【摘要】：目的：分析總結我科對兒童肝母細胞瘤的治療效果,探討影響肝母細胞瘤患兒預后的因素及治療經(jīng)驗。 方法：回顧性分析我科2001-2011共10年間收治的20例肝母細胞瘤患兒的臨床資料,追蹤隨訪其生存狀況并對其進行生存分析、Kaplan-Meier單因素分析。 結果：20例肝母細胞瘤患兒中,中位隨訪時間為39個月(1～114個月)。其中14例無瘤存活,4例死亡,2例失訪。19例行手術治療,1例未行手術。規(guī)律化療14例,不規(guī)律化療6例。2年生存率為83.33%,5年生存率為76.84%。 Kaplan-Meier單因素分析提示：影響肝母細胞瘤患兒預后的因素為年齡、病理分型、腫瘤能否根治性切除及術后2個月AFP是否降至正常水平,而性別、腫瘤PRETEXT分期、是否行術前化療并不是影響HB預后的因素。 結論：1、年齡、病理分型、腫瘤能否根治性切除、術后2個月AFP是否降至正常水平可能為影響肝母細胞瘤預后的因素：年齡較大、病理分型為上皮型、腫瘤根治性切除、術后2個月AFP降至正常水平的患兒生存時間較長；2、在本中心的技術水平下,結合化療并且可以行根治性手術的患兒,治療效果較好。
[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.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R735.7

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