Liu Anthony P Y, Liu Qi, Shing Matthew M K, Ku Dennis T L, Fu Eric, Luk Chung-Wing, Ling Siu-Cheung, Cheng Kevin K F, Kwong Dora L W, Ho Wilson W S, Ng Ho-Keung, Gajjar Amar, Yasui Yutaka, Chan Godfrey C F, Armstrong Gregory T
Department of Oncology, St Jude Children's Research Hospital, Memphis, TN.
Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
JCO Glob Oncol. 2020 May;6:704-721. doi: 10.1200/JGO.19.00378.
Despite being the most common pediatric solid tumors, incidence and outcome of CNS tumors in Chinese children have not been systematically reported. We addressed this knowledge gap by comparing the epidemiology of pediatric CNS tumors in Hong Kong and the United States.
Data between 1999 and 2016 from a population-based cancer registry in Hong Kong, China, on patients < 18 years old with CNS tumors (Hong Kong cohort) and from the US SEER Program (Asian/Pacific Islander and all ethnicities) were compared. Incidence and overall survival (OS) by histology were evaluated.
During the study period, 526 children were newly diagnosed with CNS tumors in Hong Kong (crude incidence rate, 2.47 per 100,000; 95% CI, 2.26 to 2.69). Adjusted incidences were significantly lower in the Hong Kong (2.51; 95% CI, 2.30 to 2.74) than in the SEER (Asian/Pacific Islander: 3.26; 95% CI, 2.97 to 3.57; < .001; all ethnicities: 4.10 per 100,000; 95% CI, 3.99 to 4.22; < .001) cohorts. Incidences of germ cell tumors (0.57 0.24; < .001) were significantly higher, but those of glial and neuronal tumors (0.94 2.61; < .001), ependymomas (0.18 0.31; = .005), and choroid plexus tumors (0.08 0.16; = .045) were significantly lower in Hong Kong compared with SEER (all ethnicities) cohorts. Compared with the SEER (Asian/Pacific Islander) cohort, histology-specific incidences were similar except for a lower incidence of glial and neuronal tumors in Hong Kong (0.94 1.74; < .001). Among cohorts, OS differed only for patients with glial and neuronal tumors (5-year OS: Hong Kong, 52.5%; SEER [Asian/Pacific Islander], 73.6%; SEER [all ethnicities], 79.9%; < .001).
We identified important ethnic differences in the epidemiology of CNS tumors in Chinese children. These results will inform the development of pediatric neuro-oncology services in China and aid further etiologic studies.
尽管中枢神经系统（CNS）肿瘤是最常见的儿科实体瘤，但中国儿童CNS肿瘤的发病率和预后尚未得到系统报道。我们通过比较香港和美国儿科CNS肿瘤的流行病学情况，填补了这一知识空白。
比较了1999年至2016年期间来自中国香港基于人群的癌症登记处的18岁以下CNS肿瘤患者数据（香港队列）以及美国监测、流行病学和最终结果（SEER）计划（亚裔/太平洋岛民及所有种族）的数据。评估了按组织学分类的发病率和总生存率（OS）。
在研究期间，香港有526名儿童被新诊断为CNS肿瘤（粗发病率为每10万人2.47例；95%置信区间为2.26至2.69）。香港的校正发病率（2.51；95%置信区间为2.30至2.74）显著低于SEER计划（亚裔/太平洋岛民：3.26；95%置信区间为2.97至3.57；P<0.001；所有种族：每10万人4.10例；95%置信区间为3.99至4.22；P<0.001）队列。与SEER计划（所有种族）队列相比，香港生殖细胞肿瘤的发病率（0.57对0.24；P<0.001）显著更高，但胶质和神经元肿瘤（0.94对2.61；P<0.001）、室管膜瘤（0.18对0.31；P = 0.005）和脉络丛肿瘤（0.08对0.16；P = 0.045）的发病率显著更低。与SEER计划（亚裔/太平洋岛民）队列相比，除香港胶质和神经元肿瘤发病率较低（0.94对1.74；P<0.001）外，各组织学类型的发病率相似。在各队列中，仅胶质和神经元肿瘤患者的OS存在差异（5年OS：香港为52.5%；SEER计划[亚裔/太平洋岛民]为73.6%；SEER计划[所有种族]为79.9%；P<0.001）。
我们发现中国儿童CNS肿瘤的流行病学存在重要的种族差异。这些结果将为中国儿科神经肿瘤学服务的发展提供参考，并有助于进一步的病因学研究。
