Department of Radiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China.
BMC Gastroenterol. 2011 Jun 25;11:78. doi: 10.1186/1471-230X-11-78.
Hepatoblastoma (HBL) and hepatocellular carcinoma (HCC) are respectively the first and the second most common pediatric malignant liver tumors. The purpose of this study was to evaluate the combined use of the ultrasound examination and the assessment of the patients' clinical features for differentiating HBL from HCC in children.
Thirty cases of the confirmed HBL and 12 cases of the confirmed HCC in children under the age of 15 years were enrolled into our study. They were divided into the HBL group and the HCC group according to the histological types of the tumors. The ultrasonic features and the clinical manifestations of the two groups were retrospectively analyzed, with an emphasis on the following parameters: onset age, gender (male/female) ratio, positive epatitis-B-surface-antigen (HBV), alpha-fetoprotein increase, and echo features including septa, calcification and liquefaction within the tumors.
Compared with the children with HCC, the children with HBL had a significantly younger onset age (8.2 years vs. 3.9 years, P < 0.001) and a significantly smaller frequency of positive HBV (66.7% vs. 13.3%, P < 0.001). The septa and liquefaction were more frequently found in HBL than in HCC (25/30, 83.3% vs. 2/12, 16.7%, P < 0.001; 17/30, 56.7% vs. 3/12, 25%, P = 0.02). When a combination of the liquefaction, septa, negative HBV and onset age smaller than 5 years was used in the evaluation, the sensitivity was raised to 90%, the accuracy was raised to 88%, and the negative predictive value was raised to 73%.
Ultrasonic features combined with clinical manifestations are valuable for differentiating HBL from HCC in children.
肝母细胞瘤（HBL）和肝细胞癌（HCC）分别是儿童中最常见的第一和第二大恶性肝肿瘤。本研究旨在评估超声检查与患者临床特征相结合，用于区分儿童中的 HBL 和 HCC。
本研究纳入了 30 例经组织学证实的 HBL 和 12 例经组织学证实的 15 岁以下儿童 HCC。根据肿瘤的组织学类型将他们分为 HBL 组和 HCC 组。回顾性分析两组的超声特征和临床表现，重点关注以下参数：发病年龄、性别（男/女）比例、乙肝表面抗原阳性（HBV）、甲胎蛋白升高以及肿瘤内的回声特征包括分隔、钙化和液化。
与 HCC 患儿相比，HBL 患儿的发病年龄明显较小（8.2 岁 vs. 3.9 岁，P < 0.001），HBV 阳性率明显较低（66.7% vs. 13.3%，P < 0.001）。HBL 中分隔和液化更为常见（25/30，83.3% vs. 2/12，16.7%，P < 0.001；17/30，56.7% vs. 3/12，25%，P = 0.02）。当液化、分隔、HBV 阴性和发病年龄小于 5 岁相结合进行评估时，敏感性提高至 90%，准确性提高至 88%，阴性预测值提高至 73%。
超声特征结合临床表现有助于区分儿童中的 HBL 和 HCC。
