CAJ | 학술논문

目的：探讨晚期儿童肝母细胞瘤（hepatoblastoma，HB）的预后情况。方法回顾性分析首都医科大学附属北京同仁医院儿科2006年4月-2014年7月收治的103例患儿中随访3年以上的30例晚期HB患儿的临床资料，总结其临床疗效和预后情况。结果（1）POG／CCG临床分期：III期12例，完全缓解（CR）10例（83％）；IV期18例，CR 8例（44％），两组CR率无显著差异（P＝0.08）；（2）血清AFP：30例患儿中28例明显升高，占93％；（3）术前化疗：提高了69％的肿瘤完全切除率；（4）疗效与预后：30例患儿5年总体生存率为58％。胎儿型、POG／CCG III期和肿瘤完全切除患儿生存率明显提高（P＜0.05）。结论儿童晚期HB经综合治疗预后尚可。胎儿型预后较好，但肿瘤未完全切除，POG／CCG IV期及伴有远处转移尤其是肺转移患儿预后仍较差，应尽可能地早期诊断及治疗。
목적：탐토만기인동간모세포류（hepatoblastoma，HB）적예후정황。방법회고성분석수도의과대학부속북경동인의원인과2006년4월-2014년7월수치적103례환인중수방3년이상적30례만기HB환인적림상자료，총결기림상료효화예후정황。결과（1）POG／CCG림상분기：III기12례，완전완해（CR）10례（83％）；IV기18례，CR 8례（44％），량조CR솔무현저차이（P＝0.08）；（2）혈청AFP：30례환인중28례명현승고，점93％；（3）술전화료：제고료69％적종류완전절제솔；（4）료효여예후：30례환인5년총체생존솔위58％。태인형、POG／CCG III기화종류완전절제환인생존솔명현제고（P＜0.05）。결론인동만기HB경종합치료예후상가。태인형예후교호，단종류미완전절제，POG／CCG IV기급반유원처전이우기시폐전이환인예후잉교차，응진가능지조기진단급치료。
Objective Tostudyontheprognosisofadvancedhepatoblastoma(HB)inchildren. Methods Retrospectiveanalysisontheclinicaldataof30withadvancedhepatoblastomacasesfollowed up more than 3 years in 1 03 cases of children,from Apr.2006 to Jul.201 4 in pediatric of Beijing Tongren hospital,capital medical university and sum up the clinical outcome and prognosis.Results (1 ) Clinical stage (POG /CCG):In 1 2 cases of III stage,1 0 patients were complete remission (CR), account for 83%.In 1 8 cases of IV stage,8 patients were CR ,account for 44%.No statistically significant difference (P=0.08)between III and IV stage.(2)Serum AFP level :In all cases,28 cases were significantly high,account for 93%.(3 )Preoperative chemotherapy:Complete resection of the tumor increased 69%.(4)Efficacy and Prognosis:In 30 cases,the 5-year over survival rate was 58%.The univariate analysis showed that factors including Fetal type ,POG /CCG III,Complete resection of primary tumor could significantly increased the 5-year survival rate. Conclusions Multimodalitytreatmentcaneffectivelyimproveremissionrateandprolongthesurvivaltimeofchildren with advanced HB .Prognosis of Fetal type is good.But HB POG /CCG IV,Incomplete resection of the tumor,Distant metastasis especially in lung are highly useful in predicting poor prognosis.