婴儿恶性实体肿瘤的流行病学及预后相关因素

Epidemiology and prognostic factors of infantile malignant solid tumor

作为儿童肿瘤的重要组成部分,婴儿恶性实体肿瘤发病相对罕见,其既有儿童肿瘤的一些共性,也有自身的特殊性。婴儿肿瘤多为胚胎源性肿瘤,发病机制涉及发育生物学、遗传学和环境因素等多个环节。婴儿恶性肿瘤的构成比分布不同于大年龄组儿童,肿瘤登记信息系统不完善、人口迁徙、出生缺陷及围生期因素、环境暴露、性别、种族等因素可影响流行病学数据的统计。异质性是婴儿恶性实体瘤的突出特征之一,从治疗大年龄儿童肿瘤所获得的经验不能直接外推到婴儿身上。婴儿恶性实体肿瘤的治疗需要同时兼顾治疗方法的有效性及对婴儿生长发育的远期影响。早期诊断并选择合理的治疗方式,大多数婴儿恶性实体肿瘤的预后优于年长儿童。因此,有必要将婴儿恶性实体肿瘤作为一个独立的亚群进行管理。现就当前国内外婴儿恶性实体肿瘤的流行病学及预后因素的研究现状作简要论述。

As an important part of childhood tumors,infantile malignant solid tumor is relatively rare,which has some common characteristics of childhood cancer as well as its own particularity.Most infantile tumors are embryo-derived tumors,whose pathogenesis is related to developmental biology,genetics and environmental factors.The distribution of constituent ratio of infantile malignant tumors is different from that of older children,and the epidemiological data statistics can be influenced by the imperfect children tumor registration system,population migration,birth defects and perinatal factors,environmental exposure,gender,race and other factors.Heterogeneity is one of the prominent features of malignant solid tumor in infants.The experience gained from treatment of older children cannot be directly extrapolated to infants.The principle of treating infantile malignant solid tumors should take into account both the effectiveness and the long-term impact on infant growth.Early diagnosis and appropriate treatment mean that the prognosis of most infants with malignant solid tumor to be better than that of older children.Therefore,it is necessary to manage these tumors as a separate entity.The advance of epidemiology and prognostic factors of infantile malignant solid tumors at home and abroad was reviewed in this paper.