中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2008年
12期
1312-1315
,共4页
朱丽娟%颜建华%李永平%张浩%鲁志卿%高韶晖
硃麗娟%顏建華%李永平%張浩%魯誌卿%高韶暉
주려연%안건화%리영평%장호%로지경%고소휘
视网膜母细胞瘤%预后%病理危险因素
視網膜母細胞瘤%預後%病理危險因素
시망막모세포류%예후%병리위험인소
Retinoblastoma%Prognosis%Histopathologic risk factors
目的 研究视网膜母细胞瘤患者预后的相关病理因素,探讨评估患者预后的病理学指标.方法 对1995-2004年期间在中山大学中山眼科中心经眼球摘除并病理确诊的125例视网膜母细胞瘤单眼患者的临床病理资料和随访资料进行回顾性研究,应用Cox比例风险模型单因素和多因素分析影响预后的病理因素.结果 视网膜母细胞瘤患者总体5年生存率为89%,单因素预后分析显示视神经断端浸润(χ2=114.150,P=0.000)、巩膜浸润(χ2=35.080,P=0.000)、眶组织浸润(χ2=28.765,P=0.000)、虹膜浸润(χ2=18.242,P=0.000)、睫状体浸润(χ2=11.495,P=0.001)和角膜浸润(χ2=10.240,P=0.001)为影响预后的重要因素;多因素预后分析显示视神经筛板后浸润(P=0.045,Wald值4.013)和视神经断端浸润(P=0.000,Wald值37.559)为影响预后的重要因素.结论 视网膜母细胞瘤病理检查有广泛脉络膜浸润、巩膜浸润、眶组织浸润、视神经筛板后浸润和视神经断端浸润是影响患者预后的重要危险因素.
目的 研究視網膜母細胞瘤患者預後的相關病理因素,探討評估患者預後的病理學指標.方法 對1995-2004年期間在中山大學中山眼科中心經眼毬摘除併病理確診的125例視網膜母細胞瘤單眼患者的臨床病理資料和隨訪資料進行迴顧性研究,應用Cox比例風險模型單因素和多因素分析影響預後的病理因素.結果 視網膜母細胞瘤患者總體5年生存率為89%,單因素預後分析顯示視神經斷耑浸潤(χ2=114.150,P=0.000)、鞏膜浸潤(χ2=35.080,P=0.000)、眶組織浸潤(χ2=28.765,P=0.000)、虹膜浸潤(χ2=18.242,P=0.000)、睫狀體浸潤(χ2=11.495,P=0.001)和角膜浸潤(χ2=10.240,P=0.001)為影響預後的重要因素;多因素預後分析顯示視神經篩闆後浸潤(P=0.045,Wald值4.013)和視神經斷耑浸潤(P=0.000,Wald值37.559)為影響預後的重要因素.結論 視網膜母細胞瘤病理檢查有廣汎脈絡膜浸潤、鞏膜浸潤、眶組織浸潤、視神經篩闆後浸潤和視神經斷耑浸潤是影響患者預後的重要危險因素.
목적 연구시망막모세포류환자예후적상관병리인소,탐토평고환자예후적병이학지표.방법 대1995-2004년기간재중산대학중산안과중심경안구적제병병리학진적125례시망막모세포류단안환자적림상병리자료화수방자료진행회고성연구,응용Cox비례풍험모형단인소화다인소분석영향예후적병리인소.결과 시망막모세포류환자총체5년생존솔위89%,단인소예후분석현시시신경단단침윤(χ2=114.150,P=0.000)、공막침윤(χ2=35.080,P=0.000)、광조직침윤(χ2=28.765,P=0.000)、홍막침윤(χ2=18.242,P=0.000)、첩상체침윤(χ2=11.495,P=0.001)화각막침윤(χ2=10.240,P=0.001)위영향예후적중요인소;다인소예후분석현시시신경사판후침윤(P=0.045,Wald치4.013)화시신경단단침윤(P=0.000,Wald치37.559)위영향예후적중요인소.결론 시망막모세포류병리검사유엄범맥락막침윤、공막침윤、광조직침윤、시신경사판후침윤화시신경단단침윤시영향환자예후적중요위험인소.
Objective To define the histopathologic risk factors for prognosis in patients with retinoblastoma treated by eyeball enucleation.Methods Clinicopathologic data of 125 patients with unilateral retinoblastoma were retrospectively reviewed,and all of them were treated by eyeball enucleation between 1995 and 2004 in Zhongshan Ophthalmic Center, Sun Yat-sen University.The Cox regression model was used for multivariate and univariate analysis.Results The overall five-year survival rate was 89% for the 125 pa-tients.The histopathologic factors significantly associated with poor prognosis for patients with retinoblastoma from univariate analysis included invasion to cut section of the optic nerve(χ2=114.150, P=0.000 ) ,sclerai in-vasion (χ2=35.080, P=0.000), orbital invasion (χ2=28.765, P=0.000) ,iris invasion (χ2=18.242, P=0.000), ciliary body invasion(χ2=11.495, P=0.001), corneal invasion (χ2=10.240, P=0.001)and factors independent-ly associated with poor prognosis from a multivariate analysis were postlaminary optic nerve invasion (P=0.045 ,wald value is 4.013 )and involvement of optic nerve to transsection line(P=0.000,wald value is37.559). Conclusion Massive choroidal invasion, scleral invasion, orbital invasion, postlaminary optic nerve invasion and optic nerve transsection line invasion were important prognostic factors in patients with retinoblastoma af-ter eyeball enucleation.
