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患有慢性肝病的儿童的肝脏肿瘤

Liver tumors in children with chronic liver diseases.

作者信息

Sintusek Palittiya, Phewplung Teerasak, Sanpavat Anapat, Poovorawan Yong

机构信息

Thai Pediatric Gastroenterology, Hepatology and Immunology Research Unit, Department of Pediatrics, Division of Gastroenterology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand.

Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand.

出版信息

World J Gastrointest Oncol. 2021 Nov 15;13(11):1680-1695. doi: 10.4251/wjgo.v13.i11.1680.

Abstract

Liver tumors are rare in children, but the incidence may increase in some circumstances and particularly in chronic liver diseases. Most liver tumors consequent to chronic liver diseases are malignant hepatocellular carcinoma. Other liver tumors include hepatoblastoma, focal nodular hyperplasia, adenoma, pseudotumor, and nodular regenerative hyperplasia. Screening of suspected cases is beneficial. Imaging and surrogate markers of alpha-fetoprotein are used initially as noninvasive tools for surveillance. However, liver biopsy for histopathology evaluation might be necessary for patients with inconclusive findings. Once the malignant liver tumor is detected in children with cirrhosis, liver transplantation is currently considered the preferred option and achieves favorable outcomes. Based on the current evidence, this review focuses on liver tumors with underlying chronic liver disease, their epidemiology, pathogenesis, early recognition, and effective management.

摘要

肝脏肿瘤在儿童中较为罕见,但在某些情况下发病率可能会增加,尤其是在慢性肝病中。大多数由慢性肝病引发的肝脏肿瘤是恶性肝细胞癌。其他肝脏肿瘤包括肝母细胞瘤、局灶性结节性增生、腺瘤、假瘤和结节性再生性增生。对疑似病例进行筛查是有益的。最初使用影像学检查和甲胎蛋白替代标志物作为非侵入性监测工具。然而,对于检查结果不明确的患者,可能需要进行肝活检以进行组织病理学评估。一旦在患有肝硬化的儿童中检测到恶性肝脏肿瘤,目前肝移植被认为是首选方案,并且效果良好。基于当前证据,本综述重点关注伴有潜在慢性肝病的肝脏肿瘤、其流行病学、发病机制、早期识别及有效管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fe9/8603454/b5efda9d23a9/WJGO-13-1680-g001.jpg

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