视网膜母细胞瘤眼球摘除术后病理与预后分析

发布时间：2018-04-16 04:08

本文选题：视网膜母细胞瘤 + 化疗　；参考：《眼科新进展》2014年12期

【摘要】：目的分析视网膜母细胞瘤(retinoblastoma,Rb)侵犯眼球部位与患者预后之间的关系,为病情的预测和治疗提供依据。方法回顾性分析2003年1月至2011年2月于中山大学中山眼科中心行眼球摘除术的单眼Rb患者。记录术后肿瘤侵犯的部位、治疗情况和生存情况并评估患者的5 a生存率(5 year probability event-free survival,5-PEFS)。随访以患者死亡或至2012年2月截止,随访时间为(46.3±29.2)个月。结果共有202例202眼患者纳入研究,其中筛板及筛板前侵犯所占比例最大(40.6%),5-PEFS也最高(96.1%);筛板后视神经侵犯和视神经断端侵犯者5-PEFS分别是82.5%和40.0%,三者比较差异有显著统计学意义(P0.01)。筛板后视神经侵犯接受治疗的患者5-PEFS(91.6%)有高于未治疗者(66.7%)的趋势(P=0.09);视神经断端侵犯者接受治疗与未治疗的5-PEFS分别是50.0%和0(P0.01),单纯脉络膜侵犯患者5-PEFS是93.8%,巩膜侵犯患者接受和未接受辅助化疗的5-PEFS分别是57.1%和77.8%(P0.05)。2例眼眶侵犯患者均死亡,4例患者眼球摘除术后眼眶复发,从眼球摘除术到眼眶复发的时间是5~15个月,平均为9.8个月。结论 Rb眼球摘除术后病理检查对患者预后的预测和辅助治疗有指导意义;眼球摘除术后2 a,尤其1 a内是Rb复发的高发期,这期间所有患者需要密切随诊。
[Abstract]:Objective to analyze the relationship between the location of retinoblastoma (RB) and the prognosis of retinoblastoma (retinoblastoma) so as to provide evidence for the prediction and treatment of retinoblastoma.Methods from January 2003 to February 2011, the patients with single eye RB who underwent ophthalmectomy at Zhongshan Eye Center, Sun Yat-sen University, were analyzed retrospectively.The site, treatment and survival of the tumor were recorded and the 5-year survival rate was evaluated. The 5-year survival rate was 5 year probability event-free survival.The follow-up period was 46.3 卤29.2 months.Results 202 cases (202 eyes) were included in the study, among which the proportion of ethmoid plate and ethmoid plate invasion was 40.6%. The 5-PEFS of posterior sieve plate optic nerve invasion and optic nerve terminal invasion was 82.5% and 40.0% respectively, the difference was statistically significant (P 0.01).There was a higher trend of P0.09 in the patients with posterior sieve plate optic nerve invasion than in the untreated group (50.0% and 0% respectively, 5-PEFS was 93.8 in patients with choroidal invasion and 93.8 in patients with scleral invasion).The rate of 5-PEFS receiving adjuvant chemotherapy was 57.1% and that of 77.8%(P0.05).2 patients with orbital invasion were 57.1% and 4 cases respectively, and there were 4 cases of orbital recurrence after enucleation.The time from enucleation to orbital recurrence was 5 ~ 15 months, with an average of 9.8 months.Conclusion pathological examination after Rb enucleation has guiding significance in predicting prognosis and adjuvant therapy, especially in 1 year after enucleation, it is a high incidence stage of RB recurrence, during which all patients need to be closely followed up.
【作者单位】：中山大学中山眼科中心;遵义医学院附属医院眼科;
【基金】：广东省科技计划项目基金资助(编号:2008B030301069)~~
【分类号】：R739.7

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