Saha V, Love S, Eden T, Micallef-Eynaud P, MacKinlay G
Department of Paediatric Oncology, St Bartholomew's Hospital, London.
Arch Dis Child. 1993 Jun;68(6):771-4. doi: 10.1136/adc.68.6.771.
The duration of symptoms before diagnosis (lag time) was defined for 184 of 236 children diagnosed as having a malignancy at the Royal Hospital for Sick Children, Edinburgh for the time period January 1982 until December 1990. The natural logarithm of the lag time was correlated with age, gender, diagnostic group, white cell count in acute leukaemia, clinical stage of disease in solid tumours, and event free survival. Age was significantly associated with lag time, older children presenting later. In the diagnostic groups, mean lag time ranged from 2.8 weeks in nephroblastoma to 13.3 weeks for brain tumours. Diagnostic group was predictive for lag time after adjustment for age, with for example, a significantly longer lag time for those with brain tumours. However lag time was not predictive of event free survival and it is likely that lag time has other major determinants. When compared with previous studies, there also appears to be a regional variation in lag time for diagnostic groups. It seems likely that this is a reflection of geographical difference in the structure of health systems and is therefore yet another important determinant.
1982年1月至1990年12月期间，在爱丁堡皇家儿童医院被诊断患有恶性肿瘤的236名儿童中，有184名儿童被确定了诊断前症状持续时间（延迟时间）。延迟时间的自然对数与年龄、性别、诊断组、急性白血病的白细胞计数、实体瘤的疾病临床分期以及无事件生存期相关。年龄与延迟时间显著相关，年龄较大的儿童就诊时间较晚。在各诊断组中，平均延迟时间从肾母细胞瘤的2.8周到脑肿瘤的13.3周不等。在对年龄进行调整后，诊断组可预测延迟时间，例如，脑肿瘤患者的延迟时间明显更长。然而，延迟时间并不能预测无事件生存期，延迟时间可能还有其他主要决定因素。与之前的研究相比，各诊断组的延迟时间似乎也存在地区差异。这似乎反映了卫生系统结构的地理差异，因此也是另一个重要的决定因素。
