超选眼动脉介入治疗视网膜母细胞瘤患儿预后不良的危险因素  

Risk factors of poor prognosis in children with retinoblastoma undergoing superselective ophthalmic arterial interventional therapy

作　　者：胡思雨 刘婷婷[1] 周娜 HU Siyu;LIU Tingting;ZHOU Na(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,He’nan,China)

机构地区：[1]郑州大学第一附属医院眼科,郑州4500000

出　　处：《癌症进展》2024年第23期2565-2568,2627,共5页Oncology Progress

基　　金：2021年度河南省青年人才托举工程项目(2021HYTP012)。

摘　　要：目的 探讨超选眼动脉介入治疗视网膜母细胞瘤(RB)患儿预后不良的危险因素。方法 选取82例超选眼动脉介入治疗RB患儿,随访1年,根据预后情况分为预后不良和预后良好。比较预后不良和预后良好患儿的临床资料,采用Logistic回归模型分析超选眼动脉介入治疗RB患儿预后的影响因素。基于影响因素构建超选眼动脉介入治疗RB患儿预后不良的列线图预测模型,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估列线图预测模型对超选眼动脉介入治疗RB患儿预后不良的预测价值。结果 随访1年,预后不良25例,预后良好57例。预后不良与预后良好患儿的发病位置、肿瘤分期、组织分型、血清神经元特异性烯醇化酶(NSE)水平、血清乳酸脱氢酶(LDH)水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,发病位置为双眼、肿瘤分期为眼外期、组织分型为未分化型、血清NSE水平较高、血清LDH水平较高均是超选眼动脉介入治疗RB患儿预后不良的危险因素(P<0.05)。列线图预测模型预测超选眼动脉介入治疗RB患儿预后不良的AUC为0.855,具有中等预测价值。结论 发病位置为双眼、肿瘤分期为眼外期、组织分型为未分化型、血清NSE水平较高、血清LDH水平较高均是超选眼动脉介入治疗RB患儿预后不良的危险因素,临床应详细评估上述因素,积极给予针对性治疗,从而改善患儿预后。Objective To analyze the risk factors of poor prognosis in children with retinoblastoma undergoing super-selective ophthalmic arterial interventional therapy.Method A total of 82 children with RB who underwent superselec-tive ophthalmic arterial interventional therapy were selected and followed up for 1 year.According to the prognosis,they were divided into poor prognosis and good prognosis.The clinical data of children with poor prognosis and good progno-sis were compared,and the influencing factors of prognosis in children with RB who underwent superselective oculoarte-rial interventional therapy were analyzed by Logistic regression model.A nomogram prediction model for poor prognosis in children with RB who underwent superselective ophthalmic arterial interventional therapy was constructed based on the influencing factors.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the predictive value of nomogram prediction model for poor prognosis in children with RB who un-derwent superselective ophthalmic arterial interventional therapy was evaluated.Result After 1 year of follow-up,there were 25 cases with poor prognosis and 57 cases with good prognosis.There were statistically significant differences in the location of disease,tumor stage,tissue type,serum neuron specific enolase(NSE)level and serum lactate dehydroge-nase(LDH)level between children with poor prognosis and good prognosis(P<0.05).Multivariate Logistic regression analysis showed that disease in binocular location,extraocular stage,undifferentiation,high serum NSE level,and high se-rum LDH level were risk factors for poor prognosis of children with RB who underwent superselective ophthalmic arteri-al interventional therapy(P<0.05).The AUC of nomogram prediction model for predicting poor prognosis of children with RB who underwent superselective ophthalmic arterial interventional therapy was 0.855,which had moderate predic-tive value.Conclusion Disease in binocular location,extraocular stage,undiff

关 键 词：视网膜母细胞瘤 超选眼动脉介入治疗 预后不良 危险因素 

分 类 号：R739.7[医药卫生—肿瘤]