Case-control study of perinatal factors and hepatoblastoma in children with an extremely low birthweight
Case-control study of perinatal factors and hepatoblastoma in children with an extremely low birthweight
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DOI：
10.1046/j.1442-200x.2000.01287.x
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发表时间：
2000-10-01
影响因子：
1.4
通讯作者：
Tokunaga, Y
中科院分区：
文献类型：
--
作者：
Maruyama, K;Ikeda, H;Tokunaga, Y
背景：肝母细胞瘤与低出生体重之间存在显著关联。一项病例对照研究揭示了极低出生体重（< 1000 g）儿童肝母细胞瘤的危险因素。方法：比较12例肝母细胞瘤患者和75例出生体重匹配对照组的产前和产后病史，包括父母史。结果：肝母细胞瘤患者的胎龄（23 ~ 32周，中位25周）明显低于对照组（23 ~ 36周，中位27周，P=0.072）。肝母细胞瘤患者的婴儿体重恢复到与出生体重相同水平的时间也往往比对照组更长（P=0.055）。所有肝母细胞瘤患者接受氧疗的时间为4 ~ 508天（中位114天），明显长于对照组的0 ~ 366天（中位62天）（P=0.022）。所有肝母细胞瘤患儿均给予速尿治疗，这些患儿的使用时间（6-460天，中位89天）明显长于对照组（0-241天，中位44天P=0.027）。单因素Cox回归分析显示，出生时恢复体重所需时间、氧疗和速尿治疗持续时间与肝母细胞瘤的发生显著相关(风险比(HR)=1.044， P=0.013；HR = 1.006, P = 0.001;HR=1.007， P=0.001)。虽然各因素之间存在显著相关性，但多因素Cox回归分析发现，氧疗持续时间是一个显著的独立危险因素（HR=1.006， P=0.001）。结论：氧疗和速尿治疗及生长速度是极低出生体重儿肝母细胞瘤发展的危险因素，而氧疗时间是预测肝母细胞瘤发展的最重要因素。需要进一步的研究来确定肝母细胞瘤发展的真正原因，并保护低出生体重的儿童免受癌症的发展。
Background: There is a significant association between hepatoblastoma and low birthweight. A case-control study was conducted to reveal risk factors for hepatoblastoma in children of extremely low birthweight (< 1000 g).Methods: Prenatal and postnatal histories, including parental histories, of 12 hepatoblastoma cases and 75 birthweight-matched controls were compared.Results: The gestational age of the hepatoblastoma cases (23-32 weeks; median 25 weeks), tended to be lower than that of the controls (23-36 weeks; median, 27 weeks; P=0.072). The time for an infant's bodyweight to return to the same level as the birthweight also tended to be longer in hepatoblastoma cases than in controls (P=0.055). All hepatoblastoma cases received oxygen therapy for a period of 4-508 days (median 114 days), which was significantly longer than the 0-366 days (median 62 days) in the controls (P=0.022). Furosemide was given to all hepatoblastoma cases and was used for a significantly longer period in these infants (6-460 days; median 89 days) than in the controls (0-241 days; median 44 days P=0.027). A univariate Cox regression demonstrated that the time taken to regain bodyweight at birth and the duration of both oxygen therapy and furosemide treatment were significantly associated with the development of hepatoblastoma (hazard ratio (HR)=1.044, P=0.013; HR=1.006, P=0.001; and HR=1.007, P=0.001, respectively). Although there were significant correlations between the factors, a multivariate Cox regression analysis identified the duration of oxygen therapy as a significant independent risk factor (HR=1.006, P=0.001).Conclusions: Oxygen therapy and furosemide treatment, along with the rate of growth, are risk factors for the development of hepatoblastoma in children of extremely low birthweight, and the duration of oxygen therapy is the most important factor in predicting the development of hepatoblastoma. Further studies are necessary to determine the real reasons for the development of hepatoblastoma and to protect children of low birthweight from the development of cancer.