新潟県における神経芽細胞腫の発症状況と1歳6ヵ月児の再スクリーニングの試み

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  • Analysis of the Neuroblastoma Patients Found in Niigata Prefecture and a Preliminary Study on Second Mass-Screening of 1-year and 6 Month-Old Children for this Disease

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Neuroblastoma is one of the malignant tumors in chidren. In Oct, 1985, mass-screening of 6-month-old infants for this disease started in Niigata Prefecture. Up to now, this screening test has detected 17 neuroblastoma patients among apparently normal infants. All of the 17 patients received early treatment, and have been alive and well. However, besides these patients, additional 17 patients were discovered with this disease which manifested itself at an older age than those found by the screening test. Age-related incidence of the 17 patients was 4 cases under 1year of age, 5 at 1year, 3 at 2 yrs, 3 at 3 yrs, 1 at 4 yrs, 1 at 5 yrs, respectively. They were found at a later stage of the disease than those found on the routine screening test. Despite the normal judgement of mass-screening test performed at the age of 6 months, 7 of 15 cases (46.5%) were found to have increased urinary excretion of VMA and/or HVA. Although the patients were treated vigorously for advanced neuroblastoma, 8 (47%) of the 17 patients had already died, and 3 cases have been on relapses. These data, revealing poor prognosis for the patients found at an older age, prompted us to screen children at 1 year and 6 months of age, using VMA test on dried urine-soaked paper. Between Sept 1992 and Feb 1993, 1,428 (62.5%) of 2,172 children whose parents had been informed the significance of the test, received the screening test in Niigata City. However, probably due to rather small number of the samples, we still have not found any of neuroblastoma patients in this preliminary test. From these results, and considering the poor prognosis of the patients with advanced neuroblastoma, we propose a second mass-screening test of young children for neuroblastoma at the age of 1year and 6 months.

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