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本文报道经病理检查证实的26例小儿肝癌,其中肝母细胞瘤12例,肝细胞性肝癌14例。年龄最小64天,最大16岁。男女之比为2.25:1。两型肝癌临床表现各不相同,易误诊为肝炎、肝硬化、肝脓疡、肾胚胎瘤、肾绞痛、败血症、结核性胸膜炎等。肝癌起源部位以右叶为多(11例),其次为左叶(6例),多灶性起源5例。平均生存期7个月。主要死亡原因为全身衰竭或肝昏迷,其次为上消化道出血、肝破裂出血。本文6例有肝炎病史,其中3例HBsAg阳性,3例病理检查有肝硬化,分别在肝炎后4年(2例)、10年(3例)和11年(1例)发现肝癌,且全部为肝细胞性肝癌,提示肝炎和肝癌的密切关系。
This article reports 26 cases of pediatric liver cancer confirmed by pathology, including hepatoblastoma in 12 cases and hepatocellular carcinoma in 14 cases. The youngest 64 days, maximum 16 years old. The ratio of men to women is 2.25: 1. Two types of liver cancer clinical manifestations vary, easily misdiagnosed as hepatitis, liver cirrhosis, liver abscess, renal embryonal tumor, renal colic, septicemia, tuberculous pleurisy. The origins of liver cancer were the right lobe (11 cases), the left lobe (6 cases) and the multifocal origin (5 cases). The average survival period of 7 months. The main cause of death was systemic failure or hepatic coma, followed by upper gastrointestinal bleeding and hepatic rupture. Six cases of this history of hepatitis, including 3 cases of HBsAg positive, 3 cases of liver cirrhosis pathological examination, respectively, in hepatitis 4 (2 cases), 10 years (3 cases) and 11 years (1 case) found liver cancer, and all For hepatocellular carcinoma, suggesting the close relationship between hepatitis and liver cancer.