CAJ | 학술논문

目的通过对视网膜母细胞瘤(Rb)临床特征的分析,找出患者临床表现与疾病严重程度的潜在关系,为病情的预测提供参考.方法回顾性临床研究.对2003年1月到2011年2月在中山眼科中心就诊并且资料完整的Rb患者共314例.记录就诊时的临床信息,包括性别、年龄、眼别、症状、就诊延迟时间等,分析这些因素与预后的关系.结果白瞳是最常见的症状.不合并其他症状的单纯白瞳患者就诊延迟时间短,5年生存率也较高(85％).表现为斜视和视矇的患者年龄大、就诊延迟时间长,但5年生存率高,分别是100％、92.3％.有眼突表现的患者就诊延迟时间最长,5年生存率最低(17.8％).就诊延迟时间＞6个月的患者5年生存率(64.7％)显著低于≤6个月的患者(84.7％).Cox比例风险回归模型分析发现眼突和就诊延迟时间长是对生存有显著意义的影响因素.结论白瞳、斜视和视矇是Rb较轻的早期临床表现,预后较好.眼突是预后差的标志.就诊延迟时间长是影响生存的高危因素,也是人为且可避免的因素.如果能在早期阶段发现并及时治疗,Rb的生存率会得到很大的提高.
목적 통과대시망막모세포류(Rb)림상특정적분석,조출환자림상표현여질병엄중정도적잠재관계,위병정적예측제공삼고.방법 회고성림상연구.대2003년1월도2011년2월재중산안과중심취진병차자료완정적Rb환자공314례.기록취진시적림상신식,포괄성별、년령、안별、증상、취진연지시간등,분석저사인소여예후적관계.결과 백동시최상견적증상.불합병기타증상적단순백동환자취진연지시간단,5년생존솔야교고(85％).표현위사시화시몽적환자년령대、취진연지시간장,단5년생존솔고,분별시100％、92.3％.유안돌표현적환자취진연지시간최장,5년생존솔최저(17.8％).취진연지시간＞6개월적환자5년생존솔(64.7％)현저저우≤6개월적환자(84.7％).Cox비례풍험회귀모형분석발현안돌화취진연지시간장시대생존유현저의의적영향인소.결론 백동、사시화시몽시Rb교경적조기림상표현,예후교호.안돌시예후차적표지.취진연지시간장시영향생존적고위인소,야시인위차가피면적인소.여과능재조기계단발현병급시치료,Rb적생존솔회득도흔대적제고.
Objective To study the potential correlation with clinic characteristics and survival of the retinoblastoma patients,which maybe useful as a reference for assessing the prognosis.Methods Retrospective study was carried out on the 314 Rb patients who were diagnosed and treated at Zhongshan Ophthalmic Center of Sun Yat-Sen University between January 2003 and February 2011.All clinical information of patients was recorded,including gender,age,presenting symptoms,and lag time before treatment etc.The relationship between these factors and prognosis was analyzed.Results The most common presenting sign was leukocoria.The 5-year survival rate of the patients with isolated leukocoria was 85％.The patients with strabismus and blurred vision also had a high 5-year survival rate (100％ and 92.3％ respectively),although they were older and longer delay.The patients with protopsis had lowest 5-year survival rate (17.8％) and the longest lag time in all retinoblastoma patients.The 5-year survival rate of patients with a lag time of ＜ 6months was 84.7％,and that of those with ＞6 months was 64.7％.Cox proportional hazards regression model analysis finds that exophthalmia and longer diagnostic delay time were the risk factors for Rb patients.Conclusions Leukocoria,strabismus and blurred vision are the early clinical features of patients with retinoblastoma,and have a relatively good prognosis.Proptosis is a symbol of poor prognosis.Delaying treatment is the high-risk factor for Rb patients and meanwhile the anthropic factor that maybe avoided.The survival rate of patients can be greatly improved if retinoblastoma could be found early and treated promptly.