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Objective To analyze the relationship between the clinical features of hepatoblastoma and serum alpha-fetoprotein level.Methods We did a retrospective study in 74 cases into the relationship of clinical stages,treatment,prognosis,and AFP value in hepatoblastoma.Results In Stage Ⅰ and Ⅱ patients,the average AFP was (36 333 ± 13 782) ng/ml and in Stage Ⅲ and Ⅳ,the average AFP was (78 346 ± 27 956) ng/ml,P ＜ 0.05.68 patients received preoperative chemotherapy with alpha-fetoprotein determinations before and after chemotherapy respectively.In 44 cases AFP decreased ＞ 50％ after chemotherapy,and in 20 cases AFP declined ＞90％,while in 13 cases AFP increased after chemotherapy.15 cases had serum AFP measured on the first postoperative day,among them 10 cases had a ＞ 50％ AFP decline,3 cases had a ＜ 50％ AFP decline,while in 2 cases AFP value increased.52 cases were postoperatively followed-up,with overall 3 year-survival rate of 86.5％ ; 7 cases recurred,4 died.The average preop AFP level in 7 recurred cases was (27 060 ± 3 569) ng/ml,while the average preop AFP level in those of 3-year recurrence-free was (29 865 ± 5 867) ng/ml,P ＞ 0.05.Only 57％ tumor recurred cases had back to normal AFP level within one month postop,while 89％ long term survivals reported normal range of AFP during that period,P ＜ 0.05.Conclusions Serum AFP level in patients with hepatoblastoma is related to the course of disease.It can be used to estimate the effect of clinical chemotherapy.The speed of alpha-fetoprotein decline postop can be used as an indicator of prognosis.The postoperative normal AFP level within 4 weeks predicts a favorable prognosis.
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Objective To study the effect of traditional Chinese medicine on survival time in children solid tumors with chemotherapy. Methods 76 children with solid tumors, which were collected from January 2005 to March 2006, were randomly divided into treatment group (35 cases), control group (41 cases). The treatment group was treated with chemotherapy + self-dispensing Fuzheng Jianpi Chinese medicine. The control group was treated with chemotherapy alone. Results The survival rate of the treatment group was higher than that of the control group, the difference was statistically significant (P = 0.0024). The average survival time after chemotherapy in the treatment group was (31± 2) months (95 % CI 27-34 months), the control group was (21±2) months (95 % CI 16-25 months), which was shorter than the treatment group.Conclusion Chinese medicine and chemotherapy can prolong the survival time of children with solid tumors.
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Objective To improve the recognition of various CT appearances of hepatoblastoma(HB) and evaluate the role of CT in diagnosis. Method In a total of 24 cases, abdominal scan was performed. In 12 of them contrast enhanced CT was available. The CT manifestions of the 24 HB cases were retrospectively analyzed and correlated with clinical pathological findings. Results Fourteen tumors involved the right lobe, 4 tumors involved the left lobe,and 6 both liver lobes. One case invaded the liver diffusely.Most of HB appeared as an intrahepatic well circumscribed round or lobulated solid mass with or without pseudocapsule.Three of them manifested as multiple nodules and distributed in one or both liver lobes.Exophytic growing of tumor was seen in 7 cases. The tumor mass usually exhibited inhomogeneous density and heterogeneous enhancement,some associated with reticular and curvilinear density.Peripheral rim enhancement was present in 3 cases.Calcified foci were found in 6 cases.The hepatic parenchyma outside the tumor was normal in all cases.Two subdiaphragmatic and greater omentum tumor infiltrations could not be found on CT scan. Rare findings included tumor thrombus in one case in IVC, lymphnode metastasis in one case. Conclusion The various CT patterns described in this study are helpful in recognizing and evaluating the prognosis of HB.CT scan could acurately localize and characterize the mass,while not always correct in tumor staging.