Association between congenital cardiovascular malformations and neuroblastoma
Association between congenital cardiovascular malformations and neuroblastoma
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DOI：
10.1016/j.jpeds.2003.12.032
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发表时间：
2004-04-01
影响因子：
5.1
通讯作者：
Lipsitz, SR
中科院分区：
文献类型：
--
作者：
George, RE;Lipshultz, SE;Lipsitz, SR
目的 我们探讨了先前在病例报告中描述的神经母细胞瘤与先天性心血管畸形 (CCM) 之间的关联。研究设计 对 158 名神经母细胞瘤患者和 192 名白血病儿童组成的对照组进行了超声心动图和图表审查。比较各组中 CCM 患者的比例。结果 70 名神经母细胞瘤且超声心动图检查患者中有 14 名 (20%) 患有 CCM，而 192 名白血病患者中超声心动图检查有 7 名 (3.6%) (P = .0001)。如果所有未进行超声心动图检查的神经母细胞瘤患者 (n = 88) 被认为具有正常的心脏解剖结构，则这种差异仍然显着（158 名神经母细胞瘤患者中的 14 名检测到 CCM [8.9%]，而 192 名白血病患者中检测到 7 名 [3.6%]；P = 0.045）。神经嵴源性 CCM 在神经母细胞瘤患者中更为常见，在 70 名神经母细胞瘤患者中检测到 5 例，而在 192 名白血病患者中检测到 2 例 (P = .016)。神经母细胞瘤患者的先天性心血管畸形与小于1岁的癌症诊断和较低的神经母细胞瘤分期有关，但与肿瘤MYCN扩增无关。结论神经母细胞瘤和CCM可能相关。我们建议对新诊断的神经母细胞瘤住院患者进行超声心动图筛查。
Objective We explored the association between neuroblastoma and congenital cardiovascular malformations (CCM), previously described in case reports.Study design Echocardiogram and chart reviews of a series of 158 patients with neuroblastoma and a control group of 192 children with leukemia were performed. The proportion of patients with CCM in each group was compared.Results Fourteen of the 70 (20%) patients with neuroblastoma and echocardiography had CCM, compared with 7 of the 192 (3.6%) patients with leukemia with echocardiograms (P = .0001). If all of the patients with neuroblastoma without echocardiograms (n = 88) are considered to have normal cardiac anatomy, this difference remains significant (14 of 158 patients with neuroblastoma have CCM detected [8.9%] versus 7 of 192 patients with leukemia [3.6%]; P = .045). Neural crest-derived CCM were more common in patients with neuroblastoma, detected in 5 of 70 patients with neuroblastoma versus 2 of 192 patients with leukemia (P = .016). Congenital cardiovascular malformations in patients with neuroblastoma were associated with a cancer diagnosis at age less than 1 year and a lower neuroblastoma stage, but there was no association with tumor MYCN amplification.Conclusions Neuroblastoma and CCM maybe associated. We recommend echocardiography for CCM screening inpatients with newly diagnosed neuroblastoma.