Macarthur Carol J
Department of Otolaryngology, Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon 97239, USA.
Curr Opin Otolaryngol Head Neck Surg. 2006 Dec;14(6):397-405. doi: 10.1097/MOO.0b013e328010ba6b.
Hemangiomas are the most common benign tumor in infancy, affecting approximately 10% of infants. More than half of hemangiomas involve the head and neck. Increased understanding of hemangiomas has come about from identification of immunohistochemical markers, developmental defects associated with certain hemangiomas, and morphologic and classification schemes (focal versus segmental).
Immunohistochemical markers have been identified which are specific to hemangiomas in all phases of development and involution. Morphologic subtypes and anatomic locations have been identified that place an infant at higher risk for complications from the hemangioma. Hemangiomas associated with other developmental anomalies have been identified, which help guide the treating physician to tease out which infants will need more complete systemic investigations or imaging. Importantly for surgeons, studies have continued to identify which lesions may benefit from early intervention, either surgical or medical.
While full understanding of the mechanisms that turn on and turn off hemangiomas of infancy is not complete, progress has been made in identification of markers, subtypes at increased risk for complications, and in treatment. With continued work in these areas, we have increased knowledge of treatment options, optimal timing of surgical intervention, and ultimately, preventive options.
血管瘤是婴儿期最常见的良性肿瘤，约10%的婴儿受其影响。半数以上的血管瘤累及头颈部。随着免疫组化标志物的鉴定、某些血管瘤相关的发育缺陷以及形态学和分类方案（局灶性与节段性）的出现，人们对血管瘤的认识不断加深。
已鉴定出在血管瘤发育和消退的所有阶段都具有特异性的免疫组化标志物。已确定了形态学亚型和解剖位置，这些因素会使婴儿发生血管瘤并发症的风险更高。已发现与其他发育异常相关的血管瘤，这有助于指导治疗医生判断哪些婴儿需要更全面的全身检查或影像学检查。对外科医生来说重要的是，研究不断确定哪些病变可能从早期干预（手术或药物治疗）中获益。
虽然对婴儿期血管瘤发生和消退机制的全面理解尚未完成，但在标志物的鉴定、并发症风险增加的亚型以及治疗方面已取得进展。随着这些领域的持续研究，我们对治疗选择、手术干预的最佳时机以及最终的预防措施有了更多了解。
