Tamaro P, Brunetti D, Zanazzo G A, Stanta G
Centro di Emato-Oncologia, Clinica Pediatrica, IRCCS Burlo Garofolo, Università degli Studi, Trieste.
Epidemiol Prev. 1997 Jul-Sep;21(3):202-10.
The study objectives were: 1) to analyse the incidence and death rates from cancer among children aged 0-14 years resident in the north-eastern Italian province of Trieste between 1972-1993, using data from the population-based Trieste Cancer Registry; 2) to evaluate the local diagnostic facilities by analysing the accuracy of histological diagnoses, the causes of delay in the diagnosis, and the interval between onset of symptoms and diagnosis of cancer; 3) to calculate the proportion of patients treated following the most effective therapy protocols known at the time of the tumour detection, and to compute the actuarial five-year survival rates since diagnosis. We recorded 123 new cases of cancer (93% microscopically verified) corresponding to a rate, age-standardized to the world population, of 161.9 (standard error [SE] = 15.1) per million child-years. The most common diagnostic group was that of primary brain tumours: 40 cases, rate = 51.0 (SE = 8.4). In 102 cases the diagnosis was made at hospitals in the province of Trieste, with a median time of seven days (25th-75th percentile = 1-16) between admission and diagnosis. In 37 cases the length of the interval between the advancing of the diagnostic hypothesis of cancer and the microscopic diagnosis ranged from eight to 57 days: 20% of the interval was spent in the identification of the lesion, 50% elapsed between the identification and the biopsy, and 30% was spent in performing the microscopic diagnosis. Out of 123 cases, 30 were partly treated or completely treated at centres not located in our province, i.e., at seven different Italian hospitals (14 cases), nine European hospitals (15 cases), and at one North-American centre (one case). The 40 children with brain tumours were spread among 12 institutions. The five-year survival rate increased from 52.4% (SE = 6.3) for the 63 children with cancers diagnosed in 1972-1981 to 62.5% (SE = 7.0) for the 48 with malignancies detected in 1982-1990.
1）利用基于人群的的里雅斯特癌症登记处的数据，分析1972年至1993年居住在意大利东北部的里雅斯特省0至14岁儿童的癌症发病率和死亡率；2）通过分析组织学诊断的准确性、诊断延迟的原因以及症状出现与癌症诊断之间的间隔，评估当地的诊断设施；3）计算在肿瘤检测时按照当时已知的最有效治疗方案接受治疗的患者比例，并计算自诊断以来的精算五年生存率。我们记录了123例新癌症病例（93%经显微镜证实），按世界人口年龄标准化后的发病率为每百万儿童年161.9例（标准误差[SE]=15.1）。最常见的诊断类别是原发性脑肿瘤：40例，发病率=51.0（SE=8.4）。102例在的里雅斯特省的医院确诊，入院至诊断的中位时间为7天（第25至75百分位数=1至16天）。在37例病例中，从提出癌症诊断假设到显微镜诊断的间隔时间为8至57天：20%的间隔时间用于病变识别，50%在识别与活检之间，30%用于进行显微镜诊断。在123例病例中，30例在本省外的中心接受了部分治疗或完全治疗，即7家不同的意大利医院（14例）、9家欧洲医院（15例）和1家北美中心（1例）。40例脑肿瘤患儿分布在12家机构。五年生存率从1972年至1981年确诊的63例癌症患儿的52.4%（SE=6.3）提高到1982年至1990年检测出的48例恶性肿瘤患儿的62.5%（SE=7.0）。
