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儿童脑肿瘤不断变化的流行病学:来自病童医院的综述

The changing epidemiology of paediatric brain tumours: a review from the Hospital for Sick Children.

作者信息

Kaderali Zul, Lamberti-Pasculli Maria, Rutka James T

机构信息

Division of Neurosurgery, The Department of Surgery, The Hospital for Sick Children, The University of Toronto, Suite 1503, 555 University Avenue, Toronto, Ontario, Canada.

出版信息

Childs Nerv Syst. 2009 Jul;25(7):787-93. doi: 10.1007/s00381-008-0771-9. Epub 2008 Dec 11.

Abstract

PURPOSE

This study examines the changing epidemiology of paediatric brain tumours over the past three decades (1980-2008) in a single institution, SickKids, Toronto, Canada.

METHODS

We classified 1,866 surgical pathology cases of brain tumours in children under the age of 19 according to the World Health Organization 2007 consensus and analysed them by gender, histological tumour type, age distribution and decade.

RESULTS

Males showed a slightly higher predominance with 56.8% of cases overall. The main histological tumour types were low-grade (I/II) astrocytomas (26.4%), medulloblastoma (10.6%), anaplastic astrocytoma/glioblastoma multiforme (7.1%) and ependymoma (7.0%). Over three decades, an increasing proportion of certain tumour types, including pilocytic astrocytoma, atypical teratoma/rhabdoid tumours and neuronal/mixed neuronal-glial tumours was seen.

CONCLUSIONS

Our results are consistent with those published with similar methodologies in other countries. Any changes in the epidemiology of childhood central nervous system tumours over the past three decades may be attributed in part to changing classification systems, improved imaging technologies and developments in epilepsy surgery; however, continued surveillance remains important.

摘要

目的

本研究调查了过去三十年(1980 - 2008年)加拿大多伦多病童医院这一单一机构中儿童脑肿瘤流行病学的变化情况。

方法

我们根据世界卫生组织2007年的共识,对1866例19岁以下儿童脑肿瘤手术病理病例进行分类,并按性别、组织学肿瘤类型、年龄分布和年代进行分析。

结果

总体病例中男性占比略高,为56.8%。主要的组织学肿瘤类型为低级别(I/II级)星形细胞瘤(26.4%)、髓母细胞瘤(10.6%)、间变性星形细胞瘤/多形性胶质母细胞瘤(7.1%)和室管膜瘤(7.0%)。在三十年期间,某些肿瘤类型的比例有所增加,包括毛细胞型星形细胞瘤、非典型畸胎瘤/横纹肌样肿瘤和神经元/混合性神经元 - 神经胶质肿瘤。

结论

我们的结果与其他国家采用类似方法发表的结果一致。过去三十年儿童中枢神经系统肿瘤流行病学的任何变化可能部分归因于分类系统的改变、成像技术的改进和癫痫手术的发展;然而,持续监测仍然很重要。

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