视网膜母细胞瘤临床组织病理学高危因素及其特征的研究进展

doi:10.3877/cma.j.issn.2095-2007.2017.03.007

视网膜母细胞瘤(RB)是婴幼儿最常见的眼内恶性肿瘤，近年来其发病率呈不断上升的趋势。与发达国家相比，我国的治疗手段仍以眼球摘除为主，化疗为辅，眼球保留率仍存在较大的差距。本文通过对RB临床组织病理高危因素的深入研究，探讨其与患者临床特征、临床分期及辅助检查的相关性，从而可以进一步指导治疗方案，加强个体化综合治疗，对提高我国RB患儿的生存率、眼球保留率以及降低预后转移风险有着重要的临床价值。

关键词: 视网膜母细胞瘤, 视网膜细胞瘤组织病理学高危因素, 临床特征, 临床分期, 影像学

Retinoblastoma (RB) is the most common intraocular malignant tumor in infants. In recent years, the incidence of retinoblastoma has been on the rise. In China, the treatment of retinoblastoma is still mainly based on enucleation of eyeball, supplemented by chemotherapy, compared with the developed countries, there is still a big gap in eye reservation rate. Through in-depth study of the RB histopathologic high risk factors, and to explore the clinical features, clinical staging and auxiliary examination correlation, which can further guide treatment, strengthen individualized comprehensive treatment. It has important clinical value for improving the survival rate, eye retention rate and reducing the risk of metastatic risk of RB in children.

Key words: Retinoblastoma, Retinobalstoma histopathologic high risk factors, Clinical features, Clinical stages, Imageology

图1 判断视网膜母细胞瘤组织病理学高风险因素的病理图　A　图示光镜下观察RB眼球组织切片，可见筛板后凸，肿瘤细胞侵犯筛板(黑色箭头)；B图示光镜下观察RB眼球组织切片，可见肿瘤细胞穿过筛板(黑色箭头)；C图示光镜下观察RB眼球组织切片，可见肿瘤细胞穿过筛板后视神经(黑色箭头)；D图示光镜下观察RB眼球组织切片，可见肿瘤细胞侵犯巩膜导管(黑色箭头)；E图示光镜下观察RB眼球组织切片，可见肿瘤细胞侵犯大范围脉络膜(经线≥3mm)(刻度线所示)；F图示光镜下观察RB眼球组织切片，可见肿瘤侵犯虹膜(黑色箭头)、睫状体(黄色三角形)及房角(红色五角星)(免疫组织化学染色×40)

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Advances in clinical histopathology of high-risk factors and characteristics of retinoblastoma

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Advances in clinical histopathology of high-risk factors and characteristics of retinoblastoma