1267例儿童神经系统肿瘤的流行病学  

Epidemiology of nervous system tumors in childhood： a survey based on 1267 consecutive cases

作　　者：周大彪[1] 罗世祺[1] 马振宇[1] 甲戈[1] 罗麟[2] 戴珂[2] 张玉琪[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050 [2]北京市神经外科研究所神经病理室

出　　处：《中华神经外科杂志》2007年第1期4-7,共4页Chinese Journal of Neurosurgery

摘　　要：目的回顾性分析儿童神经系统肿瘤的流行病学特点。方法2001年1月至2005年12月五年间，获得组织病理学诊断的儿童（年龄≤15岁）原发性神经系统肿瘤1267例，按照WHO2000年新分类，分析患者性别、肿瘤部位和组织学类型、分级与年龄的相关性。结果脑和椎管肿瘤分别为1177例（92．9％）和90例（7．1％），均以低级别肿瘤为主（65．2％和76．7％），总的男女性别之比为1．6：1。脑肿瘤以幕上居多（60．4％），而750例神经上皮性脑肿瘤以幕下居多（57．3％）。常见的五类脑肿瘤是星形细胞肿瘤（29．9％）、颅咽管瘤（19．8％）、髓母细胞瘤（15．7％）、生殖细胞肿瘤（GCT）（7．5％）和室管膜肿瘤（5．9％），男性比例最高的是GCT和髓母细胞瘤。33．8％的星形细胞肿瘤发生于青春期；颅咽管瘤除婴幼儿组外，各年龄组发病几乎均等；髓母细胞瘤多见于7—9岁（33．0％），而在婴幼儿和青春期发病较低；GCT在2岁内无患病者，10—15岁占71．6％。室管膜肿瘤以幕下为主（77．1％），婴幼儿期的发生比例最高。椎管肿瘤常见的是星形细胞瘤（17．8％）、室管膜肿瘤和脂肪瘤（均为15．6％）。结论本研究基于WHO新分类，反映了国内儿童神经系统肿瘤的流行病学特点。Objective To determine the epidemiology of nervous system tumors in childhood retrospectively. Methods During a 5-year period from January 2001 to December 2005, one thousand and two hundred sixty-seven primary tumors in children （ ≤ 15 years of age） were diagnosed histopathologically according to the latest WHO 2000 nervous system tumor classification. The distribution of gender, tumor location and histological type/grade in relation to age was investigated. Results In this series, brain and spinal tumors were 1177（92.9% ） and 90（7.1% ） with the predominance of low-grade tumors （65.2% and 76.7% respectively）. The overall gender ratio （male-to-female） was 1.6： 1. Of brain tumors, 60.4% were supratentorial. There were 750 brain tumors of neuroepithelial tissue, of which 57.3% was infratentorial. The most common five brain tumors were astrocytic tumors （ 29.9% ）, craniopharyngiomas （ 19.8% ）, medulloblastomas （15.7%） , germ cell tumors （GCTs） （7.5%） and ependymal tumors （5.9%）. The highest preponderance of boys was observed in GCTs followed by medulloblastomas. 33.8% of the artrocytic tumors were seen in adolescent group. There was an even distribution of craniopharyngiomas through 4-to 15- years of age groups. Medulloblastomas occurred more frequently in children age 7 ～ 9 years （33.0%） than infants or adolescents. GCTs were not encountered in children in the first 2 years of life whereas teenage children accounted for 71.6%. Ependymal tumors were mostly frequent in infants （24.3%） with marked infratentorial prevalence （77.1%）. The common entities of spinal tumors were astrocytomas （ 17.8% ）, ependymal tumors and lipomas （15.6% each）. Conclusions The present study based on the new WHO classification reflects the domestic epidemiology of nervous system tumors in childhood.

关 键 词：流行病学 儿童 神经系统肿瘤 WHO分类 

分 类 号：R686[医药卫生—骨科学]