中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
4期
288-294
,共7页
鲍萍萍%李凯%吴春晓%黄哲宙%王春芳%向詠梅%彭鹏%龚杨明%肖现民
鮑萍萍%李凱%吳春曉%黃哲宙%王春芳%嚮詠梅%彭鵬%龔楊明%肖現民
포평평%리개%오춘효%황철주%왕춘방%향영매%팽붕%공양명%초현민
恶性实体肿瘤%儿童%发病率%时间趋势%流行病学
噁性實體腫瘤%兒童%髮病率%時間趨勢%流行病學
악성실체종류%인동%발병솔%시간추세%류행병학
Malignant solid tumors%Pediatric%Incidence%Time trend%Epidemiology
目的 分析上海市15岁以下儿童恶性实体肿瘤发病特征和变化趋势,为病因学研究提供线索,为防治措施的制定和评估提供依据.方法 资料来源于上海市肿瘤登记信息系统和儿童肿瘤专项调查.采用儿童肿瘤国际分类ICCC-3进行归类分析.统计2002-2010年上海全市儿童恶性实体肿瘤发病情况及性别、年龄别和瘤别分布特征,应用基于Poisson分布的标化发病率比较方法,计算2007-2010年和2002-2006年两个时期标化发病率比.结果 (1)2002-2010年上海全市共新诊断15岁以下儿童恶性实体肿瘤868例,分别占全部恶性肿瘤和全部儿童恶性肿瘤新发病例数的0.2％和65.8％.年均发病率为79.0/100万,标化发病率为80.2/100万.(2)男性儿童恶性实体肿瘤标化发病率为86.3/100万,女性为73.8/100万.0～4岁组发病率为93.4/100万,5～9岁为65.2/100万,10 ～14岁组为79.3/100万.(3)年均发病率最高的5种恶性实体瘤依次为:中枢神经系统肿瘤(23.8/100万)、淋巴瘤(11.0/100万)、生殖细胞恶性肿瘤(7.8/100万)、神经母细胞瘤(7.7/100万)和软组织肉瘤(6.8/100万).(4)与2002-2006年相比,2007-2010年总的儿童恶性实体肿瘤发病率无明显改变,但男性儿童发病率显著增加,标化发病率分别为94.3/100万和79.5/100万,标化发病率比1.2(95％ CI:1.0～ 1.4).女性儿童发病率无明显变化.两个时期不同亚瘤别发病率比较差异均无统计学意义.儿童恶性实体肿瘤为罕见疾病,尤其是某些少见癌肿的病例数较少,波动较大,在结果解释时需加以注意.结论 2002-2010年上海市儿童恶性实体肿瘤男性发病率高于女性,不同年龄段发病率不同,年龄发病率以0～4岁为最高,中枢神经系统肿瘤是最常见的儿童恶性实体肿瘤.研究结果为开展相关病因学等研究提供了重要线索,亦提示需积累更长时间和更多地区的人群监测资料加以证实和探讨可能的影响因素.
目的 分析上海市15歲以下兒童噁性實體腫瘤髮病特徵和變化趨勢,為病因學研究提供線索,為防治措施的製定和評估提供依據.方法 資料來源于上海市腫瘤登記信息繫統和兒童腫瘤專項調查.採用兒童腫瘤國際分類ICCC-3進行歸類分析.統計2002-2010年上海全市兒童噁性實體腫瘤髮病情況及性彆、年齡彆和瘤彆分佈特徵,應用基于Poisson分佈的標化髮病率比較方法,計算2007-2010年和2002-2006年兩箇時期標化髮病率比.結果 (1)2002-2010年上海全市共新診斷15歲以下兒童噁性實體腫瘤868例,分彆佔全部噁性腫瘤和全部兒童噁性腫瘤新髮病例數的0.2％和65.8％.年均髮病率為79.0/100萬,標化髮病率為80.2/100萬.(2)男性兒童噁性實體腫瘤標化髮病率為86.3/100萬,女性為73.8/100萬.0～4歲組髮病率為93.4/100萬,5～9歲為65.2/100萬,10 ～14歲組為79.3/100萬.(3)年均髮病率最高的5種噁性實體瘤依次為:中樞神經繫統腫瘤(23.8/100萬)、淋巴瘤(11.0/100萬)、生殖細胞噁性腫瘤(7.8/100萬)、神經母細胞瘤(7.7/100萬)和軟組織肉瘤(6.8/100萬).(4)與2002-2006年相比,2007-2010年總的兒童噁性實體腫瘤髮病率無明顯改變,但男性兒童髮病率顯著增加,標化髮病率分彆為94.3/100萬和79.5/100萬,標化髮病率比1.2(95％ CI:1.0～ 1.4).女性兒童髮病率無明顯變化.兩箇時期不同亞瘤彆髮病率比較差異均無統計學意義.兒童噁性實體腫瘤為罕見疾病,尤其是某些少見癌腫的病例數較少,波動較大,在結果解釋時需加以註意.結論 2002-2010年上海市兒童噁性實體腫瘤男性髮病率高于女性,不同年齡段髮病率不同,年齡髮病率以0～4歲為最高,中樞神經繫統腫瘤是最常見的兒童噁性實體腫瘤.研究結果為開展相關病因學等研究提供瞭重要線索,亦提示需積纍更長時間和更多地區的人群鑑測資料加以證實和探討可能的影響因素.
목적 분석상해시15세이하인동악성실체종류발병특정화변화추세,위병인학연구제공선색,위방치조시적제정화평고제공의거.방법 자료래원우상해시종류등기신식계통화인동종류전항조사.채용인동종류국제분류ICCC-3진행귀류분석.통계2002-2010년상해전시인동악성실체종류발병정황급성별、년령별화류별분포특정,응용기우Poisson분포적표화발병솔비교방법,계산2007-2010년화2002-2006년량개시기표화발병솔비.결과 (1)2002-2010년상해전시공신진단15세이하인동악성실체종류868례,분별점전부악성종류화전부인동악성종류신발병례수적0.2％화65.8％.년균발병솔위79.0/100만,표화발병솔위80.2/100만.(2)남성인동악성실체종류표화발병솔위86.3/100만,녀성위73.8/100만.0～4세조발병솔위93.4/100만,5～9세위65.2/100만,10 ～14세조위79.3/100만.(3)년균발병솔최고적5충악성실체류의차위:중추신경계통종류(23.8/100만)、림파류(11.0/100만)、생식세포악성종류(7.8/100만)、신경모세포류(7.7/100만)화연조직육류(6.8/100만).(4)여2002-2006년상비,2007-2010년총적인동악성실체종류발병솔무명현개변,단남성인동발병솔현저증가,표화발병솔분별위94.3/100만화79.5/100만,표화발병솔비1.2(95％ CI:1.0～ 1.4).녀성인동발병솔무명현변화.량개시기불동아류별발병솔비교차이균무통계학의의.인동악성실체종류위한견질병,우기시모사소견암종적병례수교소,파동교대,재결과해석시수가이주의.결론 2002-2010년상해시인동악성실체종류남성발병솔고우녀성,불동년령단발병솔불동,년령발병솔이0～4세위최고,중추신경계통종류시최상견적인동악성실체종류.연구결과위개전상관병인학등연구제공료중요선색,역제시수적루경장시간화경다지구적인군감측자료가이증실화탐토가능적영향인소.
Objective To examine the recent incidences and trends of childhood malignant solid tumors in Shanghai.Method Data from the population-based Shanghai Cancer Registry and related retrospective survey were used to analyze the patterns of incidence and trends of malignant solid tumors diagnosed between 2002 and 2010 in children aged 0-14 years.The distributions of incidences were described according to gender,age and cancer types which were classified according to International Classification of Childhood Cancer (ICCC).Annual age-standardized rates (ASRs) were adjusted by the world standard population.Approximate confidence intervals for standardized rate ratios (SRR) based Poisson distribution test-based methods were used to assess changes in incidence over the period 2002-2006 and 2007-2010.Result (1) A total of 868 cases of childhood malignant solid tumors were diagnosed in Shanghai during 2002-2010,accounting for 65.8％ of all childhood cancers.The ASR of 2002-2010 was 80.2 per million for all solid tumors.(2) The ASR was higher in boys (86.3 per million) than in girls (73.8 per million) with SRR 1.2 (95％ CI 1.0-1.3).Incidence rate was the highest in the first five years of life with 93.4 per million.The age-specific incidence rates in 5-9 and 10-14 age groups were 65.2 and 79.3 per million,respectively.(3) CNS tumors,lymphomas,germ cell tumors,neuroblastoma,and soft tissue sarcomas were the top 5 most common solid tumors in children,with the incidence rate of 23.8,11.0,7.8,7.7 and 6.8 per million,respectively.The patterns of subgroups varied in different age groups.Blastomas,such as neuroblastoma,retinoblastoma,were more common in the children aged 0-4 years,whereas epithelial carcinomas and bone tumors developed more frequently in elder children aged 10-14years.(4) Compared with the ASR in 2002-2006,the ASR for both genders in 2007-2010 had no substantial changes (78.7 per million in 2002-2006 and 82.9 per million in 2007-2010).However,among boys,the incidence rate in 2007-2010 was significantly higher than that in 2002-2006 with SRR 1.2 (95％ CI:1.0-1.4).For specific subgroups of cancer,there were no substantial changes.Some cautions should be taken when interpreting results involving a small number of cases per year and those with wide 95％ confidence intervals.Conclusion The incidence rate of pediatric malignant solid tumors among males was higher than females during 2002-2010,and it differed among different age groups with the highest in the first five years of life.CNS tumor was the most common type of solid tumors in children.This was a unique characteristics comparing with adult reflected in disease spectrum and age of onset.The patterns of incidence and its trends for childhood malignant solid tumors in Shanghai could provide a basis for etiologic research and preventive interventions.The findings also suggest an urgent need for longer population-based surveillance to verify the pattern and changing trends.
