| Objective:The clinical characteristics of children with neuroblastoma,the sex of each child,LDH,whether the tumor surrounding the blood vessels,the largest diameter of the tumor,whether there was bone marrow infiltration,whether surgical treatment was carried out,and the impact on the prognosis of each child were analyzed.Methods: Collect 45 children diagnosed as NB in the pediatric blood ward and pediatric surgery ward of the second hospital of Hebei Medical University from January 1,2014 to December 31,2019.SPSS 20.0 was used to analyze the collected data.Inclusion criteria: 1)Age≤14 years old.2)The clinical staging and grouping of children were mainly based on the International NB staging system(INSS)and the NB risk grouping system(COG).1.Six evaluation indicators for the design of excerpts of cases,systematic inclusion in the sex of children with NB in the group,LDH,whether the tumor surrounding the blood vessels,the maximum diameter of the tumor,whether there was bone marrow infiltration,and whether surgery was performed.2.Design follow-up table,collect statistics and integrate the survival of children in the group and calculate the survival time.Statistical analysis of data:sex,LDH,whether the tumor surrounding the blood vessels,the maximum diameter of the tumor,whether there was bone marrow infiltration,and whether surgical treatment had an impact on the prognosis and survival time of children.3.Statistical analysis: The statistical software used SPSS 20.0.The measurement data were expressed in mean±standard deviation,and the count data was expressed as percentage.Kaplan-Meier method was used to calculate one-year and three-year overall survival rates and event-free survival rates and to draw survival curves.And used Log-Rank to compare survival curves.COX regression model was used to screen the influence of each factor on the survival time.COX multi-risk regression model was further established to screen the independent influencing factors through multi-factor analysis.Chi square test was used for distribution of indicators in the prognosis and analysis of the correlation analysis within the group.And P<0.05 indicates that the difference was statistically significant.Results:1.Gender and age: A total of 45 clinical cases were collected,of which27 were boys and 18 were girls.The onset age was between one month old and13 years old.2.Pathological stages: The clinical staging of 45 children was based on neuroblastoma INSS,including 0 case in stage I,0 case in stage II,11 cases in stage III,34 cases in stage IV.3.Clinical features:The common clinical symptoms of early stage of onset was including tumor in 25 cases,pain in different parts in 9 cases,fever in 7 cases,diarrhea in 2 cases,anemia in 1 case and claudication in 1case.There were 21 cases of bone marrow infiltration in children with early stage of onset,20 cases of the tumor surrounding the blood vessels,18 cases of LDH>500U/ L,and 17 cases with a maximum tumor diameter > 8cm.4.Treatment plans:In our hospital,we accorded to the condition of the children to choose the best treatment plan for them.The treatment plan of 30 cases were chemo therapeutics combined with operation,12 cases were chemotherapy alone,1 case was surgery,1 case was surgery combined with radiotherapy and chemotherapy,and 1 case was chemotherapy,ASCT and CAR-T.5.Survival situation analysis:Of the 45 patients,25 cases survived and 20 cases died.A total of 6 cases of 45 children had recurrences.After treatment,3cases did not response and died.Only 2 cases responsed after treatment.1 case did not response and continued treatment.The overall annual overall survival rate and the annual event-free survival rate of the 45 children were 82.20% ±5.7%,The three-year overall survival rate was 42.9% ± 8.4%,and the three-year event-free survival rate was 34.3% ± 8.0%.6.Analysis of factors affecting prognosis:The chi square test was used for the correlation analysis within the group of 45 NB children,and the Log-Rank test was used to analyze the survival curve of children,and COX regression model single-factor screening of 45 NB children showed that the tumor surrounding the blood vessels by the tumor,and the maximum diameter of the tumor had influence on the prognosis of children with NB.However,the multi-factor analysis of the COX regression model showed that only the tumor surrounding the blood vessels was the main factor affecting the prognosis of the affected child.Conclusions:1.The most common clinical manifestations in the early stage of neuroblastoma in children were tumor,pain and fever.2.The incidence rate of boys was slightly higher than girls.3.The tumor is malignant and had a high mortality rate.The overall survival rate for three years and three-year event-free survival rate were significantly lower than reported in China.4.Whether the tumor surrounding the blood vessels was a relatively independent risk factor affecting the survival of children. |
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