Ikeda Hitoshi, Nakamura Yosikazu
Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan.
J Pediatr Surg. 2015 Sep;50(9):1506-12. doi: 10.1016/j.jpedsurg.2014.12.010. Epub 2014 Dec 20.
BACKGROUND/PURPOSE: In Japan, an increase in hepatoblastoma with low birth weight has become evident since the 1990 s, and there is concern about a possible increase in unfavorable neuroblastomas after the cessation of mass screening in 2004.
The trends in incidence of malignant solid tumors in children younger than 15 years of age were inferred by evaluating registration incidence in the registry of the Japanese Society of Pediatric Surgeons.
A significant trend toward an increase in the registration incidence for hepatoblastoma was observed (p<0.001). Hepatoblastomas with low birth weight (<1500 g) represented as many as 16% of hepatoblastomas. In hepatocellular carcinoma, there was a significant trend toward a decrease (p=0.042). The registration incidence of nonmass screening-detected neuroblastoma remained unchanged until 2003, but the registration incidence in the period from 2004 to 2012 was significantly higher than that in the period from 1996 to 2003 (p=0.021). There was an increase in the relative incidence of favorable stages after the cessation of mass screening.
The notable increase in hepatoblastoma during the last three decades is partly attributed to an increase in hepatoblastoma in children of low birth weight, but this alone is not sufficient to explain the increase in hepatoblastoma. The increase in neuroblastoma after the halt of mass screening is so minimal that it is not recommended to consider reimplementation of mass screening.
背景/目的:在日本,自20世纪90年代以来,低出生体重儿肝母细胞瘤的发病率呈明显上升趋势,且人们担心在2004年大规模筛查停止后,预后不良的神经母细胞瘤可能会增加。
通过评估日本小儿外科医师学会登记处的登记发病率,推断15岁以下儿童恶性实体瘤的发病趋势。
观察到肝母细胞瘤的登记发病率有显著上升趋势(p<0.001)。低出生体重(<1500g)的肝母细胞瘤占肝母细胞瘤总数的16%。肝细胞癌则有显著下降趋势(p=0.042)。2003年前,非大规模筛查发现的神经母细胞瘤登记发病率保持不变,但2004年至2012年期间的登记发病率显著高于1996年至2003年期间(p=0.021)。大规模筛查停止后,预后良好阶段的相对发病率有所增加。
过去三十年中肝母细胞瘤的显著增加部分归因于低出生体重儿肝母细胞瘤的增加,但仅此一点不足以解释肝母细胞瘤的增加。大规模筛查停止后神经母细胞瘤的增加非常微小,因此不建议重新实施大规模筛查。