The Clinical Pathological Study Of Preoperative Interventional Treatment For Abdominal Malignant Tumors In Children

Objective:The study is a comparative analysis of the clinical data and pathological findings in 33 children with Abdominal malignant tumors (12 cases of interventional group,21 cases of simple resectional group), to evaluate the clinical feasibility and curative effect of preoperative interventional treatment. Through this project we also try to interpret the pathological significance of the preoperative interventional treatment and discuss the mechanism of growth retardation and nemosis of tumor cells and find an index evaluating the effects of the interventional treatment and provide the theoretical basis for establishment of reasonable application choices. Materials and Methods Patients: The study group included 12cases suffered from Abdominal malignant tumors in children, 8 male and 4 female, aged 4-88 months, performed preoperative interventional treatment in which 2were with high differentiation, 3 with intermediate and 7 with poor differentiation.A control group included 21cases of simple tumor surgical resection, 16 male and 5 female, aged 4-92 months. The pathological grading was 4 high differentiation, 7 intermediate and 10 poor differentiation. Measurement and item: 1.The change of clinical symptom and responses of 12 patients With Abdominal malignant tumors in children after interventional treatment were reviewed and analized, compared with the finding of surgery and long curative effect of 21 patients with sample resection at same time. 2.To reviewe and comparethe pathological findings of resected tumor specimen between the two groups(33 cases) by muti-measurement ,and evalutae clinical valuement about interventional treatment more. detect apoptosis of pathological slices of both groups by adopting terminal-deoxynucleotigyl-transferase medical dUTP-X nick end labeling (TUNEL) firstly.Results: Clinical findings: 1. In 12 cases of the study group tumor shrinkage (41.7 % in median) was obtained. There were 4 cases of significant response and 5 of good response, while 3 cases remained stable condition, and in total 64.7% cases had response to the preoperative interventional treatment. Significant response was observed in 50% of the patients who underwent chemoembolization, and it was believed that interventional treatment were efficient in inducing the tumor shrinkage. 2. The capsule of the tumor remained intact in 11/12 in the study group, 1 case with ruptured tumor during operation and another case represented the invasion of the tumor into adjacent tissues. Severe adhesion of with the surrounding structures was found in 2 cases. In the control group 6 cases were found with intact capsule; 6 cases with ruptured tumor; 5 cases with the invasion into adjacent tissue; and severe adhesion was found in 11 cases.Significance difference was found (P＜0.01) in the aspects of the number of cases with intact capsule, severe adhesion, and tumors that were completely removed. Radical resection was performed in all cases of the study group (12/12), and this ratio was much higher than that of the control group (66.7% or 14/21), in which simple resection was performed without preoperative interventional treatments. 3. Blood loss was 142.2±73.2 ml in the study group, which was lower than that in control group (258.2±214.4 ml). The comparison between the means obtained in the two groups revealed statistical difference P＜0.05 (t=2.13), while it seemed there was no difference of the time spent in surgeries between the two group (study group: 135.0±47.1 min, control group: 136.4±47.1min, P＞0.05). 4. The side effects of interventional treatment were observed in some cases,representing mild symptoms, short duration and low morbidity. 5. After the preoperative interventional treatment, the clinical conditions were improved and no major complication or condition resulting in delaying the surgery was encountered. Pathology: 1. X3 and X4 degeneration was observed in 7 cases out of 12 (58.3%), which was significantly higher than that of the co...