小児肝癌の臨床病理学的検討 : 特に予後を左右する因子について

抄録

The histopathological findings as well as clinical and follow-up data in 7 patients with adult-type liver cell carcinoma and in 17 patients with hepatoblastoma have been analysed and discussed particularly with regard to histopathological prognostic factors. All 7 patients with adult-type liver cell carcinoma died of cachexia with metastases to the lungs and lymph nodes. Primary liver tumors in these patients were of a morphologically diffuse type without pseudocapsules. Vascular invasion was noted in all of them. Nine of hepatoblastoma patients are alive and well without any evidence of recurrence; they have survived for periods from 1 to 17 years following resection of primary or metastatic tumors. Fifteen hepatoblastomas had pseudocapsules and 7 patients with tumors having no capsular invasions are all alive. Five of 6 patients with pure, well-differentiated hepatoblastoma are all alive, exhibiting excellent prognosis. Five of 7 patients with hepatoblastoma accompanied by vascular invasion died mainly because of metastases to the lungs. The histology of the neoplastic tissue in vascular invasion and metastatic foci of these patients was mainly of a poorly differentiated variety. Regardless of the extent of predominance in histologic differentiation, patients with portions of poorly differentiated foci should be followed up very closely by observing the serum level of α-fetoprotein. Through reference to histological types and the presence or absence of capsular and vascular invasion, as some of relevant prognostic factors, the prognosis of primary liver carcinomas in infancy and childhood can be envisaged