广东省儿童青少年白血病流行特征分析

目的了解广东省儿童青少年白血病发病的分布状况,提出病因假设,为儿童青少年白血病预防和控制提供依据。方法采集广东省儿童青少年恶性肿瘤基本信息,用SPSS13.0统计软件分析儿童青少年白血病的发病率,并比较三间分布的差异。结果广东省0～18岁儿童青少年2003-2004年白血病年平均发病率为1.36/10万,位居儿童青少年恶性肿瘤的第一位;男性年发病率为1.65/10万,女性年发病率为1.04/10万,男性明显高于女性（P〈0.01）;0～4岁组发病率为4.05/10万,5～9岁组发病率为2.52/10万,10～14岁组发病率为2.35/10万,15～18岁发病率为2.28/10万,随着年龄的增加发病率有明显下降的趋势（P〈0.01）;地区分布上,江门市发病率最高为3.13/10万,茂名市最低为0.42/10万,发病危险相差7.45倍,差异有统计学意义（P〈0.01）,这可能与土壤天然放射性核素^226Ra、^232Th以及室内氡有关;时间分布上,2004年发病率为1.48/10万,明显高于2003年的1.24/10万（P〈0.05）,无明显季节性;在不同类型的白血病中,以急性淋巴细胞性白血病所占比例最大为62.22%,其次为急性非淋巴细胞性白血病占31.25%。结论广东省儿童青少年白血病发病居儿童恶性肿瘤第一位,主要类型为急性淋巴细胞性白血病,须加强儿童白血病的防治,特别是江门、珠海、汕头、佛山等高发地区。

Epidemiological Analysis on Childhood Leukemia in Guangdong Province

Objective To explore the distribution of childhood leukemia in Guangdong province, put forward etiological hypothesis involved, and to provide evidence for prevention and control of the disease. Methods Data were provided by childhood cancer reporting system, SPSS 13.0 was used to calculate the incidence and compare significant differences among place, time and personal characteristics. Results The average incidence of childhood leukemia （0 - 18 years） was 1.36/10^5 per year during 2003 to 2004 in Guangdong province, which ranked first in all childhood cancers. The incidence of childhood leukemia in males was 1.65/10^5 and in females 1.04/10^5, there was significant difference between genders （P 〈 0. 01 ）. The incidence significantly declined with increasing age, which was 4.05/10^5 for 0 -4 age - group, 2. 52 /10^5 for 5 -9 age - group, 2.35/10^5 for 10 - 14 age - group, and 2. 28/10^5 for 15 - 18 age group. The incidences were significantly different in different places, with the highest incidence of 3.13/10^5 in Jiangmen area, and the lowest incidence of 0. 42/10^5 in Maoming area. This difference probably associated with natural ionizing radiation （indoor radon and terrestrial ^226Ra and^232Th）. The incidence was 1.48/10^5 in 2004, higher than that （ 1.24/10^5 ） in 2003 （ P 〈 0. 05 ）. There was no difference in seasonality. The acute lymphoblastic leukemia （ALL） was the leading type （62.22%）. The second type was acute myeloid leukemia （ AML）, accounting for 31.25%. Conclusion The incidence of leukemia ranked first in all childhood cancers in Guangdong province. The main type of leukemia was ALL Preventive measurements and treatments should be strengthened especially in areas with high incidence such as Jiangmen, Zhuhai, Shantou and Foshan.