以眼球摘除术作为首次治疗的视网膜母细胞瘤患儿的高危病理因素分析  

Analysis of High-risk Pathological Factors for Ophthalpectomy as the First Treated Children with Retinoblastoma

作　　者：李倩 袁梦 王兰兰 马彩霞 LI Qian;YUAN Meng;WANG Lanlan(Henan Provincial People's Hospital/Zhengzhou University People's Hospital,Zhengzhou,450000)

机构地区：[1]河南省人民医院,郑州大学人民医院,450000

出　　处：《实用癌症杂志》2022年第10期1730-1732,1736,共4页The Practical Journal of Cancer

摘　　要：目的 分析以眼球摘除术作为首次治疗的视网膜母细胞瘤患儿的高危病理因素。方法 选取以眼球摘除术作为首次治疗的视网膜母细胞瘤患儿102例作为研究对象。采集患者性别、年龄、病程、高危病理因素、肿瘤侵犯视神经、肿瘤侵犯大范围脉络膜、肿瘤侵犯眼前节、肿瘤侵犯至眼球外、虹膜表面新生血管信息,分析以眼球摘除术作为首次治疗的视网膜母细胞瘤的高危病理因素。结果 102例患者中39例患者具有高危病理因素,占比38.24%;肿瘤侵犯筛板或筛板前视神经63例,占比61.76%;肿瘤侵犯筛板后视神经32例,占比31.37%;肿瘤侵犯大范围脉络膜14例,占比13.73%;肿瘤侵犯眼前节7例,占比6.86%;肿瘤侵犯至眼球外10例,占比9.80%;虹膜表面新生血管阳性54例,占比52.94%。虹膜表面新生血管阳性患儿中高危病理因素占48.15%(26/54)、肿瘤侵犯筛板后视神经占84.48%(44/54)较虹膜表面新生血管阴性患儿[27.08%(13/48)、16.67%(8/48)]高(P<0.05)。logistic回归分析显示,侵犯大范围脉络膜、侵犯视神经断端、侵犯睫状体、侵犯视神经是眼球摘除术作为首次治疗的视网膜母细胞瘤的高危因素(P<0.05)。结论 眼球摘除术作为首次治疗的视网膜母细胞瘤患儿中具有高危病理因素的患者占比38.24%,且虹膜表面新生血管阳性患儿多数存在肿瘤侵犯筛板后视神经高危病理因素,而侵犯大范围脉络膜、侵犯视神经断端的危险性最大。Objective To analyze the high risk pathological factors of enucleation as first treated children with retinoblastoma.Methods 102 children with retinoblastoma were first treated in January 2018 ~ in January 2021.Information on patients’ gender,annual collar,course of disease,high-risk pathological factors,tumor invasion of optic nerve,large range of choroidal,tumor invasion of immediate node,tumor invasion to outside eyeball,and iris surface was analyzed to analyze the high-risk pathological factors of eye removal as the first retinoblastoma treatment.Results 39 of the 102 patients had high-risk pathological factors,accounting for 38.24%,63,61.76%,32,31.37%,14 extensive choroid,13.73%;7 tumor invasion,6.86%,10,9.80%;54 positive iris surface,52.94%.High-risk pathology for neovcularization on iris surface 48.15%(26/54)and 84.48%(44/54)after tumor invasion screen plate were higher than 27.08%(13/48)and 16.67%(8/48)(P<0.05).logistic regression analysis revealed that invasion of extensive choroidal,optic nerve breaks,ciliary invasion,and optic nerve invasion were high risk factors for eye removal as first treated retinoblastoma(P<0.05).Conclusion 38.24% of patients have high-risk pathological factors,and most children with iris-positive iris surface has high-risk pathological factors of optic nerve after tumor invasion screen plate,with the greatest risk of choroidal invasion and optic nerve fracture.

关 键 词：视网膜母细胞瘤 眼球摘除术 首次治疗 高危病理因素 

分 类 号：R73-36[医药卫生—肿瘤]