title: The comparison of grey-scale ultrasonic and clinical features of hepatoblastoma and hepatocellular carcinoma in children: a retrospective study for ten years.
abstract: BACKGROUND
  Hepatoblastoma (HBL) and hepatocellular carcinoma (HCC) are respectively the first and the second most common pediatric malignant liver tumors. The purpose of this study was to evaluate the combined use of the ultrasound examination and the assessment of the patients' clinical features for differentiating HBL from HCC in children.
  
  
  METHODS
  Thirty cases of the confirmed HBL and 12 cases of the confirmed HCC in children under the age of 15 years were enrolled into our study. They were divided into the HBL group and the HCC group according to the histological types of the tumors. The ultrasonic features and the clinical manifestations of the two groups were retrospectively analyzed, with an emphasis on the following parameters: onset age, gender (male/female) ratio, positive epatitis-B-surface-antigen (HBV), alpha-fetoprotein increase, and echo features including septa, calcification and liquefaction within the tumors.
  
  
  RESULTS
  Compared with the children with HCC, the children with HBL had a significantly younger onset age (8.2 years vs. 3.9 years, P < 0.001) and a significantly smaller frequency of positive HBV (66.7% vs. 13.3%, P < 0.001). The septa and liquefaction were more frequently found in HBL than in HCC (25/30, 83.3% vs. 2/12, 16.7%, P < 0.001; 17/30, 56.7% vs. 3/12, 25%, P = 0.02). When a combination of the liquefaction, septa, negative HBV and onset age smaller than 5 years was used in the evaluation, the sensitivity was raised to 90%, the accuracy was raised to 88%, and the negative predictive value was raised to 73%.
  
  
  CONCLUSIONS
  Ultrasonic features combined with clinical manifestations are valuable for differentiating HBL from HCC in children.
authors.affiliation: Department of Radiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhuang
authors.forename: Yu-Lan
authors.initials: YL
authors.lastname: Peng
authors.forename: Tian-Wu
authors.initials: TW
authors.lastname: Chen
authors.forename: Yong
authors.initials: Y
authors.lastname: Jiang
authors.forename: Yan
authors.initials: Y
authors.lastname: Luo
authors.forename: Qiong
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus; D018197:Hepatoblastoma / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies; D017678:Sex Distribution; D014463:Ultrasonography
chemical_list: D006514:Hepatitis B Surface Antigens