单中心急性淋巴细胞白血病患者的流行病学分析  

Epidemiological analysis of patients with acute lymphoblastic leukemia in a single center

作　　者：杨敏 王雪梅 潘艳莎 张长玲 陈红英 郭渠莲 刘文君 YANG Min;WANG Xuemei;PAN Yansha;ZHANG Changling;CHEN Hongying;GUO Qulian;LIU Wenjun(Department of Pediatrics,Affiliated Hospital of Southwest Medical University,Pediatric Hematological Oncology and Birth Defects Laboratory,Sichuan Clinical Research Center for Birth Defects,Sichuan Luzhou 646000,China;Department of Hematology,Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院儿科,儿童血液肿瘤与出生缺陷实验室,四川省出生缺陷临床医学研究中心,四川泸州646000 [2]西南医科大学附属医院血液内科,四川泸州646000

出　　处：《现代肿瘤医学》2025年第6期1007-1016,共10页Journal of Modern Oncology

基　　金：四川省科技计划项目(编号:2022YFS0622)。

摘　　要：目的:收集急性淋巴细胞白血病(acutelymphoblasticleukemia,ALL)患者的病例资料,分析总结ALL患者的流行病学特征。方法:收集2013年01月至2022年12月我中心收治的新发ALL患者的临床资料,回顾性分析其年龄、性别、发病季节、地域分布、危险因素暴露史、家族史、分型特征等流行病学资料。结果:ALL患者男女比例为1.06∶1,中位年龄17.3岁,儿童发病年龄高峰1~5岁,成人好发年龄呈数个分散小高峰。发病季节高峰为夏季,常住地农村∶城市=4.26∶1。危险因素暴露占比前三分别为母亲孕期有害物质接触、父亲在母亲孕期/分娩后吸烟、母亲孕期感染。一至三级亲属中有异常疾病史者占6%,以肺癌及消化系统肿瘤为主。顺产占87.3%,剖宫产占12.8%;头胎占45.5%,二胎占35.3%,三胎及以上占19.3%;儿童中6月龄内母乳喂养占88.5%,配方奶喂养占4.8%,混合喂养占6.8%。B-ALL占83.3%,T-ALL占16.7%;正常染色体核型占56.7%,伴染色体数目和(或)结构异常占43.3%;融合基因阳性率47.3%,占比前三融合基因分别是BCR-ABL(28.0%)、E2A-PBX1(5.8%)、TEL-AML1(5.2%)。结论:本研究中ALL男性多于女性,儿童发病年龄高峰1~5岁,发病季节高峰为夏季,常住地多为农村,有胎儿期/生后有害物质暴露史、亲属血液病/恶性肿瘤病史者占比较高,免疫分型以B型为主,染色体核型以正常为主,融合基因以BCR-ABL、E2A-PBX1、TEL-AML1多见。Objective:To collect the clinical data of acute lymphoblastic leukemia(ALL)patients,analyze and summarize the epidemiological characteristics of them.Methods:The clinical data of newly diagnosed ALL patients admitted to our center from January,2013 to December,2022 were collected,and the epidemiological data such as age,gender,onset season,regional distribution,exposure history of risk factors,family history,and typing characteristics were retrospectively analyzed.Results:The male to female ratio of ALL patients was 1.06∶1,and the median age was 17.3 years old.The peak age of childhood ALL patients was 1~5 years old,and the peak age of adult ALL patients was several scattered small peaks.The seasonal peak of the disease was in summer.The ratio of permanent residence in rural area∶city was 4.26∶1.The top three exposure risk factors were maternal exposure to harmful substances during pregnancy,father smoking during pregnancy/after delivery,and maternal infection during pregnancy.6%of the patients had a history of abnormal diseases in their first to third grade relatives,mainly lung cancer and digestive system tumors.In these patients,87.3%were delivered by vaginal delivery and 12.8%by cesarean section,45.5%were firstborns,35.3%were the second children,and 19.3%were three or more children.Among the children with ALL,88.5%were breastfed within 6 months of age,4.8%were fed by formula,and 6.8%were fed by mix.The immunophenotype showed that B-ALL accounted for 83.3%and T-ALL accounted for 16.7%.In cytogenetic tests,56.7%of the patients had normal chromosome karyotype,and 43.3%had numerical and/or structural abnormalities.The positive rate of fusion gene was 47.3%,and the top three fusion genes were BCR-ABL(28.0%),E2A-PBX1(5.8%)and TEL-AML1(5.2%).Conclusion:In this study,there were more males than females with ALL.The peak age of onset in children was 1~5 years old.The peak season of onset was summer,and most of the patients lived in rural areas.There was a relatively high proportion of patients with fetal/postnata

关 键 词：单中心 急性淋巴细胞白血病 流行病学 儿童 成人 

分 类 号：R733.71[医药卫生—肿瘤]