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视网膜母细胞瘤:2007 - 2008年的新进展

Retinoblastoma: what is new in 2007-2008.

作者信息

Schefler Amy C, Abramson David H

机构信息

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

Curr Opin Ophthalmol. 2008 Nov;19(6):526-34. doi: 10.1097/ICU.0b013e328312975b.

Abstract

PURPOSE OF REVIEW

This review highlights many of the most important articles published from June 2007 to May 2008 on retinoblastoma. Significant advances in molecular biology, translational research, and clinical reports are detailed.

RECENT FINDINGS

The most significant recent findings in the molecular biology of retinoblastoma include the evidence for aneuploidy and genomic instability as cancer causes rather than the long-held Knudson's 'two-hit' hypothesis; the evidence that retinoma may represent a precursor lesion for retinoblastoma prior to the acquisition of genomic instability; and the evidence that a horizontal interneuron may be the cell of origin in murine knockout retinoblastoma and may be capable of clonal expansion after differentiation. Translational studies also demonstrate promise for the use of topotecan and 2-deoxy-D-glucose in children. Finally, the introduction of intraarterial chemotherapy for human intraocular retinoblastoma appears to be safe and effective and may eliminate the need for enucleation in many patients.

SUMMARY

Exciting new advances in both the basic science and clinical applications of new therapies continue to emerge for this rare disease. We expect that local control rates even for advanced intraocular retinoblastoma will soon reach 100% in the developed world as a result of new findings in the clinic and in the laboratory.

摘要

综述目的

本综述重点介绍了2007年6月至2008年5月发表的许多关于视网膜母细胞瘤的最重要文章。详细阐述了分子生物学、转化研究和临床报告方面的重大进展。

最新发现

视网膜母细胞瘤分子生物学方面最近最重要的发现包括:非整倍体和基因组不稳定作为癌症病因的证据,而非长期以来的克努森“两次打击”假说;视网膜细胞瘤可能代表在获得基因组不稳定之前视网膜母细胞瘤的前驱病变的证据;以及水平中间神经元可能是小鼠基因敲除视网膜母细胞瘤的起源细胞且在分化后可能能够进行克隆扩增的证据。转化研究也显示了拓扑替康和2-脱氧-D-葡萄糖在儿童中应用的前景。最后,动脉内化疗应用于人类眼内视网膜母细胞瘤似乎是安全有效的,并且可能使许多患者无需进行眼球摘除术。

总结

对于这种罕见疾病,基础科学和新疗法临床应用方面令人兴奋的新进展不断涌现。我们预计,由于临床和实验室的新发现,在发达国家,即使是晚期眼内视网膜母细胞瘤的局部控制率也将很快达到100%。

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