摘要
目的分析和探讨儿童视网膜母细胞瘤(Rb)的临床特点。设计回顾性病例系列。研究对象北京同仁医院2009年1月至12月收治的244例(312眼)儿童视网膜母细胞瘤患者的病历资料。方法对上述患儿临床病历资料进行回顾,分析患儿的发病年龄、首诊症状、家族史,肿瘤的临床分期、治疗方法、随诊结果及疗效等。主要指标发病年龄、性别、临床分期、治疗方法及效果。结果 (1)Rb患儿初诊平均年龄(1.97±1.42)岁,中位数年龄1.75岁,3岁以下占83.19%(203/244)。(2)男性137例,女性107例,差异无统计学意义(χ2=0.05,P=0.240)。(3)患儿初诊症状常为白瞳或黄白色反光67.62%(165/244)。(4)244例患儿中8例(3.27%)有家族史,其中双眼发病患儿中7.94%(5/63)有家族史,单眼发病的患儿中仅1.73%(3/173)有家族史。(5)Rb分期:除10眼于入院前眼球已摘除外,余302眼分期:A-C期14.56%(44/302),D期41.39%(125/302),E期44.05%(125/302)。(6)单纯眼球摘除术50例,综合治疗加眼球摘除90例。放疗、化疗结合眼局部治疗、鞘内注射治疗104例。(7)随访12～24个月,244例患儿中,失访及放弃治疗16例(25眼),死亡6例(10眼),死亡率为2.63%(6/228),存活率97.37%(222/228)。结论本组Rb患者发病年龄小,无性别差异,白瞳为最常见首发症状,Rb晚期为多,有一半患者行眼球摘除治疗,2年存活率较高。
Objective To present the clinical characteristics of retinoblastoma （Rb） cases. Design Retrospective case series. Participants The clinical information of 244 Rb cases from Jan. 2009 to Dec. 2009. Methods The age at initial diagnosis, symptoms at presenting, family history, clinical stage, treatment scenario and therapeutic effect were retrospectively analyzed. Main Outcome Measures The age at initial diagnosis, sex, clinical stage and therapeutic effect. Results （1） The mean age at initial diagnosis was 1.97±1.42 years （range 0.08-8 years）, medium 1.75 years. 83.19% （203/244） of the children was younger than 3 years old. （2） 137 of the children were male, 107 of them were female, the difference was not significant （x2=0.05,P=0.240）. （3） Leucocoria was the most common symptom at presenting, which happened in about 67.62% of cases （165/244）. （4） In all the 244 cases, 8 cases （3.27%） showed the positive family history. Among them, 5 cases were binocular Rb, and the other 3 cases were monocular Rb. （5） Rb stage： expect for 10 patients who had been performed enucleation of eyeball before coming to Beijing Tongren Hospital, according to IRC stage, 14.56% （44/302） of the cases was A-C stage, 41.39%（125/302） was D stage, and 44.05%（125/302） was E stage. （6） Enucleation of eyeball was performed on 50 patients. Radiotherapy, chemotherapy combined with local treatment were performed on 104 patients. The combined treatment plus enucleation were performed on 90 cases. （7） The patients were followed up for 12 to 24 months. The survival rate was 97.37% （222/228）, and mortality rate was 2.63% （6/228）, except for 16 cases losing to follow-up or giving up the treatment. Conclusion Rb is early onset. Leucocoria is the most common symptom. Most of the cases are in the end-stage. And half of them were performed enucleation of eyeball.
出处
《眼科》
CAS
2011年第2期113-115,共3页
Ophthalmology in China
