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[日本神经母细胞瘤大规模筛查的现状。日本儿童癌症协会神经母细胞瘤委员会]

[Present status of neuroblastoma mass screening in Japan. Neuroblastoma-Committee of the Japanese Childhood Cancer Society].

作者信息

Sawada T, Nagahara N, Ohi R, Yamamoto K, Okabe I, Hanawa Y, Hashizume K, Matsui I, Ohkawa H, Tunoda A

机构信息

Dept. of Pediatrics, Kyoto Prefectural University of Medicine Medical School.

出版信息

Gan To Kagaku Ryoho. 1990 Dec;17(12):2319-26.

PMID:2260868
Abstract

In 1973, mass screening program for 6-month old infants for early detection of neuroblastoma using a VMA spot test of a urine sample was initiated in Kyoto. In 1985, nation wide mass screening was initiated throughout the entire country and the Government has given the financial support to each district. In 1988, the Government recommended the institution of mass screening by quantitative measurements of VMA, HVA and creatinine using HPLC (high performance liquid chromatography), instead of the qualitative test of VMA alone. From 1974, at the time of initiation of mass screening for neuroblastoma to the end of October, 1989, 383 cases with this tumor have been discovered throughout the screening program. Three hundreds eighty three cases (88%) of them had been registered to the Neuroblastoma Committee of the Japanese Society of Pediatric Oncology. In this paper, the mass screening program was introduced and the 337 cases with this tumor detected by 6-month old screening were analyzed their clinical symptoms, findings, urinary VMA and HVA levels, primary sites, weights of primary tumor, histology, stages at diagnosis, metastatic sites, and the results of the treatment. Three hundreds twenty eight cases (97%) of them are expected to be cured. And we discussed clinical problems related to mass screening program for neuroblastoma, such as an increase of the incidence of infantile neuroblastomas detected by this program and the spontaneous regression.

摘要

1973年,京都启动了针对6个月大婴儿的大规模筛查项目,通过对尿样进行香草扁桃酸(VMA)斑点试验来早期检测神经母细胞瘤。1985年,在全国范围内启动了大规模筛查,政府为每个地区提供了财政支持。1988年,政府建议采用高效液相色谱法(HPLC)对VMA、高香草酸(HVA)和肌酐进行定量检测,而不是仅对VMA进行定性检测,以此开展大规模筛查。从1974年神经母细胞瘤大规模筛查启动至1989年10月底,在整个筛查项目中已发现383例该肿瘤病例。其中383例(88%)已向日本小儿肿瘤学会神经母细胞瘤委员会进行了登记。本文介绍了大规模筛查项目,并对通过6个月大婴儿筛查检测出的337例该肿瘤病例的临床症状、检查结果、尿VMA和HVA水平、原发部位、原发肿瘤重量、组织学、诊断分期、转移部位以及治疗结果进行了分析。其中328例(97%)有望治愈。此外,我们还讨论了与神经母细胞瘤大规模筛查项目相关的临床问题,例如该项目检测出的婴儿神经母细胞瘤发病率增加以及肿瘤的自发消退。

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