Single Center Study Of Children With Neuroblastoma

Part one Background and purposeNeuroblastoma(NB)is the most common extracranial solid tumor in childhood,and is the most common malignant tumor in infant period,with an annual incidence of about 10.54 per million.The base of children's population in our country is huge,The total number of children under 14 is about 230 million(accounted for 16.6% of the total population),but has not yet formed a perfect system of registration,follow-up of neuroblastoma,large epidemiological studies can only refer to the experience of western countries,such as in the US and Europe;Meanwhile,in henan,a populous province,there are about 20.46 million children under the age of 14(accounted for 21.4% of the total population),but no large sample case reports and epidemiological studies had reported.This paper summarizes and analyzes the morbidity of neuroblastoma in children by collecting the medical records of children with neuroblastoma diagnosed in our center.Methods Retrospective analysis of the medical records of children with neuroblastoma diagnosed in our center from January 2012 to December 2017.Such as age,sex,regional origin,initial symptoms and symptoms at first visit to a doctor etc,were summarized.Result1.According to the inclusion and exclusion criteria,a total of 338 cases of children's medical records were collected,aged from 3 days to 14 years,with an average age of(39.02 ±31.45)months,and with a median age of 41 months,including 70 cases of infant period(0 ~ 1 years old),169 cases of toddle period(1 ~ 3years old),76 cases of pre-school age(3 ~ 7 years old),and 23 cases of school-age(7~ 14 years old).accounted for 20.7%,50.0%,22.5% and 20.7% respectively.2.For children of all ages,191 were males(56.5%),147 were females(43.5%),and males were more than females.The male to female ratio was about 1.3:1.3.Most of the children were from Henan province(98.8%),all 18 cities in Henan were distributed,the top five areas were Shangqiu,Zhoukou,Zhumadian,Zhengzhou and Anyang.Their total number of cases accounted for 50% of the province.At the same time,279 cases(82.5%)were from rural areas,59 cases(17.5%)were from urban areas,The number of rural areas is more than that of urban areas.4.Children with neuroblastoma has no characteristic symptoms.The most common symptoms were fever,abdominal mass,pain / sensation and so on,and the symptoms of different ages were different.Conclusion1.Children with neuroblastoma were more likely in infant period and toddle period(? 3 year old),with slightly more males,and the overall incidence of neuroblastoma in children remained stable for a long time.2.The age at diagnosis in children with neuroblastoma may be related to family economic status,education status and cognitive level.,distribution of medical resources and children's physical examination system.3.The symptoms of children in different ages were certainly different.While abdominal mass was common in infant and toddle period(?3 year old),the pain /sensation was common in the pre-school and school age.The second part Background and purpose Children with neuroblastoma have no specific symptoms.Symptoms can occur singly or multiple symptoms can occur;In addition,with the characteristics of concealment,high malignancy and early metastasis,the diagnosis of some children has advanced to late stage,and the overall survival rate is less than50%;Neuroblastoma has become the leading cause of death for children with cancer aged 1~5 years,accounting for 13% of all children's malignant tumor mortality.By collecting the clinical data and follow-up of the children with neuroblastoma in my center,this paper studies the diagnosis and treatment of neuroblastoma and its influencing factors,and also provides a basis for improving the diagnosis and treatment methods and improving the long-term survival rate.Method Collected medical records of neuroblastoma of children aged 0-14 years from January 2012 to December 2017 at the first affiliated hospital of zhengzhou university,such as diagnostic method,treatment plan and follow-up.Result1.236 cases of children,133 males and 103 females,the ratio of about 1.3:1;The ages are btween 6 days 14 years old,the average age is(40.17±33.36)months and the median age is 31 months,according to the age distribution of grouping and combining with the follow-up data,we can find that the younger the age,the better the prognosis.2.NSE level was combined with follow-up data.We can find that the higher the NSE level,the worse the prognosis.3.Tumor site distribution was combined with follow-up data.We can find that that tumor site is not the influence factor of prognosis.4.Tumor staging was combined with follow-up data.We can find that the lower the staging,the better the prognosis.5.Cancer risk was combined with the follow-up data.We can find that the lower the risk,the better the prognosis.6.Treatment method was combined with the follow-up data.We can find that children treated with one-stage surgery usually have a favorable result.Meanwhile,children without surgery have a poor prognosis.Conclusion The incidence of neuroblastoma is not proportional to the mortality rate,the incidence of the younger children is higher but the prognosis is better,the age is the factor affecting the prognosis.In addition,NSE level,tumor staging,tumor risk and treatment are also factors that affect the prognosis of neuroblastoma.Young age,low NSE level,low tumor stage and effective treatment are favorable prognostic factors.