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한국인 유소아기 악성종양의 임상 및 병리조직학적 고찰

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 Histopathological and clinical studies on malignant tumors of infancy childhood in Korea 
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[한글] 항생제의 급격한 발전과 이의 적절한 사용으로 말미암아 과거에 유소아기 사망원인의 대부분을 차지하였던 전염성질환은 현저하게 감소하였으나 상대적으로 악성종양에 의한 사망율은 증가하는 추세에 있다. 유소아의 악성종양은 성인의 악성종양과 그 발생양상이 다를뿐 아니라 민족이나 지역에 따라서도 차이가 있다. 따라서 본 연구는 한국인 유소아에서의 악성종양을 병리조직학적으로 분류하고 그 발생 상태 및 임상적인 특성을 조사하였던 바 다음과 같은 결과를 얻었다. 1. 1975년부터 1981년까지 유소아 전 입원환자에 대한 유소아기 악성종양의 비율은 1.21∼1.72%로서 연도별로는 특별한 차이를 보이지 않았다. 2. 유소아 악성종양 277례중 남아가 164례, 여아가 113례로 남녀비는 1.45대 1이었으며 49.8%가 5세이하였다. 3. 백혈병은 유소아 악성종양의 35.0%로 발생빈도가 가장 높았으며 그 다음이 임파종(11.5%), 교감신경조직종양(10.8%), 중추신경계 종양(6.9%), 암종(6.9%)의 순이었다. 특히, 여아에서는 백혈병(38.1%) 다음이 암종(10.6%), 교감신경조직종양(9.7%), 골종양(8.8%) 연부조직종양(8.0%)의 순이었다. 4. 백혈병의 97.9%는 급성이었으며 그중 대다수는 급성임파성백혈병(74%)이었고 급성골 수성백혈병은 13.3%에 불과하였다. 5. 임파종중에서는 임파구성임파종이 47%로 가장 많았고 조직구성임파종이 25%였으며 Hodgkin's lymphoma는 15.4%로 비교적 적었다. 6. 외국의 보고에 비하여 임파종의 빈도가 높았던 반면 중추신경계종양의 빈도는 낮았다. 7. 교감신경조직종양중에는 신경아세포종(83.3%), 중추신경계종양 중에는 수아세포종(63%), 골종양중에는 골육종(66.7%)이 가장 많았다.
[영문] Since the antibiotic era cancer is the second most common cause of death in children preceded only by death due to accident in the developed countries. Cummulative epidemiologic studies have shown that there were geographical and racial variations in the incidence of malignant childhood cancer according to the histologic type. Furthermore malignant tumors arising in pediatric age is known to differ from those of adult. In the present study, the author analized 277 malignant neoplasms. The materials were those obtained by biopsy or surgical excision in Yonsei University during the period from 1975 to 1981. Re-evaluation with histological confirmation was made, followed by study on the type and frequency of the pediatric cancer among Korean and on some clinical correlations. The results were as follows: 1. The annual ratios of malignant tumors of infancy and childhood to total pediatric admission were net increased from 1975 to 1981, being 1.21-1.72%. 2. In general, male was the victim of cancer 1.45 times more frequently than female. And nearly half of the pediatric malignancy(49.8%) was under the age of 5. 3. Of the 277 malignancies, leukemia comprised 35%, which was followed, in decreasing order of frequency, by lymphoma(11.5%), tumors of the sympathetic nerve system(10.8%), tumors of the central nervous system(6.9%) and carcinomas(6.9%). In particular, carcinomas of varying visceral organs or tissues ranked the second in female preceded only by leukemia and followed by tumors of the sympathetic nerve system(9.7%), bone tumors(8.8%) and soft tissue tumors(8.0%). 4. Among the 97 cases of leukemia 97.7% was acuter and acute lymphocytic leukemia comprised 74%, acute myelogenous leukemia being only 13.3%. 5. With respect to the malignant lymphoma, lymphocytic lymphoma was the most common type followed by histiocytic lymphoma. Hodgkin's disease was found in only 15.4% of all leukemia. 6. Lymphoma appeared more frequent in Korea than in abroad, and in tumors of central nervous system the reverse was true. 7. Among the tumors arising in sympathetic nerve system, 83% was neuroblastoma. Medulloblastoma and osteosarcoma were the commonest tumors of central nervous system and bone, being 63.0 and 66.7% respectively.
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