昆明市1126例儿童白血病流行病学特征分析

Analysis of epidemiological characteristics of 1126 children with leukemia in Kunming City

目的探讨该地区白血病患儿发病情况、预后评估和发病趋势,为研究儿童白血病发病机制和预防措施提供参考。方法回顾性分析2014—2019年昆明医科大学附属儿童医院收治的1126例初发白血病患儿的年龄、性别、民族、籍贯、MICM分型、发病季节及既往史等流行病学特征,通过二元logistic分析白血病患儿转归影响因素。结果白血病患儿以ALL为主(70.96%),AML患儿亚型以M3型为主(32.28%),ALL免疫学分型以B-ALL为主(85.81%);融合基因检测中,TEL-AML1基因的阳性率最高,为10.59%,ALL患儿TEL-AML基因的阳性率最高,为13.88%,AML患儿PML-RARa基因阳性率最高,为23.50%,CML患儿BCR-ABL基因阳性率为88.89%;男性患儿多于女性患儿;发病年龄集中在2~5岁;发病季节高峰为夏季(28.69%),患儿中的93.69%来自云南本省,昆明市患儿最多,占19.24%。二元logistic回归分析结果显示:发病年龄、诊断类型是白血病患儿转归的影响因素,OR值分别为0.936、0.370。结论儿童白血病发病趋势呈现上升趋势;随着年龄的增长患儿的转归效果愈差,非ALL患儿的转归效果较ALL患儿差。

Objective To analyze the epidemiological characteristics of childhood leukemia,explore the incidence,prognosis evaluation and trend of children with leukemia in this area,so as to provide references for the study of childhood leukemia pathogenesis and preventive measures.Methods A retrospective analysis of the age,gender,nationality,birthplace,MICM classification,onset season,past history and other epidemiological characteristics of 1126 children with newly diagnosed leukemia admitted to the Children’s Hospital of Kunming Medical University from 2014 to 2019 was done.The influence factors of children with leukemia were analyzed through binary logistic analysis.Results The predominant subtype of leukemia children was ALL(70.96%),the predominant subtype of AML children was M3 type(32.28%),and the immunological classification of ALL was predominantly B-ALL(85.81%).In fusion gene detection,TEL-The positive rate of AML1 gene was the highest,10.59%.The positive rate of TEL-AML gene in ALL children was the highest,13.88%.The positive rate of PML-RARa gene was the highest in children with AML,23.50%.All BCR-ABL gene positive of the children with CML was 88.89%.Male children are more than female children.Age of onset was concentrated in 2~5 years old.The peak of the onset season was 28.69%in summer,93.69%of the children from Yunnan Province,Kunming City accounted for 19.24%of the number of children.The binary logistic regression analysis showed that the age of onset and the factors affected the outcome of children with diagnosed leukemia,the OR values were 0.936 and 0.370.Conclusion The incidence of childhood leukemia shows an upward trend;with the increase of age.The outcome of children becomes worse,and the outcome of non-ALL children is worse than that of ALL children.