母细胞瘤的治疗效果,探讨影响肝母细胞瘤患儿预后的因素及治疗经验。方法：回顾性分析我科2001-2011共10年间收治的20例肝母细胞瘤患儿的临床资料,追踪随访其生存状况并对其进行生存分析、Kaplan-Meier单因素分析。结果：20例肝母细胞瘤患儿中,中位随访时间为39个月(1～114个月)。其中14例无瘤存活,4例死亡,2例失访。19例行手术治疗,1例未行手术。规律化疗14例,不规律化疗6例。2年生存率为83.33%,5年生存率为76.84%。 Kaplan-Meier单因素分析提示：影响肝母细胞瘤患儿预后的因素为年龄、病理分型、肿瘤能否根治性切除及术后2个月AFP是否降至正常水平,而性别、肿瘤PRETEXT分期、是否行术前化疗并不是影响HB预后的因素。结论：1、年龄、病理分型、肿瘤能否根治性切除、术后2个月AFP是否降至正常水平可能为影响肝母细胞瘤预后的因素：年龄较大、病理分型为上皮型、肿瘤根治性切除、术后2个月AFP降至正常水平的患儿生存时间较长；2、在本中心的技术水平下,结合化疗并且可以行根治性手术的患儿,治疗效果较好。
[Abstract]:Objective: to analyze and summarize the therapeutic effect of our department on hepatoblastoma in children, and to explore the prognostic factors and treatment experience of children with hepatoblastoma. Methods: the clinical data of 20 cases of hepatoblastoma treated in our department from 2001 to 2011 were analyzed retrospectively. The survival status of 20 children with hepatoblastoma was followed up and the survival was analyzed by Kaplan-Meier single factor analysis. Results: the median follow-up time was 39 months (1 ~ 114 months) in 20 children with hepatoblastoma. Among them, 14 cases survived without tumor, 4 cases died, 2 cases lost visit, 19 cases were treated surgically, and 1 case was not operated. There were 14 cases of regular chemotherapy and 6 cases of irregular chemotherapy. The 2-year survival rate was 83.33 and the 5-year survival rate was 76.84%. Univariate analysis of Kaplan-Meier indicated that age, pathological type, radical resection of the tumor and whether AFP decreased to normal level 2 months after operation were the main factors influencing prognosis of hepatoblastoma children, while sex and PRETEXT stage of tumor were the main factors influencing the prognosis of children with hepatoblastoma. Preoperative chemotherapy is not a factor affecting the prognosis of HB. Conclusion: 1. Age, pathological type, radical resection of the tumor, and whether the AFP decreased to a normal level 2 months after operation may be the factors influencing the prognosis of hepatoblastoma: age, pathological type, epithelial type, radical resection of the tumor. The survival time of children with AFP decreased to normal level 2 months after operation was longer. 2. At the technical level of the center, the children who combine chemotherapy and can undergo radical operation have good therapeutic effect.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R735.7

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