Leck I, Birch J M, Marsden H B, Steward J K
Br J Cancer. 1976 Jul;34(1):69-82. doi: 10.1038/bjc.1976.124.
Several methods of ascertaining and classifying childhood neoplasms for epidemiological study have been evaluated using material from the University of Manchester Children's Tumour Registry (CTR), which includes data from several sources on children with neoplasms first seen in the period 1954-73 who were under 15 years old and living in the Manchester Regional Hospital Board area at the time. Two systems of classification-the International Classification of Diseases (ICD) and the Morphology Section of the Manual of Tumor Nomenclature and Coding (MOTNAC; Percy, Berg and Thomas, 1968)-were tested. No major problems arose with the Morphology Section of MOTNAC, and we recommend that the revised version of this section, in the proposed "International Classification of Diseases for Oncology", should be used in epidemiological reports on children's tumours whenever possible. The ICD discriminates less well between the commoner types of childhood neoplasms, but must be retained as a supplementary classification to facilitate international comparisons. A comparison of the completeness of ascertainment achieved in recent years by each source of data showed that more than 98% of the serious cases (neoplasms that were malignant and/or lay within the craniovertebral canal) could have been identified using a combination of Hospital Activity Analysis (HAA) and cancer registration records, and more than 95% using HAA and death records. But in an analysis of 2 years' HAA returns and 6 years' cancer registrations of serious cases, nearly one quarter of the former and one fifth of the latter were shown to record diagnoses which differed from those finally assigned at the CTR. It is concluded that, in epedimiological studies based on routine records, the diagnoses given should always be checked centrally, by experts, in the light of all the available clinical and pathological material (including histological preparations).
利用曼彻斯特大学儿童肿瘤登记处（CTR）的资料，对几种用于儿童肿瘤流行病学研究的确定和分类方法进行了评估。该登记处的数据来自多个来源，涉及1954年至1973年期间首次就诊的15岁以下、当时居住在曼彻斯特地区医院委员会辖区内的肿瘤患儿。测试了两种分类系统——国际疾病分类（ICD）和《肿瘤命名与编码手册》形态学部分（MOTNAC；Percy、Berg和Thomas，1968年）。MOTNAC形态学部分未出现重大问题，我们建议，在可能的情况下，在儿童肿瘤流行病学报告中应使用拟议的“国际肿瘤疾病分类”中该部分的修订版。ICD对较常见的儿童肿瘤类型的区分能力较差，但必须保留作为补充分类，以促进国际比较。对近年来各数据来源所实现的确诊完整性进行比较表明，使用医院活动分析（HAA）和癌症登记记录相结合的方法，超过98%的严重病例（恶性肿瘤和/或位于颅椎管内的肿瘤）可以被识别，使用HAA和死亡记录则超过95%。但在对2年的HAA回报和6年的严重病例癌症登记进行分析时，发现前者近四分之一、后者五分之一记录的诊断与CTR最终确定的诊断不同。结论是，在基于常规记录的流行病学研究中，所给出的诊断应始终由专家根据所有可用的临床和病理材料（包括组织学制剂）进行集中核对。
