单中心2009至2011年住院患儿中实体肿瘤状况分析

目的 分析儿童实体肿瘤的原发部位和病理类型，为儿童实体肿瘤的诊治提供帮助。方法 回顾性收集2009年1月至2011年12月经手术/病理活检确诊的实体肿瘤患儿，采集肿瘤原发部位、病理类型和组织起源等资料，分为0～1、~4、～7、～10和～14岁组进行分析。结果 983例实体肿瘤患儿进入分析，其中良性肿瘤721例（73.3%），恶性肿瘤262例；男548例（55.7%），女435例；发病年龄8 d至14岁，中位年龄4岁。①721例良性肿瘤中，以脉管瘤（233例，32.3％）、钙化上皮瘤（161例，22.3％）、软骨瘤（68例，9.4％）、纤维瘤（67例，9.3％）和成熟畸胎瘤（66例，9.2％）多见。262例恶性肿瘤中，以神经母细胞瘤（44例，16.8％）、恶性淋巴瘤（34例，13.0％)和肾母细胞瘤（33例，12.6％)多见。②良性肿瘤好发于皮肤及软组织（324例，44.9％）、头面颈部（220例，30.5％）和骨骼（86例，11.9％）。恶性肿瘤好发于腹腔（96例，36.6%）、颅内（51例，19.5％）和头面颈部（33例，12.6％）。③恶性肿瘤以胚胎源性肿瘤最多见（171例，65.3％），其次为含类似组织成分的肿瘤（57例，21.8％）和淋巴源性肿瘤（34例，13.0％）。④良性肿瘤中，脉管瘤、钙化上皮瘤和纤维瘤主要分布于~4岁组。恶性肿瘤中，神经母细胞瘤和肾母细胞瘤在0～1岁和～4岁组累计构成比分别为84.1％和81.9％，恶性淋巴瘤在4岁以上组累计构成比为71.6％。⑤巨大恶性肿瘤29例（11.1%），其中24/29例（82.8%）年龄<4岁，腹腔为最常见原发部位（26例,89.7%）。结论 良性肿瘤是儿童实体肿瘤的主要构成。儿童恶性肿瘤好发于腹腔，组织来源以胚胎源性肿瘤为主。神经母细胞瘤及肾母细胞瘤可能是<4岁儿童腹腔巨大恶性肿瘤的主要病理类型。

Single center analysis of cases with childhood solid tumor from 2009 to 2011

Objective To investigate epidemiological and clinical features of childhood solid tumor in our hospital from Jan. 2009 to Dec. 2011. Methods Clinical and pathological data were retrospectively reviewed and analyzed. Tumor classification was performed according to WHO tumor classification and diagnostic criteria. Results In total, 983 cases of childhood solid tumor were enrolled into the study, including 721 （73.35%）benign tumors and 262 malignant tumors. There were 548 boys(55.7%) and 435 girls, aged from 8 days to 14 years (median age was 4 years old). ① Sort by the pathological type: The top five benign tumors were vascular tumor, calcifying epithelioma, chondroma, fibroma and mature teratoma, while the top three malignant tumors were neuroblastoma, lymphoma and Wilm′s tumor. ② Sort by the original site:The top three benign tumors were skin and soft tissue tumors,craniofacial and neck tumors and bone tumors, while the top three malignant tumors were abdominal tumors,intracranial tumors and craniofacial and neck tumors. ③ Most common malignant tumors were embryonal tumors (171 cases, 65.3%), followed by tumors containing similar ingredients (57 cases, 21.8%) and lymphoma (34 cases, 13.0%). ④ Solid tumors were much more prevalent in infants and toddlers, showing a characteristic single peak pattern. ⑤ 29/262 cases（11.1%） were massive malignant tumor and 26 of them（89.7%）were from abdomen. Conclusions Benign tumor remains the main type of solid tumor in children. Childhood malignant tumors commonly occur in the abdominal cavity with embryonic tumors as the predominant histological types. Neuroblastoma and Wilm′s tumor are the primary tumors with huge tumor mass in children under 4 years old.