Sawada T, Kidowaki T, Sakamoto I, Hashida T, Matsumura T, Nakagawa M, Kusunoki T
Cancer. 1984 Jun 15;53(12):2731-5. doi: 10.1002/1097-0142(19840615)53:12<2731::aid-cncr2820531232>3.0.co;2-d.
Since July 1973, the authors began developing a mass screening system using a VMA (vanilmandelic acid) spot test on 6-to-7 month-old infants for early detection of neuroblastoma in Kyoto city, Japan. Using this method, six infants with this tumor were discovered; five of the six infants were cured, and one is under treatment. These patients showed a favorable prognosis on early diagnosis. In this article, 57 neuroblastoma patients from the Department of Pediatrics, Kyoto Prefectural University of Medicine, treated during the last 20 years, from July 1962 to June 1982, are evaluated. Since the mass screening program has run smoothly since July 1974, clinical findings are compared between 35 neuroblastoma cases before mass screening from the 12-year period from July 1962 to June 1974 and 22 cases after mass screening, during the 8-year period from July 1974 to June 1982. Before mass screening, only 20% (7/35) of the patients were discovered with neuroblastoma younger than 12 months of age and 68.6% were older than 2 years of age. After mass screening, 54.6% (12/22) of the patients were younger than 12 months of age and only 31.8% (7/22) were older than 2 years of age. Before mass screening, 17.1% (6/35) survived with five of the six surviving patients being younger than 12 months of age at the time of diagnosis; 72.7% (16/22) of the patients detected after mass screening are living now. Eleven of the 16 patients have already been cured, and the remaining 5 patients are presently undergoing treatment. A marked improvement of their prognoses is dependent on the early detection of this tumor by mass screening. To date, using the VMA spot test for early detection in infancy is convenient and effective for improvement of its prognosis.
自1973年7月起，作者开始在日本京都开展一项针对6至7个月大婴儿的大规模筛查系统，通过香草扁桃酸（VMA）斑点试验来早期检测神经母细胞瘤。采用这种方法，发现了6例患有该肿瘤的婴儿；其中5例已治愈，1例正在接受治疗。这些患者早期诊断后预后良好。在本文中，对京都府立医科大学儿科在1962年7月至1982年6月的20年期间治疗的57例神经母细胞瘤患者进行了评估。自1974年7月大规模筛查项目顺利开展以来，将1962年7月至1974年这12年期间大规模筛查前的35例神经母细胞瘤病例与1974年7月至1982年6月这8年期间大规模筛查后的22例病例的临床发现进行了比较。大规模筛查前，仅20%（7/35）的神经母细胞瘤患者在12个月龄前被发现，68.6%的患者年龄超过2岁。大规模筛查后，54.6%（12/22）的患者年龄在12个月龄以下，仅31.8%（7/22）的患者年龄超过2岁。大规模筛查前，17.1%（6/35）的患者存活，6例存活患者中有5例在诊断时年龄小于12个月；大规模筛查后检测出的患者中有72.7%（16/22）目前仍存活。16例患者中有11例已治愈，其余5例患者目前正在接受治疗。其预后的显著改善取决于通过大规模筛查早期发现该肿瘤。迄今为止，使用VMA斑点试验在婴儿期进行早期检测对于改善其预后既方便又有效。
