摘要
目的探讨视网膜母细胞瘤(Rb)对眼球组织浸润侵犯程度的相关临床危险因素。设计回顾性病例系列。研究对象经组织病理学确诊的Rb患者394例。方法收集1990-2005年北京同仁医院较完整的394例Rb患者的临床病理资料,术前观察主要临床体征,术后光镜下判读Rb眼球各组织浸润程度,通过logistic多元回归分析Rb眼球组织浸润程度的临床危险因素。主要指标Rb各临床体征与眼球组织浸润程度及两者之间的相关性。结果394例Rb中侵犯视盘315例(79．7％),侵犯筛板纤维203例(51．4％),肿瘤穿过筛板至球后视神经内102例(25．8％),侵犯脉络膜102例(25．8％),视神经切除断端受累者26例(6．6％)。统计分析显示:脉络膜组织受累与病程(P=0．032)、结膜充血(P=0．023)、眼球突出(P=0．026)及继发青光眼(P=0．027)有关;视神经切除断端浸润与结膜充血(P=0．008)、虹膜新生血管形成(P=0．033)、眼球突出(P=0．000)有关。结论本组Rb视神经侵犯率较高。病程长、结膜充血、眼球突出是眼球组织侵犯的主要因素。
Objective To study the relative clinical risk factors of retinoblastoma for predicting histopathologic invasion degree. Design Retrospective observational case series. Participants 394 patients with retinoblastoma confirmed by histopathology. Methods A retrospective study on the relationship between the clinical features and histopathological invasion was performed in 394 patients with retinoblastoma treated by enucleation between 1990-2005. Observe the preoperative clinical signs and examine the histopathological invasion degree under microscope. The logistic regression model was used for multivariate analysis. Main Outcome Measures The clinical features and histopathological invasion degree and the relativity between them. Results There were 315 cases（79.7%）with optic nerve invasion. The choroid invasion rate was 25.8%. The invasion was up to the cut end of the optic nerve in 26 eyes （6.6%）.The choroid invasion related to course of disease （P=0.032）, conjunctival congestion （P=0.023）, exophthalmos （P=0.026）and secondary glaucoma（P=0.027）. The invasion up to the optic nerve line related to conjunctival congestion（ P=0.008 ）and iris neovascularization（P= 0.033）and exophthalmos （P=0.000）. Conclusion The incidence of optic nerve invasion is high in patients of this study. Long course of disease, conjunctival congestion and exophthalmos are the main risk factors for eyeball invasion due to retinobalstoma.
出处
《眼科》
CAS
2006年第6期389-391,共3页
Ophthalmology in China
