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对新冠疫情期间儿童癌症诊断延误有何担忧?

Any Concern About Delays in the Diagnosis of Childhood Cancers During the COVID-19 Pandemic?

作者信息

Koç Begüm Şirin, Tekkeşin Funda, Haccaloğlu Elif Ezgi, Beyter Büşra, Aydoğdu Selime, Kılıç Suar Çakı

机构信息

Department of Pediatric Hematology and Oncology, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey.

Department of Pediatrics, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey.

出版信息

Turk Arch Pediatr. 2023 Jan;58(1):75-79. doi: 10.5152/TurkArchPediatr.2022.22224.

Abstract

OBJECTIVE

The lockdown precautions during the COVID-19 pandemic led to concerns about the delayed diagnosis of malignancies. This study aimed to compare the duration of complaints at home and the presence of metastasis at diagnosis during the pre-pandemic and pandemic period in children with cancer.

MATERIALS AND METHODS

All children diagnosed with cancer and followed up in our clinic between 2017 and 2022 were included. Patients with a diagnosis of acute/chronic leukemia were excluded. Age, gender, cancer type, duration of complaints, and presence of metastasis at diagnosis of the children were recorded. The duration of complaints and presence of metastasis at diagnosis were compared statistically before and after March 11, 2020, the start point of the COVID-19 pandemic in our country.

RESULTS

A total of 161 patients diagnosed with cancer were analyzed retrospectively; 61% of patients were males and 39% were females. These patients were diagnosed with brain tumors (23.6%), lymphomas (23%), neuroblastoma (13.7%), rhabdomyosarcomas (10.6%), Ewing's sarcoma (4.3%), osteosarcoma (3.7%), Wilm's tumor (3.7%), and germ cell tumors (3.1%). The duration of complaint was longer during the pandemic than before the pandemic (median: 45 days vs. 30 days) (P < .05). The presence of metastases at diagnosis was 45.3% in the prepandemic period, while it was 40% during the pandemic with no statistical difference (P > .5).

CONCLUSION

We concluded that the duration of complaint before diagnosis was longer during the pandemic, while this delay did not affect the metastasis rate at diagnosis in children with cancer. The high rates of distant metastases in newly diagnosed patients both before and during the pandemic suggest that more studies are needed to diagnose these patients earlier.

摘要

目的

2019冠状病毒病(COVID-19)大流行期间的封锁预防措施引发了对恶性肿瘤延迟诊断的担忧。本研究旨在比较癌症患儿在大流行前和大流行期间在家中出现症状的时长以及诊断时转移灶的存在情况。

材料与方法

纳入2017年至2022年间在我院确诊并接受随访的所有癌症患儿。排除诊断为急性/慢性白血病的患者。记录患儿的年龄、性别、癌症类型、症状持续时间以及诊断时转移灶的存在情况。比较2020年3月11日我国COVID-19大流行起始点前后诊断时症状持续时间和转移灶的存在情况,并进行统计学分析。

结果

共对161例确诊癌症的患者进行了回顾性分析;61%为男性,39%为女性。这些患者被诊断为脑肿瘤(23.6%)、淋巴瘤(23%)、神经母细胞瘤(13.7%)、横纹肌肉瘤(10.6%)、尤因肉瘤(4.3%)、骨肉瘤(3.7%)、肾母细胞瘤(3.7%)和生殖细胞肿瘤(3.1%)。大流行期间症状持续时间比大流行前更长(中位数:45天对30天)(P <.05)。诊断时转移灶的存在情况在大流行前为45.3%,大流行期间为40%,无统计学差异(P >.5)。

结论

我们得出结论,大流行期间诊断前症状持续时间更长,但这种延迟并未影响癌症患儿诊断时的转移率。新诊断患者在大流行前和大流行期间远处转移率均较高,提示需要开展更多研究以更早诊断这些患者。

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