Hirata Koji, Muroi Ai, Tsurubuchi Takao, Fukushima Hiroko, Suzuki Ryoko, Yamaki Yuni, Ishikawa Eiichi, Matsumura Akira
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Department of Pediatrics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Childs Nerv Syst. 2020 Sep;36(9):2047-2054. doi: 10.1007/s00381-020-04573-y. Epub 2020 Mar 10.
We aimed to identify factors that affect the time to diagnosis in pediatric brain tumors and investigate the effect of time to diagnosis on clinical outcome.
A retrospective study of children with brain tumors aged less than 18 years diagnosed at the University of Tsukuba Hospital over a period of 7 years was conducted.
Eighty-five consecutive patients, with a mean age of 9.1 years, were included in the study. The median interval from symptom onset to diagnosis was 45 days (range 0-1673); median interval from symptom onset to first presentation was 31.0 days; and median interval from first presentation to diagnosis was 13.5 days. Germinoma had the longest interval from symptom onset to first presentation, and from first presentation to diagnosis. Patients presenting with endocrine disorder had a significantly longer interval from symptom onset to first presentation (p = 0.019); those with visual disturbance (p = 0.016) or endocrine disorder (p = 0.030) had significantly longer intervals from first presentation to diagnosis.
Pediatric brain tumor patients with germinoma and presenting symptoms of endocrine disorder or visual disturbance have a longer time to diagnosis. Although improved prognosis is not clearly related to a shorter time to diagnosis, we believe that early diagnosis can lead to improved treatment and better quality of life. A detailed medical history and neuroimaging studies at the earliest time possible are important for early diagnosis.
我们旨在确定影响儿童脑肿瘤诊断时间的因素，并研究诊断时间对临床结局的影响。
对筑波大学医院7年间诊断的18岁以下脑肿瘤患儿进行回顾性研究。
85例连续患者纳入研究，平均年龄9.1岁。从症状出现到诊断的中位间隔时间为45天（范围0 - 1673天）；从症状出现到首次就诊的中位间隔时间为31.0天；从首次就诊到诊断的中位间隔时间为13.5天。生殖细胞瘤从症状出现到首次就诊以及从首次就诊到诊断的间隔时间最长。出现内分泌紊乱的患者从症状出现到首次就诊的间隔时间显著更长（p = 0.019）；出现视力障碍（p = 0.016）或内分泌紊乱（p = 0.030）的患者从首次就诊到诊断的间隔时间显著更长。
患有生殖细胞瘤且出现内分泌紊乱或视力障碍症状的儿童脑肿瘤患者诊断时间更长。虽然预后改善与较短的诊断时间没有明确关联，但我们认为早期诊断可带来更好的治疗和更高的生活质量。详细的病史和尽早进行神经影像学检查对早期诊断很重要。
