实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (3): 450-453.doi: 10.3969/j.issn.1672-5069.2025.03.033

• 肝癌 • 上一篇    下一篇

不同病理学类型的儿童肝母细胞瘤超声表现研究*

唐奇琼, 贾春阳, 霍亚玲, 许晶, 王丹   

  1. 450000 郑州市 郑州大学附属儿童医院/河南省儿童医院郑州儿童医院超声医学科
  • 收稿日期:2025-02-24 发布日期:2025-05-14
  • 通讯作者: 王丹,E-mail:wangdan158975@163.com
  • 作者简介:唐奇琼,女,42岁,大学本科,主治医师。E-mail:15639096605@163.com
  • 基金资助:
    *河南省医学科技攻关计划软科学项目(编号:LHGJ20220762)

Different ultrasound manifestations in children with different pathological types of hepatoblastoma

Tang Qiqiong, Jia Chunyang, Huo Yaling, et al   

  1. Department of Ultrasound, Zhengzhou Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, Henan Province, China
  • Received:2025-02-24 Published:2025-05-14

摘要: 目的 总结分析不同病理学类型的儿童肝母细胞瘤(HB)超声表现。方法 2021年10月~2024年10月我院收治的64例HB患儿,均接受腹部彩色多普勒超声检查和穿刺活检或手术后组织病理学检查,采用免疫组化法检测组织甲胎蛋白(AFP)、糖蛋白CD34、细胞角蛋白7(CK7)、细胞角蛋白19(CK19)、整合酶相互作用分子-1(INI-1)、肝细胞石蜡抗原-1(Hepar-1)和β-联蛋白(beta-catenin)表达。结果 经病理学诊断诊断完全上皮型43例(胎儿型14例和胚胎型29例),和混合性上皮间叶型21例(伴有畸胎瘤样特征13例和不伴有畸胎瘤样特征8例);胎儿型肿瘤直径为(8.5±2.4)cm,显著小于胚胎型【(11.4±2.1)cm,P<0.05】或伴畸胎瘤样混合型【(10.7±2.2)cm,P<0.05】或不伴畸胎瘤样混合型【(10.5±2.0)cm,P<0.05】;胎儿型强回声占比为92.9%,胚胎型强回声占比为93.1%,均显著大于伴畸胎瘤样混合型的23.1% (P<0.05)或不伴畸胎瘤样混合型的37.5% (P<0.05);胎儿型钙化占比为21.4%,胚胎型钙化占比为27.6%,均显著低于伴畸胎瘤样混合型的76.9%(P<0.05)或不伴畸胎瘤样混合型的62.5%(P<0.05);胎儿型瘤内坏死囊变占比为35.7%,显著低于胚胎型的79.3% (P<0.05)或伴畸胎瘤样混合型的76.9%(P<0.05)或不伴畸胎瘤样混合型的75.0%(P<0.05)。结论 不同病理学类型的HB病灶超声表现存在一定的差异,超声检查可在一定程度上为HB病理学分型的鉴别诊断提供参考。

关键词: 肝母细胞瘤, 超声表现, 病理学, 儿童

Abstract: Objective The aim of this study was to investigate ultrasound manifestations in children with different pathological types hepatoblastoma (HB). Methods 64 children with HB were encountered in our hospital between October 2021 and October 2024, and all of them underwent abdominal color Doppler ultrasonography and surgery or biopsy for pathological examination. Expression of alpha fetoprotein, glycoprotein CD34, cytokeratin 7, CK19, integrase interactor-1, hepatocyte paraffin-1 and beta-catenin were detected immunohistochemistry. Results Liver histo-pathological examination diagnosed complete epithelial type in 43 cases, including fetal type in 14 cases and embryonic type in 29 cases, and mixed epithelial mesenchymal type in 21 cases, including teratoma-like in 13 cases and without teratoma-like in 8 cases; diameter of tumor in fetal type was (8.5±2.4)cm, much less than [(11.4±2.1)cm, P<0.05] in tumor in embryonic type or [(10.7±2.2)cm, P<0.05] in tumor in mixed epithelial mesenchymal type or [(10.5±2.0)cm, P<0.05] in tumor in without teratoma-like type; percentage of hyperechoic in fetal type was 92.9%, and in embryonic type was 93.1%, both much greater than 23.1%(P<0.05) in mixed teratoma-like or 37.5%(P<0.05) in without teratoma-like; percentage of calcification in fetal type was 21.4% and in embryonic type was 27.6%, both much lower than 76.9%(P<0.05)in mixed tumors with teratoma-like features or 62.5%(P<0.05)in mixed tumors without teratoma-like features; percentage of intratumoral necrotic cystic changes in fetal tumors was 35.7%, significantly lower than 79.3% (P<0.05)in embryonic tumors or 76.9%(P<0.05)in mixed tumors with teratoma-like features or 75.0%(P<0.05)in mixed tumors without teratoma-like features. Conclusion Different pathological features of HB in children could have different ultrasound manifestations, which might provide hints for pathological subtyping preliminarily.

Key words: Hepatoblastoma, Ultrasonography, Pathology Children