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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/11/23 19:33:05」(JST)

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The Tanner scale (also known as the Tanner stages) is a scale of physical development in children, adolescents and adults. The scale defines physical measurements of development based on external primary and secondary sex characteristics, such as the size of the breasts, genitalia, testicular volume and development of pubic and axillary hair. This scale was first identified by James Tanner, a British pediatrician and thus bears his name.^[1]^[2]^[3]

Due to natural variation, individuals pass through the Tanner stages at different rates, depending in particular on the timing of puberty. In HIV treatment, the Tanner scale is used to determine which treatment regimen to follow (adult, adolescent, or pediatric).

Definitions of stages

Adapted from text by Lawrence Neinstein, MD.^[4]

Genitals (male)

Illustration of the Tanner scale for males.

Tanner I: prepubertal (testicular volume less than 1.5 ml; small penis of 3 cm or less) [typically age 9 and younger]
Tanner II: testicular volume between 1.6 and 6 ml; skin on scrotum thins, reddens and enlarges; penis length unchanged [9-11]
Tanner III: testicular volume between 6 and 12 ml; scrotum enlarges further; penis begins to lengthen to about 6 cm [11-12.5]
Tanner IV: testicular volume between 12 and 20 ml; scrotum enlarges further and darkens; penis increases in length to 10 cm and circumference [12.5-14]
Tanner V: testicular volume greater than 20 ml; adult scrotum and penis of 15 cm in length [14+]

Breasts (female)

Illustration of the Tanner scale for females.

Tanner I: no glandular tissue: areola follows the skin contours of the chest (prepubertal) [typically age 10 and younger]
Tanner II: breast bud forms, with small area of surrounding glandular tissue; areola begins to widen [10-11.5]
Tanner III: breast begins to become more elevated, and extends beyond the borders of the areola, which continues to widen but remains in contour with surrounding breast [11.5-13]
Tanner IV: increased breast size and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast [13-15]
Tanner V: breast reaches final adult size; areola returns to contour of the surrounding breast, with a projecting central papilla. [15+]

Pubic hair (both male and female)

Tanner I: no pubic hair at all (prepubertal Dominic state) [typically age 10 and younger]
Tanner II: small amount of long, downy hair with slight pigmentation at the base of the penis and scrotum (males) or on the labia majora (females) [10–11.5]
Tanner III: hair becomes more coarse and curly, and begins to extend laterally [11.5–13]
Tanner IV: adult-like hair quality, extending across pubis but sparing medial thighs [13–15]
Tanner V: hair extends to medial surface of the thighs [15+]

Criticism

The scale has been criticized by the pornography industry for its potential to lead to false child pornography convictions, such as in the case when government experts used it to assert that pornographic actress Lupe Fuentes was underage. Fuentes personally appeared at the trial and provided documentation that showed that the DVDs in question were legally produced.^[5]^[6] The author of the classification system himself has argued that age classification utilizing the Tanner stages represents invalid use. Tanner stages do not match with chronological age but rather maturity stages and thus are non-diagnostic for age estimation.^[7]

References

^ synd/3082 at Who Named It?
^ Marshall WA, Tanner JM (February 1970). "Variations in the pattern of pubertal changes in boys". Arch. Dis. Child. 45 (239): 13–23. doi:10.1136/adc.45.239.13. PMC 2020414. PMID 5440182. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2020414/.
^ Marshall WA, Tanner JM (June 1969). "Variations in pattern of pubertal changes in girls". Arch. Dis. Child. 44 (235): 291–303. doi:10.1136/adc.44.235.291. PMC 2020314. PMID 5785179. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2020314/.
^ Lawrence S. Neinstein, M.D.: Adolescent Medicine - Children's Hospital Los Angeles CA^{[dead link]}
^ "Lupe Fuentes Saves Man From Bogus ‘Child Porn’ Charge". AVN. April 16, 2010. http://business.avn.com/articles/37817.html.
^ "Adult Film Star Verifies Her Age, Saves Fan From 20 Years In Prison". Radar Online. April 21, 2010. http://www.radaronline.com/exclusives/2010/04/adult-film-star-verifies-her-age-saves-fan-20-years-prison.
^ Rosenbloom AL, Tanner, JM (1998). "Misuse of Tanner Puberty Stages to Estimate Chronologic Age". Pediatrics 102 (6): 1494. http://dx.doi.org/10.1542/peds.102.6.1494

External links

Wikimedia Commons has media related to: Tanner scale

The Male Tanner stages
The Female Tanner stages
Line drawing of female Tanner stages (genitals)
Line drawing of female Tanner stages (breasts)
Line drawing of male Tanner stages

UpToDate Contents

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English Journal

Using endobronchial ultrasound features to predict lymph node metastasis in patients with lung cancer.

Wang Memoli JS, El-Bayoumi E, Pastis NJ, Tanner NT, Gomez M, Huggins JT, Onicescu G, Garrett-Mayer E, Armeson K, Taylor KK, Silvestri GA.Source96 Jonathan Lucas St, CSB 812, Charleston, SC 29425. silvestr@musc.edu.
Chest.Chest.2011 Dec;140(6):1550-6. Epub 2011 Jun 2.
PURPOSES: Reliable staging of the mediastinum determines TNM classification and directs therapy for non-small cell lung cancer (NSCLC). Our aim was to evaluate predictors of mediastinal lymph node metastasis in patients undergoing endobronchial ultrasound (EBUS).METHODS: Patients with known or suspe
PMID 21636663

Sex differences in trabecular bone microarchitecture are not detected in pre and early pubertal children using magnetic resonance imaging.

Modlesky CM, Bajaj D, Kirby JT, Mulrooney BM, Rowe DA, Miller F.SourceDepartment of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19716, USA. modlesky@udel.edu
Bone.Bone.2011 Nov;49(5):1067-72. Epub 2011 Aug 5.
INTRODUCTION: Sex differences in trabecular bone microarchitecture have been reported in adults and adolescents, but studies in children are lacking. The primary aim of this study was to determine if there are sex differences in magnetic resonance imaging (MRI)-based measures of trabecular bone micr
PMID 21851868

Sex differences in cortisol response to corticotropin releasing hormone challenge over puberty: Pittsburgh Pediatric Neurobehavioral Studies.

Stroud LR, Papandonatos GD, Williamson DE, Dahl RE.SourceDepartment of Psychiatry and Human Behavior, Brown Alpert Medical School and The Miriam Hospital, Providence, RI 02903, United States. lstroudri@gmail.com
Psychoneuroendocrinology.Psychoneuroendocrinology.2011 Sep;36(8):1226-38. Epub 2011 Apr 13.
OBJECTIVE: Consistent sex differences in regulation of the hypothalamic pituitary adrenocortical (HPA) axis have been shown in animal models and emerge over puberty. However, parallel work in humans is lacking despite implications for elucidating the emergence of sex differences in depression over p
PMID 21489699