PO.PS01.02 · 人群科学
儿童中枢神经系统肿瘤：对内布拉斯加儿童医院10年间收治患者的分析
Pediatric central nervous system tumors: An analysis of patients treated at Children's Nebraska over a 10-year period
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
内布拉斯加州的儿童中枢神经系统肿瘤（CNS）发病率一直高于全国平均水平。本研究是一项探索性分析，利用临床数据对内布拉斯加儿童医院或内布拉斯加医学中心在10年间收治的儿童CNS肿瘤进行特征描述。回顾电子健康记录，以识别在2013年至2023年间于内布拉斯加儿童医院或内布拉斯加医学中心确诊为CNS肿瘤、年龄0至18岁并接受治疗的患者。收集的数据包括人口统计学、临床特征和基因检测信息。使用ICD-0-3编码识别CNS肿瘤诊断患者。诊断依据2016年世界卫生组织（WHO）肿瘤分类进行归类。利用邮政编码确定患者居住县的城乡连续体编码（RUCC），以判定城市化程度。对研究人群特征进行汇总，并按城市化程度进行描述性比较，采用卡方检验判定显著性。共识别出172例在2013年至2023年间确诊为原发性中枢神经系统肿瘤、年龄0至18岁的患者。较大比例的患者在较年幼时确诊，诊断时中位年龄为7岁。研究人群以女性为主（55.81%；n=96）、存活（77.33%；n=133）、非西班牙裔白人（72.09%；n=124）以及来自大都会地区（70.93%；n=122）。就肿瘤特征而言，大多数诊断为恶性（87.21%；n=150），且在局部分期时诊断（96.49%；n=165）。胶质瘤最常见（65.12%；n=112），其次为胚胎性肿瘤（16.86%；n=29）。肿瘤位置主要报告为脑干（22.67%；n=39）或小脑（21.51%；n=37）。40例患者有基因检测数据。受影响最多的基因为KIAA1549-BRAF（14.29%；n=6），最常见的基因效应为融合（28.13%；n=9）。按RUCC分层显示，大都会与非大都会地区之间的人口统计学和临床特征差异极小。然而，恶性诊断的比例在非大都会地区高于大都会地区（p=0.0271）。鉴于儿童CNS肿瘤相对罕见，需要较长时间段的数据才能准确描述该疾病及其发生的人群。在本分析中，我们描述了内布拉斯加儿童医院和内布拉斯加医学中心收治的儿童CNS肿瘤患者人群。这些方法可扩展以纳入更多诊断年份、临床特征或预测因素（如环境暴露），从而更好地了解儿童CNS肿瘤的趋势。
查看英文原文 English abstract
Nebraska has consistently had rates of pediatric Central Nervous System Neoplasms (CNS) above the national average. The study was an exploratory analysis using clinical data to characterize pediatric CNS tumors treated at Children's Nebraska or Nebraska Medicine over a 10-year period. Electronic health records were reviewed to identify patients diagnosed with a CNS tumor, aged 0 to 18 years, and treated at Children's Nebraska or Nebraska Medicine from 2013 to 2023. Data collected included demographics, clinical characteristics, and genetic testing information. ICD-0-3 codes were used to identify patients with a CNS tumor diagnosis. Diagnoses were classified according to the 2016 World Health Organization (WHO) Classification of Tumors. Zip codes were used to identify the Rural Urban Continuum Code (RUCC) of the patient's county of residence to determine urbanicity. The study population characteristics were summarized and descriptively compared by urbanicity, with chi-squared testing to determine significance. A total of 172 patients aged 0 to 18 years were identified as being diagnosed with a primary central nervous system tumor between 2013 to 2023. A greater proportion of patients were diagnosed at a younger age, with a median age at diagnosis of 7 years. The study population was predominantly female (55.81%; n=96), alive (77.33%; n=133), non-Hispanic White (72.09%; n=124), and from a metropolitan area (70.93%; n=122). Considering tumor characteristics, most diagnoses were malignant (87.21%; n=150) and made at the local stage (96.49%; n=165). Gliomas were the most diagnosed (65.12%; n=112) followed by embryonal tumors (16.86%; n=29). Tumor locations were predominantly reported as the brain stem (22.67%; n=39) or cerebellum (21.51%; n=37). Genetic testing data was available for 40 patients. The most affected gene was KIAA1549-BRAF (14.29%; n=6) and the most common gene effect was fusion (28.13%; n=9). Stratification by RUCC revealed minimal variations in the demographic and clinical characteristics between metropolitan and non-metropolitan areas. The proportion of malignant diagnoses, however, was higher non-metropolitan areas than metropolitan areas (p = 0.0271). Given the relative rarity of pediatric CNS tumors, data over an extended time period are required to accurately describe the disease and the population in which it occurs. In this analysis, we described the population of pediatric CNS tumor patients treated at Children's Nebraska and Nebraska Medicine. These methods can be expanded to include additional diagnostic years, clinical characteristics, or predictors, such as environmental exposures to gain a better understanding of the trends in pediatric CNS tumors.
利益披露 Disclosure
A. Nichols, None..
S. Watanabe-Galloway, None..
G. Lai, None.