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儿童脑肿瘤的流行病学特征、临床表现及预后:国家儿童健康中心的经验

Epidemiological characteristics, clinical presentations, and prognoses of pediatric brain tumors: Experiences of national center for children's health.

作者信息

Yang Wei, Cai Yingjie, Chen Jiashu, Yang Ping, Ying Zesheng, Liang Yuting, Ling Miao, Zhu Kaiyi, Sun Hailang, Ji Yuanqi, Peng Xiaojiao, Zhang Nan, Ma Wenping, Ge Ming

机构信息

Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.

出版信息

Front Oncol. 2023 Jan 27;13:1067858. doi: 10.3389/fonc.2023.1067858. eCollection 2023.

Abstract

BACKGROUND

We aimed to describe the epidemiological characteristics, clinical presentations, and prognoses in a national health center for children.

METHODS

From January 2015 to December 2020, 484 patients aged 0-16 years, who were diagnosed with brain tumors and received neurosurgery treatment, were enrolled in the study. Pathology was based on the World Health Organization 2021 nervous system tumor classification, and tumor behaviors were classified according to the International Classification of Diseases for Oncology, third edition.

RESULTS

Among the 484 patients with brain tumors, the median age at diagnosis was 4.62 [2.19, 8.17] years (benign tumors 4.07 [1.64, 7.13] vs. malignant tumors 5.36 [2.78, 8.84], p=0.008). The overall male-to-female ratio was 1.33:1(benign 1.09:1 vs. malignant 1.62:1, p=0.029). Nausea, vomiting, and headache were the most frequent initial symptoms. The three most frequent tumor types were embryonal tumors (ET, 22.8%), circumscribed astrocytic gliomas (20.0%), and pediatric-type diffuse gliomas (11.0%). The most common tumor locations were the cerebellum and fourth ventricle (38.67%), the sellar region (22.9%) and ventricles (10.6%). Males took up a higher proportion than females in choroid plexus tumors (63.6%), ET (61.1%), ependymal tumors (68.6%), and germ cell tumors (GCTs, 78.1%). Patients were followed for 1 to 82 months. The overall 5-year survival rate was 77.5%, with survival rates of 91.0% for benign tumors and 64.6% for malignant tumors.

CONCLUSION

Brain tumors presented particularly sex-, age-, and regional-dependent epidemiological characteristics. Our results were consistent with previous reports and might reflect the real epidemiological status in China.

摘要

背景

我们旨在描述一家全国性儿童健康中心的脑肿瘤流行病学特征、临床表现及预后情况。

方法

2015年1月至2020年12月,纳入484例年龄在0至16岁、被诊断为脑肿瘤并接受神经外科治疗的患者。病理学诊断依据世界卫生组织2021年神经系统肿瘤分类标准,肿瘤行为根据国际肿瘤疾病分类第三版进行分类。

结果

在484例脑肿瘤患者中,诊断时的中位年龄为4.62[2.19, 8.17]岁(良性肿瘤为4.07[1.64, 7.13]岁,恶性肿瘤为5.36[2.78, 8.84]岁,p = 0.008)。总体男女比例为1.33:1(良性肿瘤为1.09:1,恶性肿瘤为1.62:1,p = 0.029)。恶心、呕吐和头痛是最常见的初始症状。最常见的三种肿瘤类型为胚胎性肿瘤(ET,22.8%)、局限性星形细胞胶质瘤(20.0%)和儿童型弥漫性胶质瘤(11.0%)。最常见的肿瘤部位是小脑和第四脑室(38.67%)、鞍区(22.9%)和脑室(10.6%)。在脉络丛肿瘤(63.6%)、ET(61.1%)、室管膜瘤(68.6%)和生殖细胞肿瘤(GCTs,78.1%)中,男性所占比例高于女性。对患者进行了1至82个月的随访。总体5年生存率为77.5%,良性肿瘤生存率为91.0%,恶性肿瘤生存率为64.6%。

结论

脑肿瘤呈现出特别的性别、年龄和区域依赖性流行病学特征。我们的结果与先前报告一致,可能反映了中国的实际流行病学状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a492/9915562/0aef8ac8a207/fonc-13-1067858-g001.jpg

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